View of ROLE OF YOGA IN STRESS MANAGEMENT

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Vol.03, Issue 09, Conference (IC-RASEM) Special Issue 01, September 2018 Available Online: www.ajeee.co.in/index.php/AJEEE

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ROLE OF YOGA IN STRESS MANAGEMENT

Ramvir Singh¹, Dr. B.k. Pal ²

1Research Scholar, Mewar University, Chittorgarh, Rajasthan,

2Head IFIIC, New Delhi

Abstract: - In an age of a highly dynamic and competitive world, man is exposed to all kinds of stressors that can affect him in all realms of life due to competition, innovation and technology transformation in all organizations cannot avoid tension, stress and anxiety in their day-to-day work. So to maintain balance between work life and personal life, we have to deliver of dedication in the form of hard work, discipline, punctuality and mental alert . It exposed to stress and tension for long periods which may manifest in the form of many ailments like hypertension, high/low blood pressure, insomnia, depression, backaches, migraine, spondylitis, etc. The stress response is a complex emotion that produces physiological changes to prepare us for fight-or-flight, to defend ourselves from the threat or flee from it.

In this scenario yoga is the answer for healing stress among working men and women. This all-in-one formula acts as a soothing agent for the burned-out Indian corporate and is fast growing on the popularity charts. It serves as reviver of mind, body and soul. The techniques of yoga comprise of physical postures, breath expansion and enhancement, relaxation and meditation techniques, coupled with philosophy of simple and natural lifestyle management. It enhances energy of the person and develops a positive attitude and also attested by many as a complete all-in-one holistic formula for stress management.

Key Words: Yoga, Stress, Stress Management, 1 INTRODUCTION

In an age of a highly dynamic and competitive world, man is exposed to all kinds of stressors that can affect him in all realms of life. Hans Selye, the Hungarian endocrinologist who find the term stress and his scientific work on the hypothetical non-specific response of an organism to stressors in life science. The term stress is derived from the Latin word Stringere, which means ―to be drawn tight.‖ Stress is a complex, dynamic process of interaction between a person and his or her life. Stress can affect one’s health, work performance, social life, and the relationship with family members. The stress response is a complex emotion that produces physiological changes to prepare us for fight-or-flight, to defend ourselves from the threat or flee from it. According to Stephen Robbins¹, stress that which arises from an opportunity, demand, constraint, threat, or challenge, when the outcomes of the event are important and uncertain. Stress can also be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker. Stress responses in healthy individuals may be adaptive and typically do not impose a health burden. However, if the threat is unremitting, particularly in

older or unhealthy individuals, the long- term effects of stressors can damage health². Stress coming from Job which can lead to high internal injury to human beings. Hence we can say that stress is a silent killer, and prolonged exposure to stress may exert harmful effects on physical, psychological, and behavioral well-being of an individual. According to the National Institute for Occupational Safety and Health, 80% of workers experience job stress. According to the study of Keeley and Harcourt³; stress is caused by heavy work demands in the job itself, which the unskilled employee with little control over how the work is done, cannot adapt to or modify. The rapid change of the modern working life is associated with increasing demands of adaptive of new skills, the new assignments, pressure of higher and continuous productivity and quality of work with continuous improvement time to time with high pressure. These factors are increasing stress among the workforce.

2 IMPACT OF STRESS

Stress-related disorders evolve gradually through four recognizable stages. First, psychological changes such as anxiety, irritability, and insomnia arise, due to

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2 over-stimulation of the sympathetic nervous system. The second stage of symptoms includes high blood pressure, elevated heart rate, and increased intestinal motility surface. In the third stage, a more profound physical or biochemical imbalance sets in, while in the final fourth stage, irreversible symptoms that often require surgical or long-term management appear. Increased sympathetic activation and the release of stress hormones, including adrenaline, lead to increases in heart rate, blood pressure, breathing, body temperature, and muscle tension⁵. In brief, the relaxation response has been proposed as an antidote to stress by relaxing of body hormones by; decreases heart rate, blood pressure, body temperature, and muscle tension which can improve the productivity. Similar to stress in the workplace, college students are also often impacted by stress. Academic stress can result from many different imperative stressors, such as final grades, term papers, examinations, and excessive homework. Stress has exhibited a negative correlation with cognitive performance, thus negatively impacting academic performance.

3 STAGES OF STRESS

Stress is a Sudden Biological Change. It has become the curse of 21^st century and is silent killer in the modern world. Stress is the greatest impact to the information era.⁶ According to Hans Selye⁷ called stress "the spice of life," and defined it as the "nonspecific response of the body to any demand made upon it." which can disturb any one’s physical, mental, emotional and behavioral balance. It can damage different organs of human body from muscles from tissues (e.g Paralysis or nerve injury) to organs and blood vessels (e.g Heart failure, high blood pressure, Brain stokes, migraines etc). It can speed up pulse rate and respiration, body temperature. In brief its effect can seems in the body metabolism, digestion, appetite, sleep, sexuality and even fertility. Occupational stress includes the environmental factors or stressors such as role conflict and poor working conditions associated with a particular job.

The body's response to stress has multiple stages⁸ (Watts, 1990).

3.1 The alarm stage (fight or flight):

The first stage of stress is the alarm reaction; means it is the body's defense mechanism, In this stage experiences an over acting of the nervous system where in adrenaline and cortisol increase and blood flows away from the brain to the muscles. To overcome the situation , the body need an increase in energy output which is generated by increasing the activity of the thyroid and adrenal glands by secreting body fluids . As a result, the fear, excitement or pressure is evident on the sufferer’s face. The indication of the alarm stage is it increases reflexes and mental focus.

3.2 The resistance stage (breakdown or repair):

In the stage commonly called as resistance stage or repair stage as our body keeps making continuous efforts to maintain homeostasis in the presence of the stressor which initiated the alarm reaction which results run down and the person starts feeling irritated, over reacts to minor situations. Psychological and behavioral changes are also clearly visible.

The resistance require cellular demand for vitamins C, A, B1, B2, B3, B5 and B6, and for the minerals potassium, zinc, manganese, iron and magnesium.

3.3 Exhaustion stage:

Exhaustion stage is a level of stress in the general adaptation; the exhaustion stage can result in physical or mental breakdowns due to the body's response to the stressor. During the resistance stage our body organelles is working hard. For example if a student was bound to get stressed if he was preparing for his upcoming exam and despite of every possible effort, he would not able to relate to his studies.

Exhaustion stage is further divided into two phases; Positive stress, Distress (Negative stress).

4 YOGA

Rapidly emerging in the Western world as a discipline for integrating the mind and body into union and harmony, when adopted as a way of life, yoga improves physical, mental, intellectual, spiritual health and is classified by the National Institutes of Health as a form of Complementary and Alternative Medicine (CAM)⁹. The word ―yoga‖ comes from a

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3 Sanskrit root ―yuj‖ which means union, to join, and to direct and concentrate one's attention¹⁰. Practice of yoga promotes strength, endurance, flexibility and facilitates characteristics of compassion, and greater self-control, while cultivating a sense of calmness.

Currently, treatment for anxiety and depression involves mostly psychological and pharmacological interventions;

however, mind-body interventions are becoming increasingly popular as a means to reduce stress. Yoga, a form of mind-body exercise, has become an increasingly widespread therapy used to maintain wellness, and alleviate a range of health problems and ailments¹¹. Yoga practice produces a physiological state opposite to that of the flight-or-fight stress response and with that interruption in the stress response, a sense of balance and union between the mind and body can be achieved¹².

Yoga has been practices more than 5000 years but it has recently gained his trend in the western countries like United States and Europe. In America, the yoga market emerged as a 5.7 yillion dollar industry in 2008, an increase of 87% from 2004¹³. Also in Japan Yoga has also found its special existence by its peculiarities like asana and pranayama¹⁴.

Yoga is an ancient discipline designed to bring balance and health to the physical, mental, emotional, and spiritual dimensions of the individual.

Yoga is often depicted metaphorically as a tree and comprises eight aspects, or limbs: yama (universal ethics), niyama (individual ethics), asana (physical postures), pranayama (breath control), pratyahara (control of the senses), dharana (concentration), dyana (meditation), and samadhi (bliss). Yoga has also found its special existence in Japan by its peculiarities like asana and pranayama¹⁵.

5 EFFECT OF YOGA IN STRESS:

Research evidence supports the belief that certain yoga techniques may improve physical and mental health through down-regulation of the hypothalamic- pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). The HPA axis and SNS are triggered as a response to psychological demand (stressor), leading to a cascade of physiologic, behavioural effects, primarily

as a result of the release of cortisol and catecholamine. This response leads to the mobilization of energy needed to combat the stressor through the classic fight-or- flight response. Over time, the constant state of hyper vigilance resulting from repeated firing of the HPA axis and SNS can lead to dysregulation of the system, and ultimately diseases such as obesity, diabetes, autoimmune disorders, depression and cardiovascular disease¹⁴. Many studies also show that yoga decreases levels of salivary cortisol, blood glucose, as well as plasma rennin levels, and 24-hour urine norepinephrine and epinephrine levels. Several literature reviews have been conducted that examined the impact of yoga on specific health conditions including cardiovascular disease, metabolic syndrome diabetes, cancer, and anxiety¹⁶. The ability to proactively handle stress in everyday life could alleviate the constant activation of the endocrine system, which in turn, increases the effectiveness of the immune system¹⁷.Yoga decreases heart rate and systolic and diastolic blood pressure significantly. Many studies suggest that, yoga reverses the negative impact of stress on the immune system by increasing levels of immunoglobulin A as well as natural killer cells. Growth hormone (GH) activates human macrophages and primes monocytes for enhanced H2 O2 release ¹⁸, when given to hypopituitary animals, GH augments antibody synthesis and skin graft rejection¹⁹, whereas prolactin (PRL) enhances macrophage function. PRL shares target transcription factors including interferon regulatory factor-1 (IRF-1) with IL-2. Yoga has been found to decrease markers of inflammation such as high sensitivity C-reactive protein as well as inflammatory cytokines such as interleukin-6 and lymphocyte-1B. These studies suggest that yoga has an immediate quieting effect on the SNS-HPA axis response to stress. While the precise mechanism of action has not been determined, it has been hypothesized that some yoga exercises cause a shift toward parasympathetic nervous system dominance, possibly via direct vagal stimulation. Shapiro et al noted significant reductions in low-frequency heart rate variability (HRV)—a sign of sympathetic nervous system activation—

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4 in depressed patients following an 8-week yoga intervention²⁰. Regardless of the pathophysiologic pathway, yoga has been shown to have immediate psychological effects immediately: decreasing anxiety and increasing feelings of being emotional, social, and spiritual well-being.

Several literature reviews have been conducted that examined the impact of yoga on specific health conditions, including cardiovascular disease, metabolic syndrome, diabetes, cancer, and anxiety.

Yoga can be wisely applied in welfare programs to improve the quality of life. A study has shown improvement of mental health of both the young and seniors by reducing stress through yoga by inhibition of the posterior or sympathetic area of the hypothalamus ²¹. Yogic practices probably inhibit the activity of the paraventricular nuclei of the hypothalamus, which in turn affects the anterior pituitary gland to produce less ACTH. The decrease in ACTH decreases the synthesis of cortisol from the adrenal glands. The decrease in cortisol levels with yoga has been observed in various studies²². A study of class students performing yoga and their SAA levels comparison show a decreased after yoga practice in both groups, and there was no difference in effect between groups.

However, after a few classes, once they became accustomed to yoga, SAA levels came down¹⁴. This shows that yoga helps to improve mental health and to overcome routine stress. Both anxiety and trait anxiety scores decreased after yoga practice. Yogic practices inhibit the areas responsible for fear, aggressiveness, and rage, and stimulate the rewarding centers in the median forebrain and other areas, leading to a state of bliss and pleasure.

This results in lower anxiety, heart rate, respiratory rate, blood pressure, and cardiac output in students practicing Yoga and meditation than in controls ²³.

The practice of meditation had been shown to increase melatonin levels in our body²⁴ and also decrease serotonin levels²⁵. A significant relationship has been observed between mind-body therapies (Transcendental meditation and visual imagery without the use of any kind of medications) and the patient's recovery from dermatomyositis, which could possibly mediated by influences on the humoral immune system²⁶.

6 EFFECT OF YOGA ON POSITIVE HEALTH

In the new modern era yoga is an increasingly popular therapy, used to maintain wellness and assist with the management of Health complaints. A review which identified two trials evaluating the effects of yoga on reducing anxiety and stress. They taken 114 subjects by Khasky and Smith, yoga and imagery were found to be more effective at increasing a relaxed state compared to the control group (p < 0.003) and guided Imagery was more effective than yoga in reducing negative thoughts (p < 0.03)²⁷. In a regional study by Malathi and Damodaran randomised 50 stressed medical students to yoga or to a nonintervention control group.7 a reduction in stress, improved sense of well-being and confidence was found in the yoga group (p < 0.001)²⁸.

Campbell et al in 2004 with the aims to understanding the contribution of Yoga to positive mental health and exploring links between yogic philosophy and psychological theory, researchers at Australia. This study conducted to find out wether, Yoga as a preventative and treatment for symptoms of mental illness or not . The Yoga classes were designed as a six-week program incorporating breathing techniques (prânâyâma), exercises for strength, vitality, and flexibility (âsanas), guided relaxation (yoga-nidrâ), and meditation.

Psychometric testing was carried out to assess symptoms of stress, anxiety, and depression across three groups: regular Yoga practitioners, beginners, and people not practice Yoga and these tests were re- administered, at the end of six weeks, the Yoga beginners group showed lower average levels of symptoms of depression, anxiety, and stress than at commencement, but levels were stable for regular Yoga practitioners and people who did not practice Yoga²⁹.

7 EFFECT OF YOGA IN OCCUPATIONAL HEALTH

Rudra Bhandari et al shows the yogic intervention was comprised of selected yogic postures, breathing mechanics (pranayama), gestures, psychic locks, concentrations, and meditations that were given for one month among 50 corporate personnel (25 male and 25 female) from the Indian Telephone Industry, Raebrali,

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5 India³⁰. The result showed significant effects of yogic intervention to manage distress and enhance work performance (p < 0.01) and favored the efficacy of corporate yoga to boost health, harmony, morale, work motivation, commitment, performance, and productivity at individual and organizational levels³⁰. 8 BIOCHEMICAL MARKERS OF STRESS Many advanced research has also been carried out on yoga, wherein the cortisol levels were assessed in multiple independent trials. However, the results were inconsistent, with the many of the studies showing no effect of yoga practice on cortisol concentrations. Conversely, Vadiraja and colleagues reported significant decreases in 6.a.m and pooled diurnal salivary cortisol concentrations in 42 breast cancer patients after a 6-week yoga intervention compared to 33 breast cancer patients in the control group.

Similarly West et al reported a significant decrease in salivary cortisol in 18 undergraduate students after a semester- long Hatha yoga course.

9 BENEFITS OF YOGA

Virtually everyone can see physical benefits from yoga, and its practice can also give psychological and well as mental benefits, such as stress reduction and a sense of well-being, and spiritual benefits, such as a feeling of connectedness with spiritual connectivity or a feeling of transcendence. Certain poses can be done by anywhere and can go for hours or minutes, depending on one’s schedule.

Several mechanisms in yoga that have play a vital role on stress levels, meaning there are multiple ways that yoga can minimize your stress levels. In several studies show that the most effective ways in which yoga targets stress are by lifting your mood means the positive effect, by allowing for increased peace and joy which can reflect in our face. By simultaneously getting our moods , enabling us to be more focused on the present moment, and by encouraging us to give ourselves a break, yoga is a very effective stress reliever.

10 CONCLUSIONS

Yoga is said to be a complete science, as it fulfills the WHO’s definition of health by addressing the individual at all physical, psychological, and social levels. Stress

affects individuals of all age groups, and people of all sectors and occupations, including doctors. Though many modalities of treatments are available for reducing stress, people are trying to find an alternative to be relieved from stress without medications. Yogic science, having persisted for 5000 years and known to be spiritual for many years, is now being proven through scientific studies to have significant benefits on health.

Yogic science includes yogasanas (postures), pranayama (breathing practices), dhyana (meditation), and relaxation techniques which benefit human beings at every level. Through research studies, yoga has proven effective in many physical and psychological ailments. Apart from the management of diseased condition, it also has been proven to improve the positive health and quality of life of the healthy.

Being doctors, we have the impression that we are healthy, though affected by enormous stress, and we tend to neglect due to our busy schedule in the hospitals.

This is occupational stress that does not spare even doctors. Doctors had already aware of the prolonged stress and its physical and mental effects in the patients, it is very important that one knows how to manage stress and protect their positive health. In this regard, doctors can start practicing yoga that has been scientifically proven to reduce stress and improve positive health, and thereby can also advise patients to overcome their problems.

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