How Come They're Happy and I'm Not? (21 page)

The term
yoga
is derived from the Sanskrit root
yug
, which means “to join.” It signifies union between an individual's soul and the universal soul—what a beautiful idea. I believe it to be a brilliant treatment and very worth your time.

From a spiritual standpoint, yoga is a strong practice that can help modify emotional processing.
Sukha
is the Sanskrit word for happiness and literally translates to “unobstructed peace.” Yoga practice is thought to clear blockages within the body, leading to a greater sense of calm and contentment with reality as it is, often with a greater sense of happiness and connectedness to others.

Physically, yoga helps us to focus the mind and achieve relaxation. Like exercise, yoga is an excellent method to deepen the breath and keep blood flowing. Yoga can reduce the stress hormone cortisol, stimulate endorphin production, raise serotonin levels, and increase the relaxation response. Muscle movement pumps lymph tissue and encourages physical cleansing of toxins.

An electroencephalogram (EEG) tests the electrical activity of the brain using electrodes placed on the surface of the head. A small study measured EEG brain waves both before and after two hours of Kriya yoga, a type of yoga designed to remove obstructions to the body and mind. In this class, it was found that alpha and theta waves increased—both signs of happiness. Other studies show that yoga increases brain levels of gamma-aminobutyric acid (GABA), a neurotransmitter that relaxes. GABA is like our brain's natural Xanax. There are a number of types of yoga. From my experience, most forms seem to be helpful—like all other recommendations, listen to your body and choose the one that seems right for you.

Cortisol is a hormone produced by our adrenal glands in response to stress. It is responsible for stress-related weight gain,
lowered immune function, and deterioration of the brain. Yoga is a powerful method for lowering cortisol levels, and results can be visible after just one class and even more with regular classes. Because high cortisol levels are associated with depression, it would make sense that yoga should be prescribed as an antidepressant therapy.

While depression destroys healthy cells in the brain, meditation can regenerate them. Recent compelling evidence from scientific researchers at Harvard revealed that meditation helps increase the creation and growth of nerves, with forty minutes of deep meditation a day showing the greatest healthy changes in brain structure. The meditators had literally changed their physical brain structure compared with people who didn't meditate. MRI scans show that meditation boosts brain thickness of structures that tend to atrophy with age. It's plausible then that meditation can slow or stop the effects of aging on the brain.

More studies are clearly needed on the benefits of meditation as well as on specific meditative techniques to determine if some are more beneficial for patients with depression. I also recommend meditation if you have strong anxiety. In some cases of low mood, especially when someone is quite sedentary, I recommend moving your body by using a social activity like tai qi or yoga instead of quiet meditation.

For most of the twentieth century, the psychiatry field has had a somewhat negative view of spirituality, probably stemming from both Sigmund Freud's antireligious bias as well as the fact that mental illness care during the late nineteenth century focused on brain chemistry and drugs. However, in the past few decades, spirituality has gained increasing recognition as an important aspect of medical and psychiatric care.

Spirituality and association with religion can be a connecting experience or an alienating one. In the most positive light, religion can bring a sense of connection, purpose, hope, and meaning as well as a feeling that people can transcend beyond their physical world to be part of a greater community. I have found that spirituality is clearly important to most patients. In fact, studies show that about 77 percent of patients prefer their physicians talk about spiritual needs. In addition, 48 percent prefer their physicians to pray with them, and 37 percent would like to see their doctor ask them about their religious beliefs. One study showed that 79 percent of people believed that spiritual faith could help with recovery from illness, injury, or disease and that 64 percent thought that physicians should join their patients in prayer if the patient requested it.

Among a group of practicing Christian patients with mild depression, one researcher looked at the effects of adding an emphasis on religious themes to a CBT program and found large reductions in depression. Whether or not the therapist was personally religious made absolutely no difference to the outcome. However, in cases in which no religious association was used, the largest reductions in depression were made by therapists who were personally religious themselves. Simply incorporating religious association into treatment enhanced outcome.

Religion is not necessary to heal from depression, but if you are reading this and you have a past religious affiliation or leaning that was a positive experience, or you have considered joining an organized religious group—I encourage you to consider this further. You will know if a group is right for you. If you do not believe religion is right for you, that is okay too—this book covers many nonreligious choices to help you achieve your best mood and health.

Acupuncture is a thousands-year-old treatment based on the system of traditional Chinese medicine (TCM). TCM looks to nature to understand health. It considers the natural world to be full of good
energy, and it views disease as an imbalance of energy in our body relative to the natural world's energy (called
qi
and pronounced “chee”). In many cases, disease is stagnant energy, a deficiency of energy or, more rarely, an excess of energy.

In TCM, there's a basic concept of
yin
and
yang
, as expressed in the symbol above. The white areas represent yang, which is full of light, energy, daytime, and movement. Yang represents the male energy, going outward, and heat. The darker area is the yin part, representing quiet, female, nourishment, dark, nighttime, stillness, coolness, and energy in reserve. In your body, yang and yin work together to create harmony, moving in and out of each other all the time. When your body is out of balance, TCM would say that yin and yang are out of harmony—one is taking over the other, either because one is too strong or the other is too weak.

Depression is typically a yin problem, and when it's out of balance, it's the reason why people become very quiet and withdrawn. Depressed people act much more yin. Aspects of life, such as excessive competition and stress, can create this imbalance. As we will learn in
chapter 8
, twice as many women experience depression than men—women are generally more yin than men are, so they are more prone to depression, especially in high-stress, competitive work environments. As such, it's recommended that women (and sensitive men) protect themselves from that kind of harshness.

Depression, in TCM, is marked by emotional disorder and the stagnation of qi caused by emotional disturbance. The disease is due to accumulated anger, anxiety, sorrow, or other unprocessed emotions that can lead to dysfunction and imbalances in yin and yang. Some say depression can be “anger turned inward.” As a result, knotted qi accumulates, and a disruption of the body and mind results.

The emotional issue decides which organ in the body has the most problems. For example, some patients tend toward fear, which can cause a kidney imbalance. Other people have a lot of anger, hostility, or lack of motivation, which are liver issues. Sometimes excessive amounts of sorrow or even happiness attack the heart. Grief and loss affect the lungs.

Practicing in New York City, I have had the honor of working with many people who experienced extreme loss during the 9/11 crisis. As is well documented, many of these people have lung and respiratory problems such as asthma, breathing difficulty, or sarcoidosis. While convention suggests that there must have been unknown particulates in the air causing these lung problems, the TCM practitioner would suggest the incredible amount of loss attacked the lungs to cause these respiratory problems. I have found that acupuncture and Chinese herbs have been valuable in alleviating symptoms while I look closer at the sense of loss to help 9/11 victims move through this grief.

In TCM, any disease, including depression, suggests that your body is out of balance with the energy and influences of the nature around you. These natural influences are categorized as wind, cold, heat, damp, dryness, and summer heat. Too much or too little of these can deplete qi or trap it so it is stuck. The long-term trapping of qi eventually leads to stagnation of qi in an organ. With
depression, this results in the body feeling fatigued. Chronic qi stagnation also depletes blood and drains nutrients—a reason I check blood for low levels of vitamin D, B
₁₂
, and other nutrients. Chronically stuck energy also increases damp, phlegm, and fire in the body and can manifest physically as mucus production, slow digestion, yeast infection, swelling, and heat sensation.

We have spent a good amount of time in this book talking about inflammation. The idea of “damp, phlegm, and fire” correlates well with the modern medical science version of inflammation. In fact, some Chinese texts refer to depression as “phlegm misting the mind.” Although TCM might seem worlds away from modern medicine in terms of language, I believe its powerful observation and treatment principles developed over thousands of years is complementary to Western medicine and can sometimes explain what modern medicine fails to describe.

I would like to discuss two organs that are very important in regard to mood and depression. Although every organ can play a role, these two seem to be the most unbalanced. Now, please note that when we talk about an organ, it does not mean that your physical heart or liver necessarily has an organic problem that you will find with a blood test, scan, or biopsy. If you suspect you have a heart problem as described below and decide to see a cardiologist, he will probably not find anything wrong. These descriptions are energetic TCM descriptions of the organ and do not imply an actual physical issue.