Yoga improves anxiety compared to other therapies, study shows

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Yoga improves symptoms of generalized anxiety disorder, a condition with chronic nervousness and worry, suggesting the popular practice may be helpful in treating anxiety in some people, according to new research by New York University Langone Health and the New York University Grossman School of Medicine. The study was published in the journal JAMA Psychiatry.

For the study, 226 men and women with generalized anxiety disorder were randomly assigned to three groups - either cognitive behavioral therapy (CBT), Kundalini yoga, or stress-management education, a standardized control technique.

The study involved an evidence-based protocol for CBT treatment of generalized anxiety disorder, including psychoeducation, cognitive interventions focused on identifying and adapting maladaptive thoughts and worrying, and muscle relaxation techniques. Kundalini yoga included physical postures, breathing techniques, relaxation exercises, yoga theory, and meditation/mindfulness practice. The stress-management education control group received lectures about the physiological, psychological, and medical effects of stress, as well as the antianxiety effects of lifestyle behaviors, such as reducing alcohol and smoking, and the importance of exercise and a healthy diet. Homework consisted of listening to educational material about stress, nutrition, and lifestyle.

Each treatment was administered in groups of three to six participants, over weekly two-hour sessions for 12 weeks with 20 minutes of daily homework assigned.

After three months, both CBT and yoga were found to be significantly more effective for anxiety than stress management. Specifically, 54 percent of those who practiced yoga met response criteria for meaningfully improved symptoms compared to 33 percent in the stress-education group. Of those treated with CBT, 71 percent met these symptom improvement criteria.

However, after six months of follow-up, the CBT response remained significantly better than stress education, the control therapy, while yoga was no longer significantly better, suggesting CBT may have more robust, longer-lasting anxiety-reducing effects, according to the study.

According to researchers, generalized anxiety disorder is a common, impairing, and undertreated condition, currently affecting an estimated 6.8 million Americans. While most people feel anxious from time to time, it is considered a disorder when worrying becomes excessive and interferes with day-to-day life. CBT is considered the gold standard first-line treatment. Medications, including antidepressants and sometimes benzodiazepines, may also be used. Yet not everyone is willing to take medication which can have adverse side effects and there are challenges with accessing CBT for many, including lack of access to trained therapists and long waitlists.

 Future research should aim to understand who is most likely to benefit from yoga for generalized anxiety disorder to help providers better personalize treatment recommendations, the researchers said.

"We need more options to treat anxiety because different people will respond to different interventions, and having more options can help overcome barriers to care," said Naomi Simon, MD, lead author of the study and professor in the Department of Psychiatry, in a statement. "Having a range of effective treatments can increase the likelihood people with anxiety will be willing to engage in evidence-based care."