Mental health issues are epidemic among today\u2019s youth.\u00a0 Recent studies suggest that up to half of all teens have complaints related to stress, anxiety, and\/or depression.\u00a0 In the United States, we have an unprecedented rise in the rates of child and teen suicide. The American Academy of Pediatrics is now recommending universal depression screening for all teens, a recommendation that promises to recognize patients at risk of severe mental health disorders, but also to increase the demand for mental health services among your patients and their families.\u00a0 In addition to patients presenting with primary mental health disorders, many patients with acute or chronic illness have difficulty adapting to their diagnoses or disabilities.\u00a0 Mental health services are needed to assure that such patients are able to achieve the best health possible.<\/p>\n
Medications are available to ameliorate mental health disorders, and many can be safely used in the primary care setting; individuals with more severe disorders may require referral to competent mental health professionals.\u00a0 However, many of these medications have unwanted side effects or are not familiar to the primary care physician, and mental health professionals are scarce in parts of Virginia.\u00a0 For these reasons and others, primary care physicians require additional approaches to respond to the challenges imposed by a growing number of patients requiring mental health support.<\/p>\n
Mindfulness practices have ancient origins in many cultures.\u00a0 Such practices share the essential effort of directing awareness to the present moment.\u00a0 Mindfulness practices, in a sense, allow one to witness, or observe, their thoughts and emotions, rather than immediately reacting or getting caught up in them.\u00a0 The practices help one understand that the individual is not simply his or her thoughts or emotions, thus empowering the patient to control negative ideation, or accepting such thoughts with grace and detachment. When undertaken regularly, mindfulness practices have been shown to confer an extraordinary number of health benefits.\u00a0 Mindfulness practitioners report reduced anxiety and depressive symptoms, improved cardiovascular health, better sleep, and better ability to adapt to social and personal challenges.\u00a0 An increasing number of studies have shown that yogic practices, such as mindfulness meditation, can help ease stress, depression and anxiety, and in fact, may be just as effective in treating symptoms as antidepressants (1).<\/p>\n
Western society has not traditionally embraced mindfulness practices, a fact which may contribute to the growing mental health epidemic.\u00a0 However, there is a growing movement to introduce simple methods of present moment awareness, techniques which can be incorporated into the daily life of even young patients.\u00a0 The most common practices include meditation and contemplation, mindful breathing, mindful walking (or eating, or in fact any action), deep breathing techniques and yoga asanas (postures and mindful movement).\u00a0 Meditation is difficult for most western pediatric patients, who are more used to an environment of near-constant stimulation, but active mindfulness can be taught and embraced by nearly any child of school-age and beyond.\u00a0 It should be noted that Yoga is not a religion, but can deepen and benefit anyone in any religion.\u00a0 Yogic practices do not conflict with personal beliefs.\u00a0 Yoga is simply a tool that can transform oneself and promote conscious connection with oneself and the world.<\/p>\n
Yoga is a particularly powerful mindfulness practice for promoting teen mental health (2). This ancient practice is markedly effective in improving health and well-being, provides stress relief and emotional regulation, and helps teens learn self-care. Self-care and learning to self-regulate are vital tools against mental illness and substance abuse, promoting a healthy body and mind (3). Recent research has shown that yogic and mindfulness-based practices can positively impact the body in many ways, including helping to regulate blood glucose levels and keeping the cardiovascular system healthy. \u00a0They have also been shown to have important psychological benefits, as the practice of yoga can help to increase alertness and positive feelings, and decrease negative feelings of aggressiveness, depression and anxiety (4\u20139).<\/p>\n
Physiologically, mindfulness practices like yoga and meditation work by modulating the body\u2019s stress response systems (10).\u00a0 They can help to calm the nervous system by enhancing parasympathetic tone and bringing the autonomic nervous system into balance.\u00a0 These practices decrease physiological arousal by reducing heart rate, lowering blood pressure, easing respiration and increased heart rate variability. \u00a0Yogic practices have been shown to increase the body\u2019s levels of natural \u201chappy neurotransmitters\u201d such as GABA, serotonin, melatonin and oxytocin (11). \u00a0The practices can calm the limbic system and enhance the work of the prefrontal cortex, helping to regulate impulse control including how one reacts to stress, regulates emotions, enhances executive function and decision making.\u00a0 Yoga decreases the size of the amygdala, which is the brain\u2019s \u201cthreat\u201d center \u2013 responsible for fear, anxiety and stress (12-15). The body goes through several physiological changes in response to stress \u2013 in fact >1400 biochemical reactions occur in response to stress, which subsequently results in alteration of our autonomic nervous system.\u00a0 If continued, these responses can cause significant perturbations, including inflammation and chronic illness.\u00a0 Signs of stress include\u00a0 apathy, lack of energy, difficulty making decisions,\u00a0 difficulty “keeping track” of things, feeling on edge,\u00a0 change in eating habits, sleeping more than usual or difficulty getting to sleep, insomnia, being more emotional, and substance abuse. Of note, symptoms of stress include mental illness and many other chronic illnesses, including chronic back pain, tension headaches, migraine headaches, neck pain, gastrointestinal problems (pain, diarrhea, IBS), palpitations, depression, anxiety, cognitive inhibition, impaired memory and weight gain.<\/p>\n
Of particular importance as well is the fact that many typical habits of today\u2019s teens include enormous tech consumption, screen time, social media and less time spent in nature and outdoors.\u00a0 This prevents them from \u201ctruly being with themselves\u201d and can lead to a feeling of disconnection from themselves and others. Yogic practices are about learning to pay attention \u2013 to one\u2019s self, one\u2019s body and to others. This can lead to a deeper awareness of one\u2019s internal state, and can help heal this disconnect.\u00a0\u00a0 In addition, yogic breathing can calm the nervous system very quickly, and studies have shown that teens can use them effectively to relax before exams, help them sleep, and calm them down when they are angry. When done regularly, focused and controlled breathing can help to control one\u2019s changing emotional state and stress level, allowing the mind and body to relax and move towards healing, resilience, connectedness and wholeness.<\/p>\n
Yoga practice improves physical fitness and strengthens the respiratory system, making one feel stronger and more in control of one\u2019s body.\u00a0 It is not surprising that yoga is rapidly growing across America.\u00a0 Yoga studios are now found in most towns and cities, and yoga teachers can be found in studios, on the internet and on television.\u00a0 In addition to active mindfulness, yoga can also serve as a safe and effective exercise for nearly anyone, and a way to manage the many disorders caused by tightness of joints and muscles.\u00a0 In fact, in February of 2017, the Annals of Internal Medicine <\/em>revised its clinical guidelines for chronic lower back pain to include yoga, mindfulness-based stress reduction and other non-pharmacologic treatments as front-line therapy for chronic lower back pain (16).\u00a0 The availability of yoga to Americans will lead to the long-term integration of this practice into the lives of many individuals, with lasting benefit.<\/p>\n Although yoga is available to nearly anyone, there are individuals for whom yoga offers both special opportunities and special challenges.\u00a0 Patients with physical, or even mental, disabilities, for example, may not be well-served in the average commercial yoga studio.\u00a0 Conventional yoga teacher training does not prepare the teacher to deal with special patients, nor to maximize the effects of yoga for medical diagnoses.\u00a0 Thus has been born the specialty of Yoga Medicine, which offers the safest and most effective way to serve the patient with physical or mental disabilities.<\/p>\n UVA is among the first institutions in the US to offer a formal Medical Yoga Clinic, and one of the very few to offer this specifically for pediatric patients.\u00a0 In the Medical Yoga Clinic, physicians with special yoga certification prescribe and lead practices that can improve a wide range of disorders, in ways that are safe and non-invasive.\u00a0 Once taught, patients can perform the practices on their own, with follow-up as required by the clinic.<\/p>\n Among the more tractable disorders for the Medical Yoga Clinic include anxiety, mild depression, chronic pain, musculoskeletal complaints, asthma, ADHD and high-functioning autism. Medical Yoga intervention may be integrated with any current therapy or medical regimen. Yoga practices with particular focus on mindfulness offer a safe and effective intervention for a growing number of pediatric patients.\u00a0 For a thorough review of Medical Yoga Therapy, see the following article (17).<\/p>\n Referrals to the Medical Yoga Clinic at UVA can be made by calling 434-924-5321.<\/p>\n <\/p>\n Ref:<\/u><\/p>\n \u00a0<\/strong><\/p>\n \u00a0<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":" Mental health issues are epidemic among today\u2019s youth.\u00a0 Recent studies suggest that up to half of all teens have complaints related to stress, anxiety, and\/or depression.\u00a0 In the United States, we have an unprecedented rise in the rates of child and teen suicide. The American Academy of Pediatrics is now recommending universal depression screening for […]<\/p>\n","protected":false},"author":338,"featured_media":1944,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[6],"tags":[71],"class_list":["post-2325","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-features","tag-is8n"],"acf":false,"yoast_head":"\n\n