By Dr. Nancy Skopp
Nov. 18, 2022

U.S. Navy photo by Petty Officer 3rd Class Taylor Crenshaw

Twenty-first century living is more stimulating and fast-moving than ever before, and the pace of modern life continues to accelerate at breakneck speed. To meet the needs of daily living, we constantly dash from here to there, sometimes neglecting exercise and sleep, scrambling to meet work deadlines, and dealing with the stresses of traffic, dependent care and other daily hassles. All the while trying to balance these demands with those of our home life, which has its own unique stressors.

Our bodies take a hit from the stress caused by the hustle and bustle of daily living. Stress accumulates over time in our bodies¹ and influences our moods and ability to regulate our emotions.² Stress management and mood regulation are important for everyone and are even more critical for people who already suffer from psychological health symptoms such as anxiety and depression.³

Traditional approaches to addressing stress-induced problems typically include evidence-based psychotherapy, medication, or some combination of both. Empirical research suggests yoga may be a beneficial supplement to such treatments, as not all people with psychological health and emotion regulation problems respond to traditional treatments alone.^4-6 Mind-body practices that have been practiced for centuries—including yoga, meditation and qigong (a Chinese practice involving meditation, controlled breathing and movements)—are considered an area called Complementary and Alternative Medicine. Formerly viewed as fringe and unscientific, yoga and other CAMs have been gaining significant traction in the research literature.³

Studies of specific types of yoga show it appears to have mood-enhancing properties⁷, possibly because some specific yoga practices appear associated with inhibited physiological stress⁸ and inflammation.⁹ Yoga practice uses breathing intended to promote the flow of energy through the body, which is thought to release accumulated stress and unpleasant emotions. In particular, studied forms of yoga seem to reduce stress perhaps by restoring the balance between the body's sympathetic and parasympathetic nervous systems. Drawing definitive conclusions about the impact of yoga practice on mental health outcomes is challenging because there are many different forms of yoga practice, making it difficult to draw valid generalized conclusions about yoga's impact on mental health.

Yoga practices of many forms have been incorporated into some DOD clinics as adjunct to evidence-based treatment for mental health conditions. For example, some military Intensive Outpatient Programs for mental health treatment have implemented certain forms of yoga as a component to their multifaceted treatment protocols designed to meet complex treatment needs.¹⁰ Importantly, mind-body practices such as yoga in any form supporting treatment are intended to help participants to manage emotional dysregulation, and to engage with and remain in evidence-based treatments.^11-13 Yoga may also be useful to help veterans manage co-morbid pain and posttraumatic stress disorder as an adjunct to evidence-based treatment.¹⁴ More research is needed on the effectiveness of specific forms of yoga as an adjunct treatment for mental health conditions and/or chronic pain in veterans and active duty military.

We all need to take care of ourselves in whatever ways we can to reduce stress and support long-term health. As medical research continues to explore the effectiveness of various CAMs as adjunct treatment to evidence-based care, people—including service members and veterans—may be able to add these tools to their arsenal of resources to cope with the stress of everyday life. At the same time, just as we would consult a medical doctor for a physical injury, it's important to select qualified professionals to assist with our psychological health. CAMs such as yoga may help with stress and emotion regulation, but complex mental health issues are often best addressed under the guidance of a mental health care provider. Thus, it is important to seek professional guidance for problems that cause significant emotional distress and interfere with daily living.

Other Mind-Body Resources

Yoga and mindfulness training are both mind-body practices intended to help with stress reduction. These apps can be used to practice mindfulness and are available via the App Store and Google Play:

• Mindfulness Coach - Learn mindfulness skills to manage stress
• Breath2Relax - Practice diaphragmatic breathing to reduce tension

References

1. American Psychological Association (2018, November 1). Stress effects on the body. https://www.apa.org/topics/stress/body
2. Richardson, C.M.E. (2017). Emotion regulation in the context of daily stress: Impact on daily affect. Personality and Individual Differences, 112, 150-156. https://doi.org/10.1016/j.paid.2017.02.058
3. Aideyan, B., Martin, G.C., & Beeson, E.T. (2020). A practitioner's guide to breathwork in clinical mental health counseling. Neuroscience Informed Counseling, 42, 78-94.
4. Burnett-Zeigler, I., Schuette, S., Victorson, D., & Wisner, K. L. (2016). Mind-body approaches to treating mental health symptoms among disadvantaged populations: A comprehensive review. Journal of Alternative and Complementary Medicine, 22, 115–124. https://doi.org/10.1089/acm.2015.0038
5. Bukar, N. K., Eberhardt, L. M., & Davidson, J. (2019). East meets west in psychiatry: Yoga as an adjunct therapy for management of anxiety. Archives of psychiatric nursing, 33(4), 371–376. https://doi.org/10.1016/j.apnu.2019.04.007
6. Tarsha, M. S., Park, S., & Tortora, S. (2020). Body-Centered Interventions for Psychopathological Conditions: A Review. Frontiers in psychology, 10, 2907. https://doi.org/10.3389/fpsyg.2019.02907
7. Pascoe, M.C., & Bauer, I.E. (2015). A systematic review of randomized control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research, 68, 270-282. http://www.journalofpsychiatricresearch.com/article/S0022-3956(15)00206-X/abstract
8. Riley, K. E., & Park, C. L. (2015). How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health psychology review, 9(3), 379–396. https://doi.org/10.1080/17437199.2014.981778
9. Djalilova, D. M., Schulz, P. S., Berger, A. M., Case, A. J., Kupzyk, K. A., & Ross, A. C. (2019). Impact of Yoga on Inflammatory Biomarkers: A Systematic Review. Biological research for nursing, 21(2), 198–209. https://doi.org/10.1177/1099800418820162
10. Skopp, N.A., Bradshaw, D., Smolenski, D., Wilson, N., Williams, T., Bellanti, D., & Hoyt, T. (2022). A pilot study of trauma-sensitive yoga and breathe2relax among service members in an intensive outpatient clinic. Unpublished manuscript.
11. Ford, J. D., Courtois, C. A., Steele, K., Hart, O. van der, & Nijenhuis, E. R. S. (2005). Treatment of complex posttraumatic self-dysregulation. Journal of Traumatic Stress, 18(5), 437–447. https://doi.org/10.1002/jts.20051
12. Held, P., Klassen, B. J., Boley, R. A., Wiltsey Stirman, S., Smith, D. L., Brennan, M. B., Van Horn, R., Pollack, M. H., Karnik, N. S., & Zalta, A. K. (2020). Feasibility of a 3-week intensive treatment program for service members and veterans with PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 12(4), 422–430. https://doi.org/10.1037/tra0000485
13. Zalta, A. K., Held, P., Smith, D. L., Klassen, B. J., Lofgreen, A. M., Normand, P. S., Brennan, M. B., Rydberg, T. S., Boley, R. A., Pollack, M. H., & Karnik, N. S. (2018). Evaluating patterns and predictors of symptom change during a three-week intensive outpatient treatment for veterans with PTSD. BMC Psychiatry, 18(242), 1–15. https://doi.org/10.1186/s12888-018-1816-6
14. Chopin, S. M., Sheerin, C. M., & Meyer, B. L. (2020). Yoga for warriors: An intervention for veterans with comorbid chronic pain and PTSD. Psychological trauma: theory, research, practice and policy, 12(8), 888–896. https://doi.org/10.1037/tra0000649>

Dr. Skopp is a clinical and research psychologist at the Psychological Health Center of Excellence. She has over 15 years of experience conducting research with the Department of Defense on topics including suicide prevention, psychological trauma, deployment outcomes, and a wide range of technology-based innovations in support of U.S. service member and veteran behavioral health.