Yoga for Depression

Recruiting at 1 trial location

Overseen By Sudha Prathikanti, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Must not be taking: Antidepressants

Disqualifiers: Psychotherapy, Pregnancy, Medical issues, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

180 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether practicing yoga for 12 weeks can reduce symptoms of mild-to-moderate major depression. Participants will either practice yoga or join an educational program focused on holistic healthcare. The researchers aim to determine if yoga can serve as an effective standalone treatment. Individuals diagnosed with clinical depression who are not currently taking antidepressants or receiving therapy may be suitable candidates. As an unphased trial, this study provides a unique opportunity to explore alternative treatments for depression without medication.

Will I have to stop taking my current medications?

If you are currently using antidepressant medication, you cannot participate in this trial. The trial is for those not taking antidepressants.

What prior data suggests that yoga is safe for treating depression?

Research shows that yoga is generally safe for people with depression. A review of many studies found yoga to be a safe option for treating depression, indicating that extensive research found no major problems for participants. Some studies on mindfulness and meditation, similar to yoga, reported minor side effects like anxiety or increased depression in a few individuals. However, these effects are uncommon, and many people benefit from yoga. Overall, yoga is well-tolerated, and most people find it improves their mood without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike standard treatments for depression, which often include medications like SSRIs or therapy approaches such as cognitive behavioral therapy, yoga offers a holistic alternative. Yoga practice is unique because it combines physical postures, breathing exercises, and meditation, which may help in reducing stress and improving mood through natural means. Researchers are excited about yoga's potential to enhance mental well-being without the side effects associated with medications. Additionally, yoga can be easily integrated into daily routines, promoting overall lifestyle improvements alongside mental health benefits.

What evidence suggests that yoga might be an effective treatment for depression?

Research has shown that yoga, which participants in this trial may practice, can help reduce symptoms of major depressive disorder (MDD). One study found that yoga worked as well as antidepressant medications for treating depression. Another study showed that yoga improved both depression and anxiety in people with MDD, with many considering it a safe and acceptable treatment. Additionally, adding yoga to regular treatment proved cost-effective for young women with MDD. These findings suggest that yoga can be a promising way to manage depression. Participants in this trial will either engage in yoga practice or participate in an education module group. ^{2 3 6 7 8}

Who Is on the Research Team?

Sudha Prathikanti, MD

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

Adults over 18 with mild-to-moderate major depression can join this study in San Francisco. Participants must speak English well and be able to attend all sessions. They shouldn't have severe mental illnesses besides depression, use antidepressants or psychotherapy during the trial, or have certain medical conditions like severe pulmonary disease.

Inclusion Criteria

People of all different backgrounds and ethnicities are welcome to participate.

You have been diagnosed with major depression based on a special interview with a healthcare professional.

My gender identity does not limit my participation.

Exclusion Criteria

You have been diagnosed with a drug or alcohol addiction within the past two months.

I have a severe lung condition.

I have a narrowing in my carotid artery.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to one of three in-person group interventions: Standard yoga practice, Ayurvedic yoga practice, or educational attention-control modules for 12 weeks

12 weeks

Weekly in-person sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Yoga

Trial Overview This study tests if yoga alone can help treat depression compared to an education program about holistic healthcare. It's a controlled trial where adults diagnosed with depression do yoga for 12 weeks at Zuckerberg San Francisco General Hospital.

How Is the Trial Designed?

Group I: Yoga practice Experimental Treatment 1 Intervention

Yoga practice groups

Group II: Education Active Control 1 Intervention

Education module group

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

Published Research Related to This Trial

A 10-week hatha yoga program for 50 participants with moderate depression showed that a supportive and non-judgmental teaching environment, along with mindfulness and breathing exercises, can enhance the effectiveness of yoga in addressing depression.

Participants emphasized the importance of mindfulness and self-acceptance as key mechanisms through which yoga may help alleviate depressive symptoms, although some expressed concerns about the physical difficulty of the classes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceptions of hatha yoga amongst persistently depressed individuals enrolled in a trial of yoga for depression. Uebelacker, LA., Kraines, M., Broughton, MK., et al.[2018]

A new yoga protocol has been developed specifically for treating mild and moderate depression, based on classical texts and expert opinions, identifying 26 practices for mild depression and 35 for moderate depression.

Expert validation showed that a significant number of these practices (13 for mild and 12 for moderate depression) were deemed essential, marking an important step towards creating a validated treatment protocol that will be tested in future randomized controlled studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Validation of Yoga Protocol for Patients with Depression. K S, D., K, M., Silambanan, S., et al.[2023]

In a study of 2508 yoga class attendees, about 27.8% reported experiencing adverse events, primarily mild musculoskeletal symptoms, indicating that while yoga is generally safe, some participants may face risks, especially those with chronic conditions.

Participants with chronic diseases, poor physical condition, or those who found the class stressful had a higher likelihood of experiencing adverse events, particularly severe ones in elderly individuals and those with chronic musculoskeletal issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A large-scale survey of adverse events experienced in yoga classes. Matsushita, T., Oka, T.[2022]

Mindful yoga appears to be a safe and beneficial intervention for older adults with depression, as participants reported improvements in both mental and physical health after the program.

The study suggests that single-sex mindful yoga groups may enhance acceptability for participants, indicating a need for further research to explore the feasibility and efficacy of this approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The experience of mindful yoga for older adults with depression. Lee, KC., Tang, WK., Bressington, D.[2019]

In a study involving 137 out-patients with major depression, those who practiced yoga (either alone or alongside medication) showed significantly greater reductions in depression scores compared to those who only received medication.

No adverse events were reported in patients practicing yoga, suggesting it is a safe and effective complementary treatment for depression in non-suicidal out-patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Positive antidepressant effects of generic yoga in depressive out-patients: A comparative study. Gangadhar, BN., Naveen, GH., Rao, MG., et al.[2021]

A systematic review of 94 randomized controlled trials involving 8,430 participants found that yoga is as safe as usual care and exercise, with no significant differences in serious adverse events or dropouts due to adverse events.

While yoga had a higher occurrence of nonserious adverse events compared to psychological or educational interventions, the overall safety profile suggests that it is a viable therapeutic option, highlighting the need for better reporting of safety data in future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cramer, H., Ward, L., Saper, R., et al.[2018]

Mindfulness yoga significantly reduces depression severity in patients with major depressive disorder (MDD), with a moderate effect size based on a meta-analysis of nine randomized controlled trials involving 581 participants.

The intervention also appears to alleviate anxiety levels in MDD patients, although it did not show a significant impact on rumination immediately after the intervention, suggesting potential benefits in the longer term.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials. Miao, C., Gao, Y., Li, X., et al.[2023]

A 9-week mindful yoga intervention (MYI) added to standard treatment did not significantly reduce depression symptoms or improve quality of life in young women with major depressive disorder (MDD) compared to standard treatment alone, based on a randomized controlled trial with 171 participants.

The study found no significant mediating effects from factors like self-criticism or mindfulness, except for self-compassion, indicating that MYI may not enhance the effectiveness of standard treatment for depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mindful yoga intervention as add-on to treatment as usual for young women with major depressive disorder: Results from a randomized controlled trial. Vollbehr, NK., Hoenders, HJR., Bartels-Velthuis, AA., et al.[2023]

A systematic review of 12 randomized controlled trials involving 619 participants found that yoga has moderate short-term effects in reducing the severity of depression compared to usual care, with a significant effect size (SMD = -0.69).

Yoga also showed limited effectiveness in reducing anxiety compared to relaxation techniques, suggesting it could be a beneficial adjunct treatment for individuals with depression, although safety data was not reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Yoga for depression: a systematic review and meta-analysis. Cramer, H., Lauche, R., Langhorst, J., et al.[2022]

Yoga has been shown to significantly improve short-term depressive symptoms, based on a systematic review of 12 randomized controlled trials involving 619 participants, although there was a high risk of bias in many studies.

The evidence for yoga's effectiveness in treating general anxiety disorder (GAD), panic disorder (PD), and posttraumatic stress disorder (PTSD) is inconclusive, with only a few small studies available and no strong conclusions drawn.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence Map of Yoga for Depression, Anxiety, and Posttraumatic Stress Disorder. Duan-Porter, W., Coeytaux, RR., McDuffie, JR., et al.[2022]

In a study of 110 persistently depressed individuals, yoga was found to significantly increase mindfulness, particularly the 'observe' aspect, compared to a health education class over a 10-week period.

While yoga showed a positive effect on mindfulness, it did not significantly reduce rumination, indicating that while yoga may enhance awareness, it may not directly address repetitive negative thinking associated with depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Yoga v. health education for attentional processes relevant to major depressive disorder. West, JL., Tremont, G., Miller, IW., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10492419/

The effectiveness of mindfulness yoga on patients with ... The aim of this study was to determine the effectiveness of mindfulness yoga intervention on major depressive disorder (MDD) patients.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10077871/

Effectiveness of yoga for major depressive disorder Yoga can improve depressive symptoms and anxiety in patients with MDD and has a safe and wide patient acceptance.

3. nature.com nature.com/articles/s41598-024-71213-9

The effect of mindfulness meditation on depressive ... The findings suggest a positive effect of mindfulness meditation on depressive symptoms in individuals with depression during the COVID-19 pandemic.

4. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1283172/full

Meta-analysis of a mindfulness yoga exercise intervention ... Studies have shown that in Major depressive disorder, positive yoga exercise is as effective as antidepressant medication and is associated ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S016517812300642X

Cost-effectiveness of a mindful yoga intervention added to ... A yoga intervention was added to treatment as usual for young women with MDD. Adding yoga was likely to be cost-effective compared to treatment as usual only.

6. nccih.nih.gov nccih.nih.gov/health/meditation-and-mindfulness-effectiveness-and-safety

Meditation and Mindfulness: Effectiveness and Safety | NCCIH The most commonly reported negative effects were anxiety and depression. In an analysis limited to 3 studies (521 participants) of mindfulness- ...

7. karger.com karger.com/pps/article/doi/10.1159/000543457/921833/Effects-of-Meditation-and-Yoga-on-Anxiety

Effects of Meditation and Yoga on Anxiety, Depression ... At baseline, 54 of 159 (34.0%) participants were at risk of anxiety and 96 (60.4%) were at risk of depression, with mean (SD) HADS scores of 11 ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11919030/

Yoga for Depressive Disorder: A Systematic Review and ... Our meta-analysis provides evidence for yoga as a safe therapeutic option for patients with depressive disorders, with statistically significant ...