It appears centuries-old practice involving postures, stretches, meditation and breathing provides benefits today at Walter Reed National Military Medical Center' s (WRNMMC) 7-West inpatient psychiatry ward and in the WRNMMC four-week, psychiatric outpatient Continuity Service "day program."

"Individuals with mental disorders are increasingly turning to integrative medicine, including yoga and meditation, for relief of their symptoms," said Inpatient Psychiatry Service Chief, Navy Lt. Cmdr. Benjamin Hershey, who explained the trend has also been observed among active duty service members.

Yoga emerged between 200 B.C. and 300 A.D. In the ancient language of India known as Sanskrit, 'Yog' means 'Yoke' or 'Union' (of mind, body and spirit).
Today, yoga can be used to treat anxiety and depression by reducing perceived stress. It also improves mood and functioning. In addition to depression, studies have examined the efficacy of yoga therapy in the treatment of schizophrenia as well as post-traumatic stress disorder.

"There is strong and growing evidence base regarding a range of psychological and physiological benefits associate with these interventions," Hershey said.

A psychiatric inpatient study presented at the 2014 American Psychiatric Association annual meeting showed voluntary, regular yoga classes self-rated as beneficial to overall treatment in 82.2 percent of participants.

"Our study indicates that patients may have a greater satisfaction with their psychiatric units as well as increased mood, decreased anxiety and greater feeling of physical well-being when participating in a voluntary yoga program in an inpatient psychiatric setting," the researchers wrote in an abstract.

The daily yoga class for psychiatric inpatients on 7-West began four years ago. Daphne Vourlekis, a licensed certified clinical social worker on the ward, started the program with volunteer yoga instructors.

Beginning as chair yoga, the program eventually expanded to use mats and occasional standing poses. The 7-West class teaches gentle yoga, and generally consists of meditation, breathing techniques, stretching, and gentle yoga poses.

"It is always a go-at-your-own-pace class," Vourlekis explained. "Patients are encouraged to find their edge, the point of mild discomfort without pain-and not move beyond it. This will help prevent moderate pain or injuries," she said.

"The daily yoga classes are voluntary, and patient attendance rates range between 30 to 80 percent. Patients experience body relaxation, feel more at ease and less tense," Vourlekis said.

"There is nothing like hearing a glowing first-hand report from a previously skeptical patient who decided to 'give it a shot' because it was so easily accessible to them during their hospitalization," Hershey added.

Yoga is taught in other areas of the medical center and base, available to all patients and staff, including the gym, as well as the integrative medicine program in the Internal Medicine Department. The ancient practice is also offered in a class for patients in the outpatient, Psychiatric Continuity Service 'day program,' led by Dr. Bhagwan Bahroo, a staff psychiatrist at WRNMMC for more than 10 years, as well as an assistant professor of Psychiatry at the Uniformed Services University of Health Services (USUHS).

Bahroo was introduced to yoga as a high school student. Now, a yogi, a devotee or adherent of yoga, the psychiatrist offers a voluntary, yoga class on Mondays at 11 a.m., for patients in the psychiatric "day program." Once a week, Bahroo incorporates two forms of yoga in an hour-long class: Hatha Yoga, a set of physical exercises and sequences of postures designed to align the skin, muscles, and bones, along with Ashtanga Yoga, which incorporates synchronized breath with postures.

"It's not fast-paced yoga," Bahroo said. The practice includes eye movement exercises that have been shown to be especially helpful for patients with PTSD, he explained.

"About 30 to 50 percent of the patients in the program take advantage of the yoga class," said the psychiatrist, who cited medical conditions that benefit from yoga including hypertension, mild heart conditions, obesity, difficulty breathing, high cholesterol and diabetes.

According to Bahroo, those who participated in the class "felt it made a difference in their lives, their psyche well-being," he said, with additional patients citing a decrease in anxiety and migraines after particular positions.

A 2014 trial published in the Journal of Clinical Psychiatry examined the effect of yoga to decrease the symptoms of PTSD resistant to treatment in women. Half of those who practiced yoga during a weekly one hour class for 10 weeks no longer met criteria for PTSD, and maintained improvements.

Yoga is one of several mind-body skills taught in a series of classes offered as part of the Integrative Health and Wellness Services, of the General Internal Medicine Service at WRNMMC. A monthly class calendar is available in the main waiting area of the General Internal Medicine Clinic, on the second floor of the America Building (Bldg. 19). Classes are held in the clinic or in a nearby space.

For more news from Walter Reed National Military Medical Center, visit www.navy.mil/.