A D V A N C E D C E N T R E F O R A D V A N C E D C E N T R E F O R A D V A N C E D C E N T R E F O R A D V A N C E D C E N T R E F O R Y O G A , N I M H A N S , B A N G A L O R EY O G A , N I M H A N S , B A N G A L O R EY O G A , N I M H A N S , B A N G A L O R EY O G A , N I M H A N S , B A N G A L O R E ---- 2 92 92 92 9 ( I N C O L L A B O R A T I O N W I( I N C O L L A B O R A T I O N W I( I N C O L L A B O R A T I O N W I( I N C O L L A B O R A T I O N W I T H M O R A R J I D E S A I N A T I O N A L I N S T I T U T E O F Y O G A , N E W D E L H I )T H M O R A R J I D E S A I N A T I O N A L I N S T I T U T E O F Y O G A , N E W D E L H I )T H M O R A R J I D E S A I N A T I O N A L I N S T I T U T E O F Y O G A , N E W D E L H I )T H M O R A R J I D E S A I N A T I O N A L I N S T I T U T E O F Y O G A , N E W D E L H I )

J U L Y , 2 0 1 0 – S E P T E M B E R , 2 0 1 0 V O L U M E 2 , I S S U E 4

PATRONS

Director & Vice Chancellor

NIMHANS

Director, MDNIY

New Delhi

ED ITOR

Dr.B.N.Gangadhar

Professor of Psychiatry

Program Director

Advanced Center for Yoga

NIMHANS, Bangalore

ED I TOR I A L

COMM I T T E E

Dr. Shivarama Varambally

Asso Professor of Psychiatry

Dr. Rashmi. Arasappa

Program Coordinator

Advanced Centre for Yoga

Dr. Satish Gaikwad

Research Officer (Scientific)

MDNIY, New Delhi

E D I T O R I A L

A S S I S T A N C E

Dr. Hariprasad.V.R

Senior Research Fellow

Advanced Centre for Yoga

A Quarterly Newsletter

SamatvamSamatvamSamatvamSamatvam

“Yoga in Depression” - One Day Seminar, 26th September, 2010

Advanced Center for Yoga - Mental health and Neurosciences, NIMHANS held one day Seminar

on Yoga in depression in NIMHANS on 26th September, 2010 at Neuroscience faculty block,

NIMHANS, Bangalore. The theme of the seminar was “Research on Yoga in depression: Neuro-

immunology and Neuroplasticity”. Program was inaugurated by chief guest Dr Vittal Murthy,

Secretary, Medical education, Government of Karnataka. Dr.P. Satishchandra, Director &

Vice-chancellor, NIMHANS, presided over the function. Prof Dr B N Gangadhar and Dr Ravi

(Registrar, NIMHANS) were the prominent dignitaries present during the inauguration.

Dr. P. Satishchandra, Director & Vice-chancellor, NIMHANS released a book on “ Yoga for

Depression” during the event.

Invited Lectures:

One hundred twenty four participants from various fields ranged

from MBBS, PG Students, consultants, AYUSH Doctors, PGs

(Immunology, Microbiology, Pathology, Rheumatology,

Neurophysiology and Radiology) attended the seminar. Partici-

pants have given positive feedback regarding the program.

Forenoon Session

Overview of Immune system & immu-nological methods

Dr. Ravi, Prof & HOD Dept. of Neurovirology

NIMHANS

Introduction to Depression & Effect of Yoga on immunological changes in patients with depression

Dr. Mukund Rao Dept. of Psychiatry

NIMHANS

Yoga & Psycho-neuro-endochrino-immunology

Dr.Raghavendra Rao Head CAM, HCG,

Bangalore

Afternoon Session

Neuroplasticity in depression—Radiological & Biochemical chnages

Dr.Naren .P.Rao Dept of Psychiatry

NIMHANS

Effect of Yoga on neuroplasticity in depression: Radiological & Biochemical changes

Dr. Naveen.G.H Advanced Centre for

Yoga NIMHANS

P A G E 2

“Practicing Yoga is

one of the

attractive options

for promoting

healthy ageing “

Editorial…... YOGA FOR HEALTHY AGEING

Elderly population around the world is increasing rapidly. The life expectancy in India has doubled over the past century to 64 years. Living longer brings along with it different health issues. The prevalence of chronic diseases has increased. Nearly 80% of elderly will have at least one chronic disease. Many have more than one disease. On an average elderly person would be taking 3 to 5 medications at a time. Elderly population is faced with significant morbidity due to medical illness. This has an adverse impact on their quality of life.

Advances in health care have improved the outcome of many of the infectious diseases. The current major health concern for the elderly is due to non communicable diseases like diabetes, hypertension, cardiovascular diseases, osteoporosis, dementia etc. Modernization of health sector has resulted in increasing health care costs that is not affordable for large proportion of elderly population. Hence the major concern of most of the ageing persons is regarding their health. Is healthy ageing possible?

Research on many of the non-communicable diseases has given insight about the role of healthy life style in the prevention and management of these disorders. Healthy nutrition, physical activity, mental stimulation and reduction of stressful environment are some of the factors promoting healthy ageing.

Practicing ‘Yoga’ is one of the attractive options for promoting healthy ageing. ‘Yoga’ as described by ‘Patanjali’ includes 8 components such as Yama, Niyama, Asana, Pranayama, Pratyahara, Dharana, Dhyana and Samadhi. Promoting the practice of Yoga in a holistic manner rather than doing only ‘Asanas’ as a kind of physical exercise is important. This holistic practice of Yoga will promote the positive life style modification necessary for healthy ageing.

Practicing yoga is helpful for improving the physical and mental health. Several studies have shown

that Yoga is helpful in the treatment of many of the chronic medical disorders in elderly like

diabetes, hypertension etc. Also there is a growing evidence for the efficacy of Yoga in the

improvement of subjective well being and Quality of life. There is a need for campaign to promote

the practice of Yoga in elderly. Health professionals can play a big role in it. Many elderly follow

the life style changes only after developing medical problems and after the advice by the physician.

One of the challenges for medical professionals to recommend Yoga as a life style change is the

heterogeneity of Yoga practices available. The experts in the field need to develop standardized

module of Yoga practices suitable for specific population. Also there has to be adequate research

evidence about the effectiveness and safety of the module. Yoga research community around the

globe is taking many steps in this direction. The Advanced Centre for Yoga at NIMHANS is

actively involved in this process. Through one of our research project, we have developed a

module of Yoga for elderly after reviewing the Yoga literature comprehensively and also validating

it with experts’ opinion. We are in the process of studying the effectiveness of this module. We

have also contributed by conducting awareness program about Yoga for elderly. Networking with

various senior citizen forums and other Non Governmental organizations working for elderly

would also help in promoting Yoga for healthy ageing.

S A M A T V A M

Dr. P.T.Sivakumar is an Associate Professor in the Dept of Psychiatry, NIMHANS.

In addition to Yoga Therapy in psychiatric disorders, he possesses research interest in

Geriatric Psychiatry and Metabolic abnormalities in Psychiatric disorders. He has several

publications, awards and conference presentations to his credit.

Dr.P.T.Sivakumar M.D(Psychiatry)

Assistant Professor, Department of Psychiatry, NIMHANS

Yoga Therapy Services for Psychiatric & Neurological Disorders

P A G E 3 V O L U M E 2 , I S S U E 4

Advanced Centre for Yoga at NIMHANS has been offering Yoga therapy for both in-patients and outpatients. 4372 patient/therapy sessions were conducted for a total of 177 patients suffering from different psychiatric & neurological conditions referred from clinical services of NIMHANS, Children and their caregivers admitted at Child & Ado-lescent Psychiatry Unit of NIMHANS. Each patient received yoga therapy session from seven days to one month.

Advanced Centre for Yoga, NIMHANS conducted one month Yoga Teachers’ Training for staff nurses of NIMHANS deputed

from different psychiatric and neurological wards. Since the launch of this program three batches of staff nurses were trained

for about one month covering selected yogic practices, four theory lecture classes about basics of yoga and its role in psychiat-

ric & neurological disorders, and one week of hands-on training in yoga teaching techniques. A total of 27 nurses took benefit

of this Yoga Teachers’ Training program.

As a result, currently these trained staff are conducting classes at various psychiatric including closed wards & neurological

wards. Information about their experiences and barriers to Yoga teaching in the wards were noted through a structured

questionnaire. Advanced Centre for Yoga is conducted a half day refresher course for these trained staff nurses. The refresher

course was attended by about 20 nurses deputed from various psychiatric and neurological wards. Dr.B.N.Gangadhar, program

director, Advanced Centre for Yoga, NIMHANS inaugurated the refresher course. Addressing the staff nurses, he emphasized

the recent studies which strongly recommend yoga based intervention for several psychiatric disorders. He expressed his

admiration for the co-operation of nursing department in Advanced Centre for Yoga, NIMHANS efforts to include yoga as a

ward routine. Dr.Hariprasad.V.R, Senior Research Fellow at Advanced Yoga Centre gave an overview about the different yogic

practices which are found to be useful in psychiatric & neurological patients. Then yoga modules for various disorders were

discussed and questions raised by the participants were answered by Dr.Hariprasad.V.R. The participants were then asked to

demonstrate the yoga practices which they were trained earlier. Dr.Hariprasad and yoga instructor monitored the practical

demonstration.

Refresher Yoga Training for Staff Nurses of NIMHANS

Table - No of patients treated at Advanced Centre for Yoga, NIMHANS

JULY

AUGUST SEPTEMBER

NO OF

NEW

PATIENTS

77

44

56

NO OF

PATIENT/

SESSIONS

1465

1444

1463

0

200

400

600

800

1000

1200

1400

1600

NO Of New Patients 77 44 56

NO Of Patient Sessions 1465 1444 1463

JULY AUGUST SEPTEMBER

P A G E 4

S A M A T V A M

Academic Program: Guest Lecture Series Physiology of Pranayama

By: Dr. Raghuraj, BNYS, PhD (Yoga), Clinical Writer, Accenture India, Bangalore

Venue: Advanced Centre for Yoga, Date: 8th April, 2010

Dr.Raghuraj spoke in detail about the physiological aspects of Pranayama. Quoting references

from the classical texts, he discussed the importance and the traditional way of doing each

Pranayama practices. Referring to the research works on Pranayama carried out by him and

colleagues at SVYASA yoga university, he said uninostril pranayamas have ability to modify

autonomic functions and improve cognitive functions especially in high frequency breathing such

as Kapalabhati. In conclusion, he stressed the immense therapeutic potential of pranayama.

Mrs.Arati Jagan spoke about her research on efficacy of yoga and psychosocial program on coping and burden of caregivers of in-patients with schizophrenia. She gave a detailed account of rigorous process of development, validation and pilot testing of one hour psychosocial program and yoga package designed based on the needs of in-patient caregivers at NIMHANS. 120 consenting family caregivers of in-patients with schizophrenia were recruited and groups of 4-6 caregivers matched on language were randomized into one of the four groups: psychosocial (N=30), yoga (N=30), combined (psychosocial + yoga; n=30) and waitlist (N =30). She gave a brief description about the various scales used to access the out come measures such as burden, coping, knowledge and social support. She concluded saying that though reducing the symptoms of the patients helps to reduce the stress of the caregivers, a yoga program either independently or as a combined intervention may be a useful tool in reducing the stress and burden in caregivers of in-patients with schizophrenia.

Theme: Yoga for Caregivers : the evidence

Chaired by: Dr.Nagendra H R, Vice-Chancelor, SVYASA Yoga University, Bangalore

Date: 3rd August, 2010 , Time: 3.00—4.00 pm

Venue: Advanced Centre for Yoga, NIMHANS

Lecture 1: Efficacy of Yoga & Psychosocial program on coping and burden of caregivers of patients

with Schizophrenia.

By: Mrs. Arati Jagan, PhD Scholar, Dept. of Psychiatric Social Work, NIMHANS

Lecture 2: Effect of Yoga therapy on anxiety, depression and quality of life among caregivers of

in-patients with neurological disorders: Randomized Controlled Trial.

By: Ms. Umadevi, M Sc Nursing, Dept. of Nursing, NIMHANS

Ms. Umadevi started her lecture with an overview about the prevalence of high levels of anxiety and stress and poor quality of life among caregivers of patients with neurological disorders. She stressed the non-availability of quality studies focusing efficacy of yoga intervention as a stress management tool in caregivers. She discussed in length about the methodology of her research work. Sixty subjects were randomized to receive either Yoga (n=30)or waitlist (n=30) .Subjects were assessed using Hospital Anxiety & Depression Scale (HADS) and WHO Quality of Life (WHOQoL BREF). She concluded saying yoga therapy is an effective tool in decreasing anxiety, depression and improving quality of life among caregivers of neurological patients

P A G E 5 V O L U M E 2 , I S S U E 4

Vedic Method of Surya Namaskara

Nama Mantra i.e hyme which is chanted at the beginning of each Suryanamaskara, is made up of four sections grouped to-gether in following fashion.

Pranavakshara (Aum) +

Beejakshara (hram, hrim, hrum, hraim, hraum and hrah) +

Paada from the three rucha (As described previously) +

Name of ‘The Sun’

So in the creation of Suryanamaskara Nama Mantra, 6 beejaksharas (viz: hram, hrim, hrum, hraim, hraum and hrah), 12 paada (Each line of a rucha consist of 2 paada, so 3 ruchas have 4 paada), and 12 names of Lord Surya (viz: Mitra, Ravi, Surya, Bhanu, Khaga, Pushan, Hiranyagarbha, Marichiman, Aditya, Savitr, Arka and Bhaskara) are used. To begin with Surynamaskara Nama Mantra is shorter arrangement of these and evolves into more complex as the worship nears an end. Step 1: The Suryanamaskara Nitya vidhi starts by performing 12 rounds chanting 12 mantras formed out of 12 paada of the Trucha. ‘Aum+1 Beejamantra + 1 rucha+ 1 Beejamantra+ Aum+ 1 Name of the Sun’ So, The First Suryanamaskara is performed by chanting, Followed by, is chanted and 2nd round of Suryanamaskara is performed. Since there are only 6 beejakskara, for the 7th round of Suryanamaskara the first beejakshara is used again and the order is continued till the 12th mantra. Step 2: Next, each Suryanamaskara is performed by chanting 6 mantras formed out of 12 paada of trucha. “Aum+2 Beejamantra + 2 rucha+ 2 Beejamantra+ Aum+ 2 Name of the Sun” Eg: 13th Suryanamaskara is performed by chanting, Step 3: 3 Suryanamaskaras are performed by chanting 3 mantras formed in the following manner out of 12 paada of the trucha. Aum+4 Beejamantra + 4 paada+ 4 Beejamantra+ Aum+ 4 Name of the Sun Step 4: Finally, one Suryanamaskara is performed by chanting Nama Mantra formed by all beejaksharas, 12 paada and all names of the Sun grouped together. Aum+ all Beejamantra + all paada+ all Beejamantra+ Aum+ all Name of the Sun At the end of 4 steps, a total of 22 Suryanamaskaras are performed. By repeating this cycle for 3 times completes one “Trucha Kalpa Namaskara” with 66 suryanamaskaras. { Continued in page no.6 }

Origins of Suryanamaskara (Contd)

P A G E 6

Research Paper 11th Biennial Australasian Schizophrenia Conference ASC 2010 held at

Sydney, Australia from 22-24th September, 2010

YOGA FOR THE NEGATIVE SYMPTOMS OF SCHIZOPHRENIA – NEW PROMISE FROM

AN ANCIENT SCIENCE

Shivarama Varambally1, Rishikesh Behere1, Jagadisha Thirthalli1, Ganesan Duraiswamy2, Rashmi Arasappa1, Venkatasubramanian Ganesan1, Gangadhar N. Bangalore1

1 National Institute of Mental Health and Neurosciences, Bangalore, India

2 Eastern Health, Box Hill, Victoria, Australia

S A M A T V A M

Background: Negative symptoms of schizophrenia may indicate worse socio-occupational functioning and poorer outcome, and respond poorly to pharmacotherapy. Yoga therapy has been found to be effective in stress and depression, which contribute to negative symptomatology. Yoga therapy may be an effective add-on treatment for these symptoms.

Methods: Data was pooled from two randomized controlled studies. The first study [1] had two

groups – Yoga and physical exercise, the second had an additional waitlist arm. Both studies

included patients with DSM-IV schizophrenia who were moderately symptomatic, stabilized on

medication, aged between 18-60 yrs, and giving informed consent. The subjects were rated on the

Positive and Negative Syndrome Scale, Social Occupational Functioning Scale, and the Hamilton

Depression Rating Scale. Subjects in the yoga and exercise groups were trained for one month in a

specific yoga/ exercise module by a trained instructor and then practiced at home for the next 3

months. All subjects were rated again after 4 months.

Results: For analysis, subjects were classified into two interventional groups – yoga or non-yoga.

Baseline demographics and clinical data were comparable across groups. Over 4 months, subjects

in the yoga group significantly improved in negative symptoms (p= 0.001) and socio-occupational

functioning (p = 0.006), without significant differences in positive symptoms and depression scores.

Conclusions: Yoga therapy as an add-on treatment effectively improves negative symptoms and

social functioning in stable schizophrenia patients and maybe a promising and cost-effective treat-

ment option in these patients.

Teertha Shloka:

“Trucha Kalpa Namaskara” is ended with a teertha shloka. Verse:

“Those who perform Surya Namaskara daily, do not face poverty in life (richness of health), one doesn’t face early death or suffer from diseases. Drink the water kept before the Sun.”

{Ref: Origins of Suryanamaskara by Dr.Shivatej Sarva, Sri Ram Prasad kraleti, Dr. Siddharth Shevade and Sri Sudhakar Joglekar.

Origins of Suryanamaskara (Contd from page 5)

Research Advanced Centre for Yoga, NIMHANS P A G E 7 V O L U M E 2 , I S S U E 4

Efficacy of Yoga in Attention Deficit/ Hyperactivity Disorder (ADHD): An open trial

Status: Abstract has been sent for “ 4th World Ayurveda Congress 2010, 9-13th December at Bangalore Effect of Yoga Therapy on neuroplasticity and cognitive functions of patients with depression

Status: Ninety subjects have been recruited for the study. The data from the pilot study is being currently analyzed for publication. Yoga therapy for Mild Cognitive Impairment—fMRI and biochemical correlates

Status: Pilot testing of the yoga package was carried out. Subjects are being invited to the participate in the study through senior citizen forums, elderly homes and paper advertisements. Currently detailed assessments are being carried out for consenting elderly. Effects of Yoga Therapy on Heart Rate Variability in Anxiety Disorder Patients: An Open Trial Status: Seventy patients have been screened. Fifty subjects have consented and have been recruited for the study. Effect of Yoga as an add-on treatment in immunological parameters of patients with depression. Status: Two hundred have been screened. Sixty subjects and 29 healthy controls were recruited for the study. Mentation in Psychosis [SLIMMS]: Prevention Analysis and the influence Psycho tropics and Yoga Status: Patients are currently being screened for this study.

Presentations/ Invited Lectures

• Delivered lecture in the seminar held at NIMHANS on 26th September, 2010 on “ Effect of yoga on neurotrophic factors in patients with depression” . theme of the seminar was yoga on neuro plasticity in depression. ( Dr.Naveen.G.H )

• Delivered two lectures on Naturopathy and Yoga treatment efficacy in patients with HIV/AIDS in

the program entitled “ HIV/AIDS training for nurses under the global fund to fight Aids, Tu berculosis and Malaria” ( GFATM) conducted at NIMHANS, College of nursing, Bangalor ( Dr.Naveen.G.H )

• Delivered a invited lecture “ Role of Yoga in Mild Cognitive Impairment & Dementia ” at workshop on “ Dementia Risk Reduction ” organized by Nightingales Centre for Aging and Alzheimer ’ s, Bangalore on 21st September, 2010. ( D r.Hariprasad.V.R )

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A wise-man accepts

(both) the good and

the bad. He

appreciates the former

by a nod of his head

and restricts the latter

in his throat, just as

Lord Shiva adorned

his head with the

crescent moon and

restricted the poison in

his throat."

Attention Readers

Advanced Centre for Yoga, NIMHANS

is organizing

ONE DAY WORKSHOP ON

“ PRINCIPLES & PRACTICE OF YOGA THERAPY FOR PSYCHIATRIC DISORDERS”

Date: 5th December, 2010

Venue: Advanced Centre for Yoga Hall, NIMHANS

Potential Participants: Yoga Therapists/Instructors, Mental Health Professionals

Registration Fees: Rs 200 only ( 50% off for students). (Participation is limited to 75 persons only)

To register Kindly contact Dr. Hariprasad.V.R / Mrs.Lalitha @ 080-2699 5730/ 2657 6465

Email: yoga.nimhans@gmail.com

3rd Floor, New DPNR Building

Opp State Bank of Mysore

National Institute of Mental Health &

Neurosciences, Hosur Road

Bangalore 560029, Karnataka

Phone: 080 - 2699 5730

Fax: 080 - 2657 6465

E-mail: yoga.nimhans@gmail.com Advanced Centre for Yoga

(Mental Health & Neurosciences)

SamatvamSamatvamSamatvamSamatvam is published by Program Director, Advanced Center for Yoga, NIMHANS, Bangalore. Please feel free to write to us about your suggestions

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