Today's treatments for depression and anxiety leave much to be desired. Pharmaceuticals may help the symptoms, but they can also have negative side effects like weight gain and decreased sexual desire that may cause people to abandon medication altogether. As cases of depression and anxiety increase throughout the world, research is being conducted to find more sustainable and accessible treatments.
"Despite modern advances in psychopharmacology, and the development of so many integrative forms of psychotherapy, we haven't made a significant dent in this epidemic of emotional illness," says clinical psychologist and yoga teacher Bo Forbes.
Forbes is the founder of Integrative Yoga Therapeutics, a system that specializes in the therapeutic application of yoga for anxiety, insomnia, depression, immune disorders, chronic pain, and physical injuries, as well as athletic performance. She is currently participating in research with neuroscientists Dave Vago and Norman Farb at the Mind & Life Institute to examine the effect of yoga on anxiety and depression.
"Most people aren't aware that inside each of us, there's a mind-body communications network that contributes to the patterns of anxiety and depression. This network includes the autonomic nervous system, the enteric nervous system (also called the belly brain or gut microbiome), the immune system, pain modulation pathways, connective tissue matrix, and more," Forbes explains.
To really effect change, Forbes says we need to access this mind-body network and change patterns in these bodily systems.
Anxiety disorders, including depression and post-traumatic stress disorder, are the most common mental illness in the United States, affecting about 40 million adults. If current trends continue, it's estimated that by the year 2020, depression will be the second leading cause of disability throughout the world.
A significant amount of research has been conducted on yoga as a therapeutic tool, and evidence supports the findings that yoga can help treat depression and anxiety. Forbes, along with neuroscientists Vago and Farb, are delving deeper into this field of study by exploring what Forbes calls one of the most compelling and emerging areas of neuroscience: interoception.
"You can think of interoceptive awareness, as it's also called, as mindfulness in the body. It pertains to the ability to inhabit the body and be present with bodily sensation as it fluctuates from one moment to the next," says Forbes.
According to Forbes, because depression and anxiety are diseases in which people experience being stuck in a cycle of negative self-talk, obsessive rumination on the past or anxiety about the future, physical exercises that increase awareness of sensations arising from within the physical body can help people heal.
"If you change your body patterns, you can change your mind," she says.
Forbes believes that interoception may be a doorway to healing many anxiety disorders, and her therapeutic yoga classes incorporate practices to strengthen this quality.
With the aim of awareness in mind, Forbes' classes are not like the typical hot, sweaty Westernized form of yoga that many of us have experienced. Her classes move slowly and are geared toward increasing awareness inside the body. They integrate breath with each movement.
Additionally, because tension in our muscles and connective tissue, or fascia, amplifies nervous system activation, she incorporates bodywork that releases connective tissue and gives people an experience of 'not depression' and 'not anxiety'. While working on connective tissue exercises, Forbes uses specific questions and cues that serve to increase a person's awareness of the sensations in his or her body.
For example, her class may begin by standing on a tennis ball and rolling the base of your foot with medium to strong pressure over the ball. This exercise massages connective tissue, stimulates the relaxation response and calms the heart. After completing this exercise, Forbes asks people to check in with their bodies.
"What is the quality of my mind right now? How deep is my breath? Does one foot feel a different sense of freedom than another foot?" she asks.
The idea of interoception having a therapeutic effect on depression and anxiety is relatively new, with most of the research being published in just the last few years. Because this research is still in its early stages, there is much more work to be done to establish interoception's significance as a treatment modality for depression and anxiety.
Until then, Forbes says to try experimenting with your own body, using yoga and connective tissue release to find what helps you over time.
"Follow the laboratory of your direct experience, and it will take you somewhere. It will teach you," she says.