This is an introductory set of slides for Stress management through Yoga.

1. Yoga in Stress Management
Dr. S. Krishnan, MD, DPM, DIP.NB, MNAMS, CYMP
Associate Professor of Psychiatry
Department of Psychiatry
Government Medical College, Thiruvananthapuram

2. Stress Common cause of ill
health in our society
Underlies as many as
70% of all visits to
family doctors.
Most important cause of
Work inefficiency
Substance use disorder
Suicide attempts
Pre marital and
extramarital relationship

3. Stress ¨Inseparable part of
human existence.
¨Responsible for a
large number of
health related
problems.
¨Affects the biological
psychological,
biological and social
functioning of a
person.

5. Do we Need A Definition
¨Stress:
– The body’s non specific response to any demand
made on it.
¨Better:
– Stress is what happens when the perceived
demands of a situation are greater than the
perceived coping skills we believe we have to deal
with the situation.
A simpler one!!!

7. BEST Life …
¨STRESS FREE LIFE

10. Physical symptoms

11. Emotional symptoms
¨Moodiness
¨Irritability
¨Inability to relax
¨Sense of loneliness / isolation
¨Depression
¨Anxiety

12. Cognitive symptoms
¨Memory disturbance
¨Concentration disturbance
¨Poor judgment / decision making
¨Seeing only negative
¨Worrying, constant

13. Behavioral symptoms
¨Eating more or less
¨Sleeping too much / too little
¨Isolating self from others
¨Neglecting responsibilities
¨Using alcohol, cigarettes, drugs to relax
¨Nervous habits – nail biting, pacing

14. There is a Method…

15. Yoga
¨ 5000 years old
¨ Founded in India (?)
¨ From sanskrit word “yuj” meaning union between
mind ,body and spirit.
¨ Include ethical discipline,physical
postures,breathing control and meditation.

16. Yoga
¨ Yoga is not only stretching.
¨ There are 8 limbs of yoga.
¨ Physical postures called “Asana” is just one of the
eight limbs of yoga
¨ Majority of types more concerned with mental and
spiritual well being.

17. Yoga
¨Yoga requires you
to make an effort
to unify your body
and mind.
¨You do this by
concentrating your
awareness on your
physical body
through breathing
and postures.

18. Maharshi Patanjali defines yoga as
Yogashcittavrttinirodhah -- that is, "Yoga means the
regulation and channeling of all the psychic
propensities."

19. The Eight Limbs of Yoga
¨ 1.Yama
¨ 2.Niyam
¨ 3.Asan
¨ 4.Pranayam
¨ 5.Pratyahar
¨ 6.Dharana
¨ 7.Dhyan
¨ 8.Samadhi

20. Yama
¨Five ethical guidelines regarding moral
behavior towards others
1. Ahimsa-Nonviolence
2. Satya-Truthfulness
3. Asteya-Nonstealing
4. Brahmacharya-No lust or sexual activity
within marriage.
5. Aparigraha-don’t collect things that are not
necessary.

21. Niyam
Five rules regarding personal behavior
1. Sauch-Clealiness
2. Santosh-Contentment
3. Tapas-Sustained Practice
4. Svadyay-Self Study
5. Ishvara Pranidhan-Surrender to God

22. The Eight Limbs Cont.
¨Asana - Practice of yoga postures
¨Pranayama - Practice of breathing exercises
¨Pratyahara - Withdrawal of the senses,
meaning that the exterior world is not a
distraction from the interior world within
oneself.

24. The Eight Limbs Cont.
¨Dharana-Concentration,The ability to focus
on something uninterrupted by external or
internal distraction
¨Dhyana-Meditation
¨Samadhi-Bliss. Building upon Breathe!
Dhyana,the
transcendence of the self through meditation.
The merging of self with the universe.

25.  Abdominal breathing
 Sends a fax to the brain to relax
 Close your eyes
 Put your hand on your belly
 Imagine …..

26. Yog-Asana

27. Asana
Does not mean EXERCISE
ASANA means POSTURE
Asana means EXISTENCE
EXSITENCE – without doing anything!
No movement. A steady posture
“STHIR SUKHAM ASANAM”
2:46
“Steady & comfortable posture is Asana”

28. Asana
Asana is a posture without movements. But to attain
this posture movements are essential.
1. Performing the Asana Pre-Position – Basal posture
2. Attaining the Asana posture with movements
3. Asana Posture – Maintaining with no movement
4. Releasing the Asana posture with movements
Note:
Step No. 3 is Asana. Step No. 2 & 4 are not Asana

29. Asana - Movements
Slow
Under control
Accompanied with a correct breathing method

30. Asana
“STHIR SUKHAM ASANAM”
2:46
Steady & comfortable posture is Asana
¨ Steadiness & comfort must be in
Physical body (mainly muscle)
Mental Condition
¨ Steadiness & comfort are also interdependent

31. Asana
Asanas can be practiced on the following Levels
0) With fast movements & without steadiness – Non yogic
level, Exercise
1) With slow movements but without steadiness – for people
with physical weakness (arthritis, frozen restriction)
2) With slow movements & with steadiness for a certain
period
3) With slow movements with steadiness for a certain period
& a relaxation of the muscles (improves organ function)
4) With slow movements & with steadiness for a certain
period, relaxation of the muscles & concentrating the
mind on any organ of the self-body
5) With slow movements & with steadiness for a certain
period, relaxation of all the muscles & concentrating the
mind on infinity

32. Yoga for Stress– HSR Clinic
Package
Department of Psychiatry, MCH,
10/05/14 TVM 32

33. 10/05/14
Department of Psychiatry, MCH,
TVM 33

34. 1. Sit in cross
legged position
2. Spine straight
3. Hand resting
on your knees.
1. Sit with both legs outstretched.
2. Fold right leg and keep the heel on the left thigh.
3. Keep the left heel on the right thigh.
4. Knees should be as close to the ground as possible.
5. Back and neck should be as straight as possible.
6. Keep your hand in chin mudra
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Department of Psychiatry, MCH,
10/05/14 TVM

35. 1. Fold the left leg in the knee and place
the toe on the floor.
2. Fold the right leg in the knee and
place the toe on the floor and join
the two toes.
3. Sit on the pit formed by the parted
heels.
4. Place the palms on the knees.
5. Keep the spine and head straight
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Department of Psychiatry, MCH,
10/05/14 TVM

36. 1. Lie down on your stomach.
2. Join legs and extend toes outwards.
3. Fold both hands in front, palm over palm and
keep the left cheek on the palms.
4. Relax all your body muscles and remain in the
position for 30 seconds.
5. Turn the head to the other side for the same
period of time.
6. This is one form of Makrasana. The other form is
given in the picture.
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Department of Psychiatry, MCH,
10/05/14 TVM

37. 1. Lie down on your stomach and keep your legs
joined and stretched.
2. Take a deep breath and raise your hands, head and
legs for 5-10 seconds.
3. Lower your body while breathing out. Repeat 5-10
times.
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Department of Psychiatry, MCH,
10/05/14 TVM

38.  Lie down facing the
ground.
 Place the hands on the
sides, palm facing the
ground.
 Raise the head and chest.
 It will be noticed that the
back bone is given a
backward curve at the
beginning portion.
 Gently come to the
original position.
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Department of Psychiatry, MCH,
10/05/14 TVM

39. 1. Lie down on your back
2. Cross legs a if in padmasana
3. Place both hands on the thighs
4. Press with your head on the ground
5. Arch your body backwards by raising the shoulder off the
ground
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Department of Psychiatry, MCH,
10/05/14 TVM

40. 1. Stand on your knees and
fold your arms over your
chest.
2. Take a deep breath and bend
backwards as much as
possible.
3. Wait for 5-10 seconds and
come back to normal
position while breathing out.
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Department of Psychiatry, MCH,
10/05/14 TVM

41. ¨ Lie down on your
abdomen
¨ Flex one leg to 90
degrees
¨ Place both hands on
side of the body on
either side of the head
¨ Turn the head to the
side of the flexed leg
¨ Lie down for 30
seconds
¨ Repeat on the opposite
side
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Department of Psychiatry, MCH,
10/05/14 TVM

42. 1. Stand straight
2. Slowly raise your heel from
the ground
3. Stand on your toes
4. Taking in a deep breath
slowly raise your
5. Hands through the sides
6. Maintain the posture for 5
seconds
7. Slowly come to the base
posture giving out the
breath
42
Department of Psychiatry, MCH,
10/05/14 TVM

43. MEDITATION

44. Dr. S. Krishnan
Associate Professor of Psychiatry
Medical College, Thiruvananthapuram
Ph: 9447 123 789

45. 15 minute Schedule
1. Bhujangasana – 5 times
2. Bhastrika in Vajrasana – 3 minutes
3. Viparitha naukasana – 5 times
4. Salabhaasana – 5 times
5. Ardha chandrasana – 5 times
6. Tadasana – 3 times
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Department of Psychiatry, MCH,
10/05/14 TVM

46. Stress and Healthcare Providers
¨Providing care to others is a rich and
rewarding experience
¨Often feel improved self esteem and
confidence
¨But….They have the responsibility of another
human being’s life.
¨No wonder they live under tremendous
stress!

47. Stress and Healthcare providers
¨Continuous exposure to suffering
¨Psychological effects of death and dying
patients
¨Decreased sleep and food
¨Long hours of work
¨Constant worry about law suits
¨CME – study ,study , study!

48. How Yoga Can help
¨ Practicing yoga can be a best thing a provider can
do for himself/herself
¨ Doing simple “Pranayam” (breathing technique) in
breaks can calm their mind.
¨ Practicing yoga for ½ hr. a day can make their body
fit to take care of others.
¨ Yogic thought process- will teach not to work only
for money.

49. Future Directions for Research
¨ Attractive treatment – Is it enough?
¨ Few studies exist – Only in its infancy
¨ Questions to be answered
– Is yoga effective (superior to minimal or no interventions)
– Heterogeneity of practices – various methods of same named
asanas,
– What are the essential elements of yoga – asana / pranayama /
others
– What is the best balance of pranayama vs asanas / physical
movements vs meditation
– Which asana to try for which patient?
– How important is it that practice should be physically vigorous
– What is the ideal amount of practice which has an antidepressant
effect
– What could be the mechanisms by which yoga reduces depression
• Is it merely the exercise component
Department of Psychiatry, MCH,
TVM 49
10/05/14

50. To think about…
¨Can yoga be used as a prophylactic treatment
for PSYCHIATRIC DISORDERS?
Department of Psychiatry, MCH,
TVM 50
10/05/14

51. DDoonn’’tt TTrryy IITT!!
10/05/14
JJuusstt DDoo IITT!!!!!!
Department of Psychiatry, MCH,
TVM 51

52. manaskrishnan2003@gmail.com
9447 123 789
52
Department of Psychiatry, MCH,
10/05/14 TVM

53. Department of Psychiatry, MCH,
10/05/14 TVM 53