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I think it's probably non-controversial that exercise (posing, stretching), and mindful activity (meditation, thoughtful breathing) are good for us. Certainly i

I think it's probably non-controversial that exercise (posing, stretching), and mindful activity (meditation, thoughtful breathing) are good for us. Certainly it's something I feel happy encouraging patients to do, particularly if they enjoy it or feel that it benifits then. What I find thought-provoking though is the use of the phase "health approach" in the first line of the abstract: > Yoga is the most popular complementary health approach practiced by adults in the United States. I wonder what exactly qualifies as a "health approach". The paper acknowledges exercise is well know to be good for people, particularly in ageing - so it's heathy, but is exercise an "approach"? What about reading, or caring for young children (both also good for your health) can that be a "health approach"? I usually try to talk about these practices as being part of a heathy lifestyle, rather than being therapies. I feel that we're over-medicalising when we start to say that riding a bicycle or hugging our friends are therapies, rather than just being healthy.

ditonal 7y ago
What I often see is something like “exercise and yoga are good self care, but for serious mental illness you need professionals.” And “professionals” in 2019 usually translate to psych meds and talk therapy (eg CBT), both of which have extremely shoddy science but get far less skepticism. I got involuntarily committed for mania/psychosis, didn’t sleep for weeks, hallucinations etc so of course I was prescribed the intense cocktail of mood stabilizers, antipsychotics etc and told I needed that and intense therapy for the rest of my life. I stopped all meds and therapy and focus on mindfulness, sobriety, routine etc and feel it’s the stable path. I entered a super deep depression when released but read everything about mental health I could get my hands on. And I now believe the best “therapy” for serious mental health issues is things like yoga and meditation, plus lifestyle changes. It gets reduced to stress reduction and mild exercise, but mindfulness is about developing awareness of feelings which leads to better emotional regulation. If you can develop more space between your thoughts and feelings and your consciousness you stop being so controlled by them. The skeptics will say it’s a bunch of new age mumbo jumbo but they don’t apply that same skepticism to psych meds even though psych meds are not understood at all, mostly work by placebo, and have awful side effects. Not so long ago doctors were ordering lobotomies and overprescribing OxyContin because an attractive pharmaceutical rep sold it to them but now when they overprescribe psych meds and talk therapy they are seemingly infallible.
- temporaryvector 7y ago
  The thing that you're missing is that most health professional will still include things like "exercise and yoga" in their treatment plans because that's what is required. Usually it's the patients that expect pills and therapy to show magical, immediate results. Nobody (well, I'm sure there are doctors that would, but at the risk of invoking a No True Scotsman, some doctors are pretty bad at their job) is going to tell a depressed person or a person with severe ADHD to just pop pills and not exercise, meditate or otherwise not do any self-care. The pills are there to help the ill person get to a place where they can start working towards those things, pills are step one of a long process, they're not the only step. The thing psych meds are not taken with much skepticism is that they can show results incredibly quickly, even if getting the right results cant take months of fine-tuning and trial and error due to the fact that the mechanisms aren't well understood. A very good analogy for mental illness and psych meds is diabetes and insulin. Most people who are prediabetic or have diabetes will have type 2, adult-onset diabetes, which can be stopped or reversed with lifestyle changes, but those are hard. If an obese person is feeling terrible and goes to a doctor and gets diagnosed with diabetes, the doctor will give them insulin because they need it to live and function, but it's not actually going to solve the problem. Insulin is just step one for such a person, step 2 involves exercise and diet, maybe surgery in severe cases, but many people can't commit to such lifestyle changes and just keep taking insulin as a stop-gap measure to keep living in relative comfort, while other people will manage to use their new feeling to take up the needed lifestyle changes and get cured (or go into remission, as they say), possibly to a point where they no longer need insulin or other medication. In the same vein, just as there is type 2 diabetes, there is type 1 diabetes, whether it manifested because of environmental factors or was purely inherited, these people need insulin to live. The state of medical science today means they will need insulin and other medication for the rest of their lives, but they still need the diet changes and exercise, nobody is expecting them to just sit on medication and nothing else. With mental illness it's the same way, some people can get better with just exercise and lifestyle changes, but some people need professional help (meds and therapy) to be able to implement those lifestyle changes and maybe get to a point where the no longer need the help. Other people, however, will need meds for the rest of their lives to have a chance at normal life, at least with the current state of medicine. One can hope for a breakthrough in the future but people need to live their lives right now, and if that involves taking a pill or two every day, so be it. In my particular case, I think that I was pretty lucky that me and my psychiatrist only took 4 or so months to find the proper combination of meds for me, but at no point did he tell me that was all I needed. He always insisted that diet, exercise and mindfulness were part of the treatment and the meds were there to help me get started. Now it's been roughly a year since I started and I lost a ton of weight, exercise regularly (including yoga) and eat healthy. I'm down to only taking my ADHD meds because the others did their job and I don't need them anymore, but even if I have to take this pill daily for the rest of my life I'm okay with it because my quality of life skyrocketed. This was not possible for me a couple of years ago when I thought that I could power through my issues with yoga and exercise alone and didn't trust psychiatrists. I think it's incredibly irresponsible to tell people that things like yoga, meditation, exercise and diet changes are a replacement for professional mental health help. This may be true for some people, but I suspect the percentage is close to the amount of people who are able to stop being alcoholics without help. The two things are orthogonal, professional medical help is one thing and a healthy lifestyle is another. Having a healthy lifestyle may mean that you don't need professional help, but professional help may be required for a person to be able to get a healthy lifestyle. Finally, professional help usually involves all those nice things like plenty of exercise and a good diet, sometimes yoga or mindfulness/meditation (even if they call it something else the principles are usually the same, CBT for example is basically mindfulness by another name). You go to the a professional so he can help you get going with all of that, because sometimes you just can't by yourself.
mistrial9 7y ago
Yoga (योग) traditions are integral to thousands of years of human civilization. Yogas are plural and evolving. Yogas of mind and heart do involve hundreds of canons of text and prayer, which are -ahem- written.
- gumby 7y ago
  I’m not sure why your post was downvoted; could be because the word “yoga” in English has a far more restrictive definition, and we are discussing, in English, an article about a subset of the physical practices of yoga that are practicedin the USA. I used to avoid yoga specifically because I grew up with it being a religious practice, later came to enjoy the thoroughly secularists western version. But I wish it were called something else. It’s similar to the use of the super useful word “jihad” only one meaning of which, and a terrible one at that, is recognized in English. Of course all cultures adopt some foreign words by first twisting them up completely.
  - Godel_unicode 7y ago
    Many judeo-christian primary schools call it "kinesthetic stretching" because of the religious meaning of "yoga".
    - gumby 7y ago
      yet all the religious part has already been stripped out! Still those folks get to make their own rules.
  - godelmachine 7y ago
    I beg to strongly disagree, sir. The analogy you have tried to draw between Yoga and the other thing are totally irrelevant and misleading. I urge all readers of “gumby”’s comment to ponder over it carefully
Cougher 7y ago
The problem is removing the word "complementary" from the phrase. A "complementary health approach" is an approach that uses practices that are not normal conventional medical practices to complement conventional practices.
JamesBarney 7y ago
> What about reading, or caring for young children (both also good for your health) can that be a "health approach"? Has this been verified with RCTs btw?
AmericanChopper 7y ago
> mindful activity (meditation, thoughtful breathing) are good for us The mindfulness craze has been criticised quite widely by psychologists, has no proven benefits, and at least some evidence that it can actually be harmful.
- Godel_unicode 7y ago
  I assume you're referring to this study about mindfulness increasing generation of false memories? https://journals.sagepub.com/doi/full/10.1177/0956797615593705 https://journals.sagepub.com/doi/full/10.1177/09567976155937...
  - AmericanChopper 7y ago
    There’s plenty of literature. Another risk that is not generally discussed is that the mindful techniques used to alter thought patterns or suppress thoughts can backfire in a huge number of different ways. Suppressing negative thoughts can just as easily unintentionally suppress coping mechanism, amongst other things. https://journals.sagepub.com/doi/full/10.1177/0956797612449176 https://journals.sagepub.com/doi/full/10.1177/09567976124491... Then you have the issue that the majority of studies done into the benefits of mindfulness could not have possibly measured the majority of the potential negative outcomes. http://irep.ntu.ac.uk/id/eprint/25868/1/221391_2996.pdf http://irep.ntu.ac.uk/id/eprint/25868/1/221391_2996.pdf Personally I don’t have an opinion one way or another. I simply don’t think it’s at all obvious that practicing mindfulness would be associated with positive or exclusively positive outcomes. I could say the same thing for yoga too. I practice yoga regularly, and there are some obvious benefits to me. It’s a good workout and it makes me feel great. But many yoga positions are pretty intense. Am I doing harm to my body in some way be regularly applying this stress to it? I have no idea, but the answer to that question absolutely does not seem obvious to me.
    - wolco 7y ago
      Yes certain poses you shouldn't do if your body is not ready for it. Mindfulness and visualizations can be harmful if you are not ready for that level. CBT too soon or too long can be harmful. If you always live and are only aware of the moment than imagination can't take hold. Everything is a balance and not everyone can sit in a lotus position but some parts might be possible some of the time for most of us.
agumonkey 7y ago
I even felt (quite often actually) that a lot of manual work can be zen inducing. Give me a good space, good tools and a boat load of things to process, and see you in 4 hours. I'll be sweating and somehow exhausted but not the burnout fatigue, just the "I made 200 things with near zero errors and it was smooth because I was free to focus". Not equivalent but not far from coding flow.
- randycupertino 7y ago
  One of the books I read that helped me finally beat my severe chronic depression has an entire section on engaging work and why it's good for your brain. It's called The Depression Cure by Steve Ilardi and basically the engaging work and any "meaningful activity" can stop your from ruminating and help you feel accomplished. Gardening, fixing things around the house and walking the dog have become part of my "daily treatment" and that among other things has been a game changer. Agree it's like coding flow- the satisfying feeling of inputs and outputs and then being able to look over everything when you're complete and know you left it all on the field.
jayd16 7y ago
>therapies, rather than just being healthy. I'm curious what you think the difference is. Whats the point of "being healthy" if its not therapeutic in some way? Isn't that just a hobby?
- ProAm 7y ago
  One costs way more money. And Im being serious.

ditonal 7y ago

What I often see is something like “exercise and yoga are good self care, but for serious mental illness you need professionals.” And “professionals” in 2019 usually translate to psych meds and talk therapy (eg CBT), both of which have extremely shoddy science but get far less skepticism. I got involuntarily committed for mania/psychosis, didn’t sleep for weeks, hallucinations etc so of course I was prescribed the intense cocktail of mood stabilizers, antipsychotics etc and told I needed that and intense therapy for the rest of my life. I stopped all meds and therapy and focus on mindfulness, sobriety, routine etc and feel it’s the stable path. I entered a super deep depression when released but read everything about mental health I could get my hands on. And I now believe the best “therapy” for serious mental health issues is things like yoga and meditation, plus lifestyle changes. It gets reduced to stress reduction and mild exercise, but mindfulness is about developing awareness of feelings which leads to better emotional regulation. If you can develop more space between your thoughts and feelings and your consciousness you stop being so controlled by them. The skeptics will say it’s a bunch of new age mumbo jumbo but they don’t apply that same skepticism to psych meds even though psych meds are not understood at all, mostly work by placebo, and have awful side effects. Not so long ago doctors were ordering lobotomies and overprescribing OxyContin because an attractive pharmaceutical rep sold it to them but now when they overprescribe psych meds and talk therapy they are seemingly infallible.

temporaryvector 7y ago
The thing that you're missing is that most health professional will still include things like "exercise and yoga" in their treatment plans because that's what is required. Usually it's the patients that expect pills and therapy to show magical, immediate results. Nobody (well, I'm sure there are doctors that would, but at the risk of invoking a No True Scotsman, some doctors are pretty bad at their job) is going to tell a depressed person or a person with severe ADHD to just pop pills and not exercise, meditate or otherwise not do any self-care. The pills are there to help the ill person get to a place where they can start working towards those things, pills are step one of a long process, they're not the only step. The thing psych meds are not taken with much skepticism is that they can show results incredibly quickly, even if getting the right results cant take months of fine-tuning and trial and error due to the fact that the mechanisms aren't well understood. A very good analogy for mental illness and psych meds is diabetes and insulin. Most people who are prediabetic or have diabetes will have type 2, adult-onset diabetes, which can be stopped or reversed with lifestyle changes, but those are hard. If an obese person is feeling terrible and goes to a doctor and gets diagnosed with diabetes, the doctor will give them insulin because they need it to live and function, but it's not actually going to solve the problem. Insulin is just step one for such a person, step 2 involves exercise and diet, maybe surgery in severe cases, but many people can't commit to such lifestyle changes and just keep taking insulin as a stop-gap measure to keep living in relative comfort, while other people will manage to use their new feeling to take up the needed lifestyle changes and get cured (or go into remission, as they say), possibly to a point where they no longer need insulin or other medication. In the same vein, just as there is type 2 diabetes, there is type 1 diabetes, whether it manifested because of environmental factors or was purely inherited, these people need insulin to live. The state of medical science today means they will need insulin and other medication for the rest of their lives, but they still need the diet changes and exercise, nobody is expecting them to just sit on medication and nothing else. With mental illness it's the same way, some people can get better with just exercise and lifestyle changes, but some people need professional help (meds and therapy) to be able to implement those lifestyle changes and maybe get to a point where the no longer need the help. Other people, however, will need meds for the rest of their lives to have a chance at normal life, at least with the current state of medicine. One can hope for a breakthrough in the future but people need to live their lives right now, and if that involves taking a pill or two every day, so be it. In my particular case, I think that I was pretty lucky that me and my psychiatrist only took 4 or so months to find the proper combination of meds for me, but at no point did he tell me that was all I needed. He always insisted that diet, exercise and mindfulness were part of the treatment and the meds were there to help me get started. Now it's been roughly a year since I started and I lost a ton of weight, exercise regularly (including yoga) and eat healthy. I'm down to only taking my ADHD meds because the others did their job and I don't need them anymore, but even if I have to take this pill daily for the rest of my life I'm okay with it because my quality of life skyrocketed. This was not possible for me a couple of years ago when I thought that I could power through my issues with yoga and exercise alone and didn't trust psychiatrists. I think it's incredibly irresponsible to tell people that things like yoga, meditation, exercise and diet changes are a replacement for professional mental health help. This may be true for some people, but I suspect the percentage is close to the amount of people who are able to stop being alcoholics without help. The two things are orthogonal, professional medical help is one thing and a healthy lifestyle is another. Having a healthy lifestyle may mean that you don't need professional help, but professional help may be required for a person to be able to get a healthy lifestyle. Finally, professional help usually involves all those nice things like plenty of exercise and a good diet, sometimes yoga or mindfulness/meditation (even if they call it something else the principles are usually the same, CBT for example is basically mindfulness by another name). You go to the a professional so he can help you get going with all of that, because sometimes you just can't by yourself.

mistrial9 7y ago

Yoga (योग) traditions are integral to thousands of years of human civilization. Yogas are plural and evolving. Yogas of mind and heart do involve hundreds of canons of text and prayer, which are -ahem- written.

gumby 7y ago
I’m not sure why your post was downvoted; could be because the word “yoga” in English has a far more restrictive definition, and we are discussing, in English, an article about a subset of the physical practices of yoga that are practicedin the USA. I used to avoid yoga specifically because I grew up with it being a religious practice, later came to enjoy the thoroughly secularists western version. But I wish it were called something else. It’s similar to the use of the super useful word “jihad” only one meaning of which, and a terrible one at that, is recognized in English. Of course all cultures adopt some foreign words by first twisting them up completely.
- Godel_unicode 7y ago
  Many judeo-christian primary schools call it "kinesthetic stretching" because of the religious meaning of "yoga".
  - gumby 7y ago
    yet all the religious part has already been stripped out! Still those folks get to make their own rules.
- godelmachine 7y ago
  I beg to strongly disagree, sir. The analogy you have tried to draw between Yoga and the other thing are totally irrelevant and misleading. I urge all readers of “gumby”’s comment to ponder over it carefully

Cougher 7y ago

The problem is removing the word "complementary" from the phrase. A "complementary health approach" is an approach that uses practices that are not normal conventional medical practices to complement conventional practices.

JamesBarney 7y ago

> What about reading, or caring for young children (both also good for your health) can that be a "health approach"? Has this been verified with RCTs btw?

AmericanChopper 7y ago

> mindful activity (meditation, thoughtful breathing) are good for us The mindfulness craze has been criticised quite widely by psychologists, has no proven benefits, and at least some evidence that it can actually be harmful.

Godel_unicode 7y ago
I assume you're referring to this study about mindfulness increasing generation of false memories? https://journals.sagepub.com/doi/full/10.1177/0956797615593705 https://journals.sagepub.com/doi/full/10.1177/09567976155937...
- AmericanChopper 7y ago
  There’s plenty of literature. Another risk that is not generally discussed is that the mindful techniques used to alter thought patterns or suppress thoughts can backfire in a huge number of different ways. Suppressing negative thoughts can just as easily unintentionally suppress coping mechanism, amongst other things. https://journals.sagepub.com/doi/full/10.1177/0956797612449176 https://journals.sagepub.com/doi/full/10.1177/09567976124491... Then you have the issue that the majority of studies done into the benefits of mindfulness could not have possibly measured the majority of the potential negative outcomes. http://irep.ntu.ac.uk/id/eprint/25868/1/221391_2996.pdf http://irep.ntu.ac.uk/id/eprint/25868/1/221391_2996.pdf Personally I don’t have an opinion one way or another. I simply don’t think it’s at all obvious that practicing mindfulness would be associated with positive or exclusively positive outcomes. I could say the same thing for yoga too. I practice yoga regularly, and there are some obvious benefits to me. It’s a good workout and it makes me feel great. But many yoga positions are pretty intense. Am I doing harm to my body in some way be regularly applying this stress to it? I have no idea, but the answer to that question absolutely does not seem obvious to me.
  - wolco 7y ago
    Yes certain poses you shouldn't do if your body is not ready for it. Mindfulness and visualizations can be harmful if you are not ready for that level. CBT too soon or too long can be harmful. If you always live and are only aware of the moment than imagination can't take hold. Everything is a balance and not everyone can sit in a lotus position but some parts might be possible some of the time for most of us.

agumonkey 7y ago

I even felt (quite often actually) that a lot of manual work can be zen inducing. Give me a good space, good tools and a boat load of things to process, and see you in 4 hours. I'll be sweating and somehow exhausted but not the burnout fatigue, just the "I made 200 things with near zero errors and it was smooth because I was free to focus". Not equivalent but not far from coding flow.

randycupertino 7y ago
One of the books I read that helped me finally beat my severe chronic depression has an entire section on engaging work and why it's good for your brain. It's called The Depression Cure by Steve Ilardi and basically the engaging work and any "meaningful activity" can stop your from ruminating and help you feel accomplished. Gardening, fixing things around the house and walking the dog have become part of my "daily treatment" and that among other things has been a game changer. Agree it's like coding flow- the satisfying feeling of inputs and outputs and then being able to look over everything when you're complete and know you left it all on the field.

jayd16 7y ago

>therapies, rather than just being healthy. I'm curious what you think the difference is. Whats the point of "being healthy" if its not therapeutic in some way? Isn't that just a hobby?

ProAm 7y ago
One costs way more money. And Im being serious.