**Abstract**

Yoga is not only an art but also an ancient science that evolved more than 5000 years ago. It is practised by people from all walks of life in almost every part of the world. In the past, the practice, which was seen to be spiritual and divine, used to be confined to smaller groups of individuals who were seeking moksha or liberation; however, the trend has transformed over the decades. Today, there are so many yoga studios worldwide, and this has made it easy for yoga enthusiasts. This chapter investigates the effectiveness of yoga not only as a complementary therapy but also as a viable option in the management of stress, anxiety and depression. Articles were retrieved using PubMed, MEDLINE and PsychInfo databases. The findings reveal that the practice of yoga as a complementary therapy and stand-alone therapy is effective in managing stress, anxiety and depression. However, further research is needed as all the studies reviewed were limited in terms of heterogeneity, sample size, intervention styles, frequency and duration of practice, and also teaching methods. The chapter concludes with suggestions for home practice.

**Keywords:** intervention of yoga, stress, anxiety, depression

### **1. Introduction**

Amongst all the mental health disorders, anxiety, depression and stress appear to be the most common ones inflicting the human society. These diseases are disorders of the biochemical and neurophysiological systems which have an impact on not only the release of mood-regulating chemicals such as serotonin, dopamine and noradrenaline, but also on the cortisol and gamma amino-butyric acid (GABA) levels [1]. More than 264 million of people regardless of age, gender or creed suffer from depression [2]. Compared to men, women are more prone to this disorder, but the worrying trend is that depression leads to suicide. Evidence shows that approximately 700,000 people worldwide take their own lives annually, and what is more shocking is that suicide is deemed the fourth cause of death amongst 15 to 19-year-olds [3].

Not only depression, but also anxiety and stress are interrelated with physical well-being. For instance, cardiovascular diseases can lead to depression and vice versa. On a same note, the deadly Covid-19 pandemic which took the entire world by a storm in 2020 has had a significant undesirable impact on mental health. As the pandemic continues to ravage lives of innocent people in every nook and corner of the globe, a wide range of psychological outcomes have been observed at different layers of the society – individual, community, national and international levels. At the individual level, people are still apprehensive of falling ill or experiencing a painful death due the virus or being stigmatized by the society [4]. Health care workers

#### *Complementary Therapies*

and families with infected patients are completely fatigued. School and college-going students are not only totally demotivated, but also displeased as they have had to switch to virtual learning which in turn has impacted not only their eyesight, but also their physical health due to prolonged hours of being glued to the computer screen, and their social life. Family bread winners in various sectors who have lost jobs, and those in dire need of financial aid are totally dejected and devastated. Findings also reveal that those who have been quarantined or isolated, experienced quite a significant amount of stress, anxiety, mood swings, depression, and insomnia [5–7]. Frequent exposure to media appears to be another detrimental contributing factor to stress and anxiety [8]. It appears that patients with depression more often than not show symptoms of anxiety disorders, while those with anxiety disorders exhibit signs of depression [9]. Nonetheless, it is evident that both disorders tend to co-exist [10]. There are still so many people out there who are anxious and stressed out that they or their loved ones may contract the disease and not survive.

As anxiety and depression are affiliated with morbidity and mortality, it is imperative that these illnesses be identified and treated. Common treatments for these mental health disorders are available. Besides psychosocial treatments, psychological treatments such as cognitive behavioral therapy and pharmacotherapy such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are usually used as the first line of treatment in moderate to severely depressed individuals [11]. Antidepressants augmented with antipsychotics have shown positive results in treating anxiety. It is noteworthy that some of the drug-based treatments for anxiety have been reported to produce a sharp decline in depressive symptoms [12, 13]; however, the strategy involved in preventing depression by treating anxiety successfully warrants further clinical investigation. Benzodiazepine, a common drug-based medication that enhances the effects of GABA at its receptor, on the other hand, is only effective in treating anxiety and not depression [9].

While treatments are readily available, some of the victims do not seek help because of financial issues, fear of being stigmatized for visiting a mental health counsellor, ignorance or for no rationale at all. Furthermore, there could be concerns about the adverse outcomes and compliance of these drugs [14].

In many parts of the world today, complementary and alternative medicine treatments are gaining popularity by all and sundry. Mindfulness-based interventions such as meditation and yoga are widely used in the therapy of both psychological and also physical ailments as research has shown a link between these practices, and physical and psychological health changes [15]. Findings seem to reveal that the practice of yoga can positively affect the biochemical and neurophysiological systems by regulating the autonomic nervous system and stress response, hence lowering the stress, anxiety and depression levels [16]. There is evidence that patients favour these conventional methods of treatment compared to mainstream approaches such as psychotherapy or psychotropic medications [17].

This chapter will look at the philosophy and benefits of yoga, review some recent research that have been done on the intervention of yoga as an adjunct or stand-alone therapy for stress, anxiety and depression, the effectiveness of this mind-body regime and its implications for the sufferers of the current society.
