This Excerpt Is from Chapter 104 Complementary and Alternative Treatments in Psychiatry

relaxation, and give many health benefits. However varied, its many techniques constitute a psychophysiological therapy which invites applications to psychiatric disorders. For reviews of yoga philosophy, techniques, neurophysiological findings, and studies in anxiety, depression, OCD (Shannahoff-Khalsa et al. 1999), and epilepsy, see Yardi (Kraft et al. 2001) and Becker (Becker, 2000). Janakiramaiah and colleagues have showed benefits of a yogic breathing technique called Sudarshan Kriya (SKY) in an open preliminary study of 15 dysthymics and 9 unipolar major depressives. Depression improved after one month of SKY practice 30 minutes/day and improved further by 3 months (Naga Venkatesha Murthy et al. 1997). In an extension of this study, 15 additional dysthymics and 15 melancholics responded positively (Naga Venkatesha Murthy et al. 1998). In a subsequent open study, 80% of 46 dysthymics completed a 3-month protocol of SKY 30 min/day. 68% of the completers attained remission (Janakiramaiah N et al. 1998). A comparison study of 45 hospitalized melancholic depressives randomized to ECT, imipramine, or SKY demonstrated that all three treatments were effective with ECT being slightly more so than SKY or imipramine (Janakiramaiah N et al. 2000). Lack of double blinding or placebo control groups limit these studies. Nevertheless, if one considers the low expectable placebo response rate in melancholic depressives, prior research findings that SKY improved REM latency and slow wave sleep and significantly reduced cortisol, it appears that SKY has powerful biological effects. Compliance with the breathing technique in these studies ranged from 56-80% compared to 50% compliance with prescription antidepressants (with complaints of significant side effects from medications). In developing a neurophysiological model of the effects of yogic breathing on the CNS, we have drawn upon several related fields of research, including: effects of breathing and chanting on hypercapnia and consequent improvements in autonomic regulation and cardiac function; hyperventilation studies; vagal nerve stimulation (VNS); thalamic oscillators; SMR (sensorimotor rhythm) and vigilance; and neuroendocrine effects. Space limitations permit only a cursory partial overview of this model. Sudarshan Kriya yoga consists of a specific sequence of breathing patterns (pranayam) separated by brief periods of normal breathing: Ujjayi – slow strained breathing against airway resistance at 3 cycles/minute; Bhastrika – forceful exhalation at