Week 10: What are the major differences between yoga as medicine and drugs as medicine?
by Linda K. Mahns
Let me begin by saying that it was difficult initially to compare/contrast yoga with drug therapy. Yoga is a body/mind/spirit-centered approach to tuning into oneself in order to become healthier physically, mentally, emotionally and spiritually. Yoga can be seen as a tool to strengthen the body, make muscles more flexible and help a person keep good balance and posture. We learned this in previous chapters of McCall’s book. Drug therapy is about suppressing a symptom or killing cells within a body in order to alleviate pain in the short term or help get rid of some unwanted bacteria, virus or tumoro within the body.
When I thought about how I wanted to answer this question, I thought I would look up what I could on yoga as medicine and compare it to research done on drug therapy. Since the chapter was written on Stress Relief for Chapter 3, I decided to pick a specific kind of drug that is used to treat depression and/or anxiety for patients (since chronic stress can lead to depression and anxiety): Selective serotonin reuptake inhibitors (SSRIs.) I’m using a scenario of a man seeking help for chronic anxiety in hopes that I can show how a relatively curious person with a desire to help himself can use “scientific medicine” and “holistic medicine” together for his benefit.
Drugs as Medicine
Let’s say a person walks in to their doctor’s office with a chronic anxiety problem. The MD will assess him, the nurse will take his vital signs and the doctor probably would recommend that the person seek professional help from a psychiatrist or a psychologist after having ruled out any physical problem that he might otherwise have had that could lead to feeling anxious (i.e. heart disorder, breathing disorder, etc.) by way of blood tests and other diagnostic tests. In this scenario, the person gets a clean bill of physical health and takes the advice to seek help with a counselor to determine a possible diagnosis from them. After some testing and talking with the counselor, it is determined that this problem is serious enough that it is affecting this man’s quality of life but maybe not to the degree of a serious compulsion or disorder. The man has been suffering on his own long enough and this counselor would like to see this person feel better so she might prescribe counseling sessions in order to teach the person coping skills for his panic and anxiety and to help speed him along in his wellness, she might offer the use of an SSRIs drug as a therapy to help the man feel better in his body and function better in the world.
Selective serotonin reuptake inhibitors work by increasing the amount of serotonin in the brain. Serotonin is a feel good hormone that is found in the body (tissues, blood, brain, intestines and central nervous system.) It helps the muscles and affects the mood, particularly when it is low in the body, a person can feel depression and anxiety.
The man agrees that he needs to learn new coping skills and agrees to take on the counseling. He also takes the information about the drug that the counselor recommended and said he wants to research it for himself and think whether or not it might be a right medicine to take for him. He schedules another appointment and then goes home to think about his options. He decides to look up SSRIs on the internet and see what information he can find. He sees that “SSRIs block the reabsorption (reuptake) of the neurotransmitter serotonin in the brain. Changing the balance of serotonin seems to help brain cells send and receive chemical messages, which in turn boosts mood. SSRIs are called selective because they seem to primarily affect serotonin, not other neurotransmitters.” (http://www.mayoclinic.com/health/ssris/MH00066) He reads about the various forms of SSRIs, their generic names and their more common names, like Prozac and Zoloft, etc.) He reads about the common side affects and sees the recommendations for what types to use and how to get off the drug slowly when the time comes so as to keep himself from having a manic episode. He also sees what other drugs and herbs may contraindicate the drugs efficacy as well as less common drug side effects or problems such as serotonin syndrome (too much serotonin) and suicide in some.
What he doesn’t see are case studies that show how SSRIs can cause bone density loss in patients and an increased risk of fractures. And another study showed an increased risk of bleeding, particularly in the elderly. These studies seem to indicate that dosage is key to administering SSRIs so that the patient has minimal adverse or common side effects.
For this man, the list of common side effects of nausea, diarrhea, nervousness, weight gain, drowsiness and insomnia are enough potential risks that he decides he doesn’t want to add to his feelings of anxiety, by feeling worse in these ways but figures he will keep this on hand and try other things first. If all else fails, he’ll have a drug to change his brain chemistry and he’d work out the dosage when the time came. He also noticed one of the herbs not to take with SSRIs (St. Johns Wort) is used by some to help with elevating the mood. He promises to look into the herb in the same way he looked up SSRIs.
Yoga as Medicine
The man attends his counseling and realizes he has a lot of chronic stress that he doesn’t seem to know how to alleviate. The counselor recommends he find something to help him be more aware of what is happening in his body so that he can realize his triggers. While at work, he serendipitously stumbles across a flyer near the kitchen advertising a local yoga class. It is aptly named, “Got stress? Get Yoga.” He decides to call and see if he can try out a class or two without committing to a full schedule. The teacher agrees and he plans to attend a class.
When he gets to the class, the instructor asks who is new to yoga. He raises his hand and the teacher then gives her introduction on how the class is taught and the expectations of the class in general. She states that yoga can be very beneficial for relieving stress naturally and will focus on breathing and asanas (poses) that will help give people good tools to use in their daily lives. She leads the students through the class and for the hour and a half, the man realizes he is feeling a little bit better than when he came in. He decides to come back and see if that was just a fluke.
What he is doing is increasing his body awareness in the poses he is doing, he’s learning breathing skills to help activate his parasympathetic nervous system (which helps him to relax and restore his brain and body) and he’s slowing down his mind in order to stay centered and present. He doesn’t really realize that all this is going on inside his brain and body, he’s just feeling better little by little. The sensation is infectious and after time and by experience, he sees how he feels better when he starts out his day with some meditation and ends the day with some light asana practice.
He continues on with yoga classes to see this experiment through a little longer. Over time, he learns about meditation, dietary and herb choices that also benefit him greatly. These things, he finds, are adding to his health and not subtracting to it with terrible side effects. He is learning to relax from and in his daily life. He continues on with his counseling and joins a support group to help him feel connected and supported with his emotional needs. He’s learning how to express his emotions fully and is learning how to detach from them, too. He finds that the progression of improvement is small but steady and he’s gaining awareness of himself that he didn’t have before. He feels a sense of gratitude to try to improve his health naturally first before utilizing chemicals but he acknowledges that having the drug there as a safety net helped him to try other things first. He still has anxiety but he has more coping mechanisms to approach it and more understanding and compassion for himself because his yoga practice has helped him learn how to take really good care of himself. He has even come to a place, over time, of appreciation for this anxiety as his teacher and as a way to open doors to him that he wouldn’t have done if everything was status quo. He realizes he is more than his anxiety. He is a whole person with lots of emotions and experiences. Yoga postures have shown him how he’s carried himself and how he sits in his car and at work and how awful it feels. The longer he works at himself, the more he wants to give back to others. His feelings of anxiety and fears seem to dissolve and the life in front of him appears more fulfilling and meaningful.
Yoga as medicine is more WHOLE-some, meaning that it has the potential to reach a whole person. Drugs as medicine is really missing the boat on treating the whole self. It is designed with one function in mind and many times causes more harm than good.
References
McCall, T., (2007.) Yoga as Medicine: The Yogic Prescription for Health and Healing. Bantam Books, NY.
Tsapakis, E., Gamie, Z., Tran, G., Adshead, S., Lampard, A., Mantalaris, A., & Tsiridis, E. (2012). The adverse skeletal effects of selective serotonin reuptake inhibitors. European Psychiatry: The Journal Of The Association Of European Psychiatrists, 27(3), 156-169.
de Abajo, F. (2011). Effects of selective serotonin reuptake inhibitors on platelet function: mechanisms, clinical outcomes and implications for use in elderly patients. Drugs & Aging, 28(5), 345-367.
Edwards, J.G. (1992). Selective serotonin reuptake inhibitors. BMJ. June 27; 304(6843): 1644–1646.
Devi, S., Chansauria, J., & Udupa, K. (1986). Mental depression and kundalini yoga. Ancient Science Of Life, 6(2), 112-118.