• What are the Symptoms?
  • How Long?
  • Any precipitating cause or factor
  • Family history
  • Is it aggravating?
  • Is it primary or secondary?
  • If secondary, what is the present medical disease?
  • Anxiety is defined as a subjective sense of unease, dread or foreboding, and may be a primary psychiatric condition or component or reaction to any medical disease.

Different forms of Anxiety are Panic disorders with intense fear with many physical symptoms. (Palpitations, sweating, trembling, shortness of breath, chest pain, dizziness, fear of death.)

  • May be self-limiting up to 1 hour. Frequency & severity may vary.
  • Its diagnosis is done after ruling out medical conditions related to cardiovascular, respiratory, endocrine & neurological disorders by selective investigations related to symptoms like blood tests Xray chest ECG, Endoscopy..etc.(Thyrotoxicosis,Pheochromocytoma,Hypoglycemia..e tc)
  • 75% of panic disorders are found to suffer from depression at some point of their illness
  • Cause is unknown but genetic predisposition and autonomic responsibility may play a part. They are found to have heightened sensitivity to somatic symptoms which triggers the arousal.
  • This forms the base of Cognitive Behavioral Therapy which teaches patients to alter the cognitive interpretations of anxiety producing experiences.
  • It is a hypothesis that these individuals have a neuronal circuit which gets stimulated by certain stimuli involving nor adrenergic & serotonergic neurons. The cornerstone of drug therapy aims at
    • correction of depression
    • immediate relief of panic symptoms.
    First group of medicines take 2 to 6 weeks to become effective, hence should be taken regularly for 3 to 6 months. Second group of medicines give rise to dependence, hence should be used for short duration.
  • In addition to CBT, described above, breathing techniques are found to be helpful

Generalized anxiety Disorder (GAD) is the presence of persistent, excessive, unrealistic worry, causing muscle tension, impaired concentration, insomnia , restlessness or autonomic arousal.

  • History of childhood fear or inhibition may be present
  • 80% of GAD suffer from depression.

Phobic disorders- are manifested as marked & persistent fear of objects or situations which lead to immediate anxiety reactions. Patients avoid the phobic stimulus which impairs their occupational or social functioning. Common examples are fear of closed spaces (claustrophobia), fear of flying (aerophobia)and fear of blood.

  • CBT forms a cornerstone to correct distorted perception & interpretations of fear producing stimuli.
  • Individual & group therapy, desensitization therapy (gradual exposure to feared situations to face & alter the responses.) are found to be useful.

Stress disorders are often observed after exposure to extreme traumatic conditions like injury, threat to self or others or death of loved one. The person’s response is fear, helplessness, horror. They may arise as acute or delayed. This may manifest as distressing recollection of events, dreams of events, actually living the event again & again, avoiding stimuli associated with trauma,etc. The stress disorders are usually self-limited & need short duration anxiolytics & supportive- expressive psychotherapy

Mode of Action of Medical Yoga Therapy

Medical Yoga Therapy offers help in the case of primary anxiety cases, by cognitive corrections in emotional reactions. It is a form of Behavioral Therapy

  • Yogic postures with props- (Passive Immediate Effect) (Supta Veerasan + Supta Badha Konasan + Viparit Dandasan) These postures lead to passive rib cage expansion in vertical, transverse &
  • Conscious Deep Breathing- Abdominal Breathing + Bucket Handle movement of 8th,9th 10th ribs + Pump Handle Movement of sternum + Clavicular Breathing. This practice also increases the proprioceptive signals from rib cage to respiratory center, but this is an active practice.
  • Ujjayi pranayam, wherein a snoring sound is produced by vibration of vocal cords signaling afferent fibers of vagus nerve.
  • Bhramari pranayam wherein M sound is produced in mouth & reverberated in oropharynx, nasopharynx, paranasal sinuses & middle ear cavity leading to sensory inputs carried by trigeminal nerves. Thus, by sending sensory signals to the respiratory center, breathing is modulated to send bio feedback to higher centers, namely cerebral cortex & hypothalamus. This biofeedback brings emotional tranquility & cognitive stability.
  • Omkar chanting prolongs exhalation leading to increase in air flow in the breathing passage. It also sends proprioceptive impulses through‟trigeminal (nasal passage, nasopharynx, oropharynx) acoustic nerve & vagi. (larynx & laryngopharynx.) It can instantly relieve panic attack. (Omkar Chanting leads to Limbic Deactivation). This is narrated by Mahamuni Patanjali in (1:31) as additional obstacles in the Yogic Study Pathway. Dukha+Daurmanasya+Angamejayatva+ Shwasprashwasa i.e., Sorrow, fickle mindedness, shakiness-restlessness anxiety & irregularities of inhalation & exhalation.