Yoga, Mindfulness and Benefits of Breath-work, revisited

I posted back in November 2015 about my personal journey with yoga. I started off with videos and home practice in 2007 and the personal changes that have occurred since then, through integration of classes with others, following the direction of personal yogis (who may or may not practice yoga, but they're still inspirational trailblazers to me), are phenomenal. Crow pose is still my favorite - I have yet to master the ego.

Crow Pose - Bakasana



I produced and edited (very sloppily, I might add) an article about the benefits of yoga and mindful breath. I have edited and re-formatted it to be easier on the eyes, the heart, and hopefully -- your soul.

 

∞Yoga on, my friends. Yoga on.∞

 

Overview:

Yoga and mindfulness, by association, are based on the concept of integration of the mind-body connection; by keeping the practitioner mindful, this in turn reduces emotional responsivity to internal or external triggers. The result is a direct impact on physiological response to environmental stressors, which influences physical health, emotional health, and spiritual connectedness (for those interested in these benefits).

 

• Physical Stress Response includes:

     ■ Breathing: typically short and shallow when a person is stressed

           ►Increased CO²/ decrease O² effects:

               ○ CO² can induce: Visual disturbances - Headache - Reduction in reasoning ability - A sense of “air hunger” or dyspnea (asphyxiation); In other words, if a person "forgets" to be mindful of their breath, the body thinks it is choking to death; the reduction in reasoning ability suggests that yoga and connected breathing sequences would enhance reasoning ability, and consequently, decision-making capability.

     ■ Stress response and fatigue

            ►Increased cortisol levels -- the effects of this response include:

                    ○ Weight gain

                    ○ Decrease in immune system function

                    ○ Memory impairment

 

• Short-term "fixes"

       ■ Alcohol Use and Abuse (once-a-month bingeing to daily use)

               ►Short-term effect: decrease in perceived stress (the body continues to react as if stress level had not changed though; this is a cognitive change or an illusion the mind creates)

               ►Long-term effect: raised cortisol levels

       ■ Caffeine Use and Abuse (yes, you can abuse caffeine; it's now in the Diagnostic and Statistical Manual's latest version)

               ►Short-term effect: increases the perceived wakefulness of the consumer

               ►Long-term effect: raises cortisol levels

 

 ∞•∞•∞

"Short term pain, long term happiness;

Short term happiness, long term pain.

Which do you choose?

 ∞•∞•∞

 

Physical body benefits of yoga and meditation

•Body systems affected: nervous system, respiratory system, cardiovascular system, diabetes, cancer, immunity, and the list goes on.

 

        ■ Specific examples of effects of yoga and meditation on particular body systems and/or disorders:

                    ►Diabetes/Blood sugar

                          ○ Postures that stimulate the pancreas lead to renewed ability of pancreas to manufacture insulin and increased insulin sensitivity.

                               ∙ This suggests that we may benefit non-diabetic patients by increasing productivity and efficiency of the pancreas (which reacts when we eat) through yoga practice.

 

                    ►Sleep and Circadian Rhythm Processes

                           ○ Transcendental Meditation (TM): increases melatonin production (melatonin is often a supplement taken to enhance sleepiness, but is actually produced by the body naturally, if given proper rest and support)

 

                     ► Response time

                             ○ Meditation, in general, increases the speed of attention location/relocation (decreasing response time and increasing information processing efficiency)

 

                     ► Mind-body connection        

                             ○ Increase in the mind's ability to focus on the present (mindfulness)

 

 ∞•∞•∞

 

Definition and overview of mindfulness meditation

» "A family of self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calm, clarity, and concentration (Walsh & Shapiro, 2006, p. 228).”

 

»  Mindfulness meditation (in contrast to other forms of meditation) “has been shown to stimulate the middle prefrontal brain associated with both self-observation and metacognition (Cahn; Polich, 2006; Siegel, 2007b) and foster specific attentional mechanisms (Valentine; Sweet, 1999).”

 

∞•∞•∞

 

Empirically-supported benefits of mindfulness and regular yoga practice

 

 »  Emotional Regulation (based on Mindfulness-Based Stress Reduction treatment, or MBSR)

   ► Benefits

        a. Decreased reactivity to internal and external stimuli

        b. Interpersonal benefits

        c. Intrapersonal benefits (those that occur within the self and relationship with the self)

              › Studies suggest a detached frame of mind results from mindfulness practice, stopping the trigger-thought-craving-use cycle, which is the addiction cycle (sugar counts, too!)

              › If a “lapse” occurs (i.e., a “slip”), acceptance that is learned through practicing mindfulness regularly may reduce making a negative situation worse and may reduce the resulting shame/blame, which helps the person get back on track more quickly to recovery.

 

»  Clinical Research Studies

     1. University of Utah study; correlation between physical changes and yoga practice

          a.  12 yogis; 14 fibromyalgia patients; 16 healthy volunteers

          b.  Fibromyalgia patients tend to perceive pain with less stimulus than those without fibromyalgia; yoga and mindfulness practices are beneficial to these patients.

 

    

     2. German study performed in 2005 with 24 “emotionally distressed” women

          a.  Effects of yoga practice on stress, depression, anxiety; yoga practice two times per week at 90-minute sessions

               › Depression scores: improved by 50%

               › Anxiety scores: improved by 30%

               › Overall well-being: improved by 65%

               › Somatic complaints such as headaches, back pain, and poor sleep: higher resolution rate (no specific measurement available)

    

     3. Descriptive 2005 study, New Hampshire; inpatients, 113 participants with bipolar disorder, major depression, and schizophrenia

          a.  Short term positive effects: decrease in scores on tension, anxiety, depression, anger, hostility, and fatigue (during a Profile of Mood states) – (FYI: a state is changeable; a trait is static)

          b.  Improves quality of life for elderly, dementia caregivers, breast cancer survivors, epilepsy patients

    

     4. Sudarshan Kriya yoga (SKY): cyclical breathing study with 45 participants who were inpatient clients receiving treatment for depression

          a. Description of yoga "treatment"

               ∙ 30 minutes, 6 times per week for 4 weeks

                  ∙ The yoga group outcomes were compared to ECT and tricyclic antidepressant

                    ∙∙ Remission rates per group: 93% ECT; 73% antidepressant; 67% breathing

    

     5. Study of 60 alcohol dependent men; 1-week detox, 2-week SKY

          a. SKY group treatment compared to alcoholism treatment

               ∙ Results included:

                  ∙∙ A drop in depression scores: 75% in SKY group vs. 60% in tx group

                  ∙∙ Decrease in both cortisol and corticotropin (the chemical that “boosts” cortisol production) in the SKY group, but not in the treatment group

 

∞•∞•∞

 

PTSD and comorbidity with substance use and/or abuse 

Substance use is often accompanied by trauma; though it may not result in clinical PTSD (e.g., a diagnosis), but can have long-lasting effects that mimic this disorder due to the environment the user allows themselves to interact with to acquire and use and/or abuse drugs and alcohol.

There is a perception by the patient that past traumatic experiences are occurring in the here-and-now based on being triggered by cues that are similar to the original event (often flashbacks, loud noises or other environmental factors)

The traumatic memory is triggered more easily due to its storage in the short-term memory system.

 
Future research directions and implications for trauma-affected populations:

■  FACT:  20% war veterans are diagnosed with PTSD

    □ Disabled Australian Vietnam veterans with PTSD study; alcohol and antidepressants

        ·5-day course of: breathing techniques, yoga, stress-reduction education, guided meditation

        ·Pre-treatment ranking via CAPS (Clinician Administered PTSD Scale); this measure rates how severe the PTSD symptoms are

        ∙Post-tx ranking at 6 weeks and 6 months dropped from average of moderate/severe symptoms to mild/moderate while the control group (who remained on the waiting list) experienced no improvement.

■  FACT: Those who have a history of substance use and/or abuse also tend to have a history of trauma, either prior to or after his or her first episode of substance use.

    □ Mindfulness Study: MBRP (Mindfulness Based Relapse Prevention) 8-week group post inpatient/outpatient substance use treatment (n=168) versus TAU (treatment as usual) group

       · Outcome: lower rates of substance use per 4-month post-intervention period measures. This included lower rates of craving, increase in acceptance and mindful action.

 

 

 

REFERENCES

    ∙Harvard Health Publications, Harvard Medical School, “Yoga for anxiety and depression” (Harvard Mental Health letter), April 1, 2009. http://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression

 

    ∙Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, Marlatt, A. (2009). Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Pilot Efficacy Trial. Substance Abuse, 30(4), 295–305. http://doi.org/10.1080/08897070903250084

 

    ∙Dartmouth Undergraduate Journal of Science, “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis” (Posted by Michael Randall ’12), Fall 2010, http://dujs.dartmouth.edu/fall-2010/the-physiology-of-stress-cortisol-and-the-hypothalamic-pituitary-adrenal-axis#.Vh6UAXpViko

 

    ∙Physiological Responses to Oxygen and Carbon Dioxide in the Breathing Environment, W. Jon Williams, Ph.D. National Institute for Occupational Safety and Health, USA NIOSH Public Meeting September 17, 2009, Pittsburgh, PA

 

    ∙Balaji, P. A., Varne, S. R., and Ali, S. S. (2012). Physiological

 

     Effects of Yogic Practices and Transcendental Meditation in

     Health and Disease. North American Journal of Medical

     Sciences, 4(10), 442–448. http://doi.org/10.4103/1947-2714.101980

  

►In progress (and taken word-for-word):

Practically speaking, you do your brain-body a lot of good. Among the benefits of TM:

• It’s the only meditation practice shown to lower blood pressure.

• The practice can help increase insulin resistance.

• TM is the most effective meditation technique to slow biological aging (my favorite!).

• It can also ease feelings of anxiety in people with anxiety disorders.

              • http://www.everydayhealth.com/columns/voices-of-experience/why-transcendental-meditation-works-stress-relief/?xid=nl_EverydayHealthLivingWithBipolarDisorder_20151122

 

∞   Yoga on, my friends. Yoga on.  ∞

 ©Nichol Elise 2015-2016, all rights reserved.

Gaps in coverage - both on this blog and with insurance

I love double entendres. Only, this one's not meant to be risqué.

I was reviewing my blog entries, as I do from time to time. I noticed a *major* gap in coverage, so to speak. Meaning, I didn't post between the two dates below:

◘  7/20/12 to 10/12/15 -- *this is more than 3 years!

    ○ Reasons I believe this happened:

        ◙ I started my traineeship with a local non-profit as a volunteer therapist in March, 2012. I held this position while I completed school and my Master's Thesis.
        ◙ In July, 2012, I started working in earnest with my thesis advisor regarding collecting data for the thesis. This involved all the nitty gritty details of writing the informed consent document to University standards, establishing validity/reliability of the instruments being used to collect the data, and finding professors on campus willing to let me collect data during class times they were teaching.
        ◙ I began collecting data, analyzing it (hired a scoring sheet intern with my Thesis Advisor's help and entering the data into SPSS) and writing the thesis in earnest. I continued to edit (and revise, revise, revise) the overall content of the document with my Thesis Advisor's help and completed it in time for graduation. It was labor and time-intensive and took 5 quarters to complete. Thanks, Selby!
        ◙ I graduated with my M.S. in Psychology in June 2013, and became employed working with a co-occurring disorders program for clients with primary substance use disorder who also were diagnosed with a secondary mental health diagnosis.

I retained both that position and my volunteer position with the non-profit until June 2014, when I was hired on full-time as a permanent employee as the Coordinator of a forensic program (forensic = legally-involved clients) with mental health and substance use disorders (about 80% of the total caseload were co-occurring, as in, had both).

As Coordinator, I did a lot of duties. And, "other duties as assigned." ☺
        --In other words, I had a lot going on.-- This part just covered the career aspect of my life.

When my younger daughter became ill, the focus became her recovery. The disclosure of any and all information pertaining to my daughter's health issues is to encourage others to speak up, to gain and give support from and to others, and to have a venue in which I can find solace knowing that I am not alone.

In October 2015, as soon as I wrote again, the focus became advocacy, due to the hardships I have had, and others included, in what we dub "the system." While I'm grateful that the health care system exists, it is far too complicated to navigate and leaves considerable gaps in coverage that are not necessarily covered by supplemental programs (if the program exists or is accessible if one does exist).

When my daughter became so ill that it became *crystal clear* to me that I needed to take time off, it was time to take action by not only speaking up in "real life", but also expressing my concerns on this blog.

We continue to fight. Every day. We are going to the neurology consult at UCLA in March. There have been several agencies that by the Higher Power of the Universe (whatever you determine yours to be) have chosen to help us. For the roadblocks we have encountered, we will continue to challenge and will continue to do so until a solution is reached.

In the meantime, I am her primary support person, her mom, her coach, her reminder of her positive qualities, her reminder that this fight may not end, but we will remain strong, and perhaps help others as a result.

I can see by the numbers that people are accessing this blog (18,000+ views and growing), and that certain posts are viewed more than others (given the higher count next to the post). It seems as though the "hot button topic" posts are the ones that get the most attention. However, not many of you comment. I hope you start!

♥Won't you please help another person (or yourself) by simply commenting and stating a need, a solution, or simply venting?♥

I'm open to all these options.

We, and others, need to hear your voice now. Please.

My voice/opinions and such are growing old to me, and I need to be able help others with all the knowledge I've gathered over the many years I've accessed our "system".

I've been talking about these issues far longer than I've been writing on this blog about it. I need a fresh perspective, an angle I haven't tried. But, MOST OF ALL...

...Take care of yourselves and each other. We're all in this world together. ♥
     

Benefits of Yoga and Mindfulness

My friend and yoga teacher, Kris, asked me to do some research on the benefits of yoga and mindfulness. Many people do not know that the two go together (and for those of you who do know this, kudos to you; you're on your way to bliss).

My personal journey with yoga began in 2007, with an online purchase of an Introduction
to Yoga DVD (if you'd like to know the exact video, post a comment and I'll happily respond, but since this isn't a tribute to online shopping or yoga DVD's, I'll keep it on the topic).

I began with poses such as Warriors I and II, and harder poses (asanas) like "bow pose" (look it up on YouTube). I realized a couple things: I don't like backbend-y poses, and I don't like being in positions that are uncomfortable for me. My response to these things is to avoid them altogether, or force my way into them. Neither is balance-inducing.

I acquired a couple of other DVD's along the way, but the true turnaround was when I started practicing with Kris in November of 2014. Our tight group of yogis had humor, lack of focus (at least, initially), and a willingness to learn. Kris, in turn, had humor to match, and an equally quick-witted way to get us back on track. We progressed. We kept a core group of yogis, and along the way, I learned from Kris the most poignant message thus far in my journey: "What you do on the mat, you take off the mat." (copyright (c) 2014, Kris; but really, I didn't come up with this).

I learned crow, bird of paradise, headstand (that I can hold for at least 2 minutes now - this is progress), and transitioned to crow-to-headstand. I was able to demonstrate this in class - which is phenomenal for me. It became a practice of teaching myself my limits - and not pushing myself too far past those limits, being patient with myself (and others), and being courageous. I'll never forget my long-time friend arriving for the class after ours and her astonished face. "What are you doing here?" she asked me. A little confused, I said I was there for the yoga class, at which time she informed me I had told her a year previous that I hated yoga. Wow. I don't know what ever prompted me to say that in the first place, but I imagine it was related to my distaste for all things uncomfortable (that could be its own blog post, but I digress).

So, since this post isn't technically about me, I'll move onto the research. It's not APA format, my collegiate friends. And it's not a paper, it's just an outline. But I thought it would be helpful information and give some guide points for future research on your own.

Without further adieu:

Yoga benefits

Overview:

Yoga and mindfulness, by association, are based on the concept of integration of the mind-body connection; by keeping the practitioner mindful, this in turn reduces emotional responsivity to internal or external triggers. The result is a direct impact on physiological response to environmental stressors, which influences physical health, emotional health, and spiritual connectedness (for those interested in these benefits).

 

1. Physical stress response

     ■ Breathing; typically short and shallow when a person is stressed

           ►Increased CO²/ decrease O² effects:

               ○ CO² can induce: Visual disturbances - Headache - Reduction in reasoning ability - A sense of “air hunger” or dyspnea (asphyxiation); In other words, if a person "forgets" to be mindful of their breath, the body thinks it is choking to death; the reduction in reasoning ability suggests that yoga and connected breathing sequences would enhance reasoning ability, and consequently, decision-making capability.

      ■ Stress response and fatigue

               ►Increased cortisol levels -- the effects of this response include:

                    ○ Weight gain

                    ○ Decrease in immune system function

                    ○ Memory impairment

2. Short-term "fixes"

       ■ Alcohol Use and Abuse (once-a-month bingeing to daily use)

               ►Short-term effect: decrease in perceived stress (the body continues to react as if stress level had not changed though; this is a cognitive change or an illusion the mind creates)

               ►Long-term effect: raised cortisol levels

       ■ Caffeine Use and Abuse (yes, you can abuse caffeine; it's now in the Diagnostic and Statistical Manual's latest version)

               ►Short-term effect: increases the perceived wakefulness of the consumer

               ►Long-term effect: raises cortisol levels

» Think of it this way: “Short-term pain, long-term happiness; short-term happiness, long-term pain.”  «

Physical body benefits of yoga and meditation

1.  Body systems affected: nervous system, respiratory system, cardiovascular system, diabetes, cancer, immunity, and the list goes on.

        ■ Specific examples of effects on certain body systems

                   ►Diabetes/Blood sugar

                          ○ Postures that stimulate the pancreas lead to renewed ability of pancreas to manufacture insulin and increased insulin sensitivity.

                               ∙ This suggests that we may benefit non-diabetic patients by increasing productivity and efficiency of the pancreas (which reacts when we eat) through yoga practice.

                    ►Sleep and Circadian Rhythm Processes

                           ○ Transcendental Meditation (TM): increases melatonin production (melatonin is often a supplement taken to enhance sleepiness, but is actually produced by the body naturally, if given proper rest and support)

                     ► Response time

                             ○ Meditation, in general, increases the speed of attention location/relocation (decreasing response time and increasing information processing efficiency)

                     ► Mind-body connection        

                             ○ Increase in the mind's ability to focus on the present (mindfulness)

 

Introduction and overview of mindfulness

» "A family of self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general mental well-being and development and/or specific capacities such as calm, clarity, and concentration (Walsh & Shapiro, 2006, p. 228).”

 

»  Mindfulness meditation (in contrast to other forms of meditation) “has been shown to stimulate the middle prefrontal brain associated with both self-observation and metacognition (Cahn & Polich, 2006; Siegel, 2007b) and foster specific attentional mechanisms (Valentine & Sweet, 1999).”

 

Empirically-supported benefits of mindfulness  and regular yoga practice

»  Emotional Regulation (based on Mindfulness-Based Stress Reduction treatment, or MBSR)

   1. Benefits

        a. Decreased reactivity to internal and external stimuli

        b. Interpersonal benefits

        c. Intrapersonal benefits (those that occur within the self and relationship with the self)

              › Studies suggest a detached frame of mind results from mindfulness practice, stopping the trigger-thought-craving-use cycle, which is the addiction cycle (sugar counts, too!)

              › If a “lapse” occurs (i.e., a “slip”), acceptance that is learned through practicing mindfulness regularly may reduce making a negative situation worse and may reduce the resulting shame/blame, which helps the person get back on track more quickly to recovery.

 

»  Clinical Research Studies

     1. University of Utah study; correlation between physical changes and yoga practice

          a.  12 yogis; 14 fibromyalgia patients; 16 healthy volunteers

          b.  Fibromyalgia patients tend to perceive pain with less stimulus than those without fibromyalgia

     2. German study performed in 2005 with 24 “emotionally distressed” women

          a.  Effects of yoga practice on stress, depression, anxiety; yoga practice two times per week at 90-minute sessions

               › Depression scores: improved by 50%

               › Anxiety scores: improved by 30%

               › Overall well-being: improved by 65%

               › Somatic complaints such as headaches, back pain, and poor sleep: higher resolution rate (no specific measurement available)

     3. Descriptive 2005 study, New Hampshire; inpatients, 113 participants with bipolar disorder, major depression, and schizophrenia

          a.  Short term positive effects: decrease in scores on tension, anxiety, depression, anger, hostility, and fatigue (during a Profile of Mood states) – (FYI: a state is changeable; a trait is static)
          b.  Improves quality of life for elderly, dementia caregivers, breast cancer survivors, epilepsy patients
     4. Sudarshan Kriya yoga (SKY): cyclical breathing study with 45 participants who were inpatient clients receiving treatment for depression
          a. Description of yoga "treatment"
               ∙ 30 minutes, 6 times per week for 4 weeks
                  ∙ The yoga group outcomes were compared to ECT and tricyclic antidepressant
                    ∙∙ Remission rates per group: 93% ECT; 73% antidepressant; 67% breathing
     5. Study of 60 alcohol dependent men; 1-week detox, 2-week SKY
          a. SKY group treatment compared to alcoholism treatment
               ∙ Results included:
                  ∙∙ A drop in depression scores: 75% in SKY group vs. 60% in tx group
                  ∙∙ Decrease in both cortisol and corticotropin (the chemical that “boosts” cortisol production) in the SKY group, but not in the treatment group

PTSD and comorbidity with substance use and/or abuse 

Substance use is often accompanied by trauma; though it may not result in clinical PTSD (e.g., a diagnosis), but can have long-lasting effects that mimic this disorder due to the environment the user allows themselves to interact with to acquire and use and/or abuse drugs and alcohol.

There is a perception by the patient that past traumatic experiences are occurring in the here-and-now based on being triggered by cues that are similar to the original event (often flashbacks, loud noises or other environmental factors)

The traumatic memory is triggered more easily due to its storage in the short-term memory system.

Future research directions:
§  FACT:  20% war veterans are diagnosed with PTSD
§  Disabled Australian Vietnam veterans w/PTSD study; alcohol and antidepressants
     ·  5-day course of: breathing techniques, yoga, stress-reduction education, guided meditation
     ·  Pre-tx ranking via CAPS (Clinician Administered PTSD Scale); rates symptom severity
          o   Post-tx ranking at 6 weeks and 6 months dropped from average of moderate/severe symptoms to mild/moderate while the control group (who remained on the waiting list) experienced no improvement.

§  Mindfulness Study: MBRP (Mindfulness Based Relapse Prevention) 8-week group post inpatient/outpatient substance use treatment (n=168) versus TAU (treatment as usual) group
      · Outcome: lower rates of substance use per 4-month post-intervention period measures.
           o Lower rates of craving, increase in acceptance and mindful action.

 

 

REFERENCES

 

    ∙Harvard Health Publications, Harvard Medical School, “Yoga for anxiety and depression” (Harvard Mental Health letter), April 1, 2009. http://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression

    ∙Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., … Marlatt, A. (2009). Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Pilot Efficacy Trial. Substance Abuse, 30(4), 295–305. http://doi.org/10.1080/08897070903250084

    ∙Dartmouth Undergraduate Journal of Science, “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis” (Posted by Michael Randall ’12), Fall 2010, http://dujs.dartmouth.edu/fall-2010/the-physiology-of-stress-cortisol-and-the-hypothalamic-pituitary-adrenal-axis#.Vh6UAXpViko

    ∙Physiological Responses to Oxygen and Carbon Dioxide in the Breathing Environment, W. Jon Williams, Ph.D. National Institute for Occupational Safety and Health, USA NIOSH Public Meeting September 17, 2009, Pittsburgh, PA

    ∙Balaji, P. A., Varne, S. R., & Ali, S. S. (2012). Physiological Effects of Yogic Practices and Transcendental Meditation in Health and Disease. North American Journal of Medical Sciences, 4(10), 442–448. http://doi.org/10.4103/1947-2714.101980

 

►In progress (and taken word-for-word):

Practically speaking, you do your brain-body a lot of good. Among the benefits of TM:

·         It’s the only meditation practice shown to lower blood pressure.

·         The practice can help increase insulin resistance.

·         TM is the most effective meditation technique to slow biological aging (my favorite!).

·         It can also ease feelings of anxiety in people with anxiety disorders.

http://www.everydayhealth.com/columns/voices-of-experience/why-transcendental-meditation-works-stress-relief/?xid=nl_EverydayHealthLivingWithBipolarDisorder_20151122

∞   Yoga on, my friends. Yoga on.  ∞