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| Hi all, a friend of mine has confided that her level of anxiety has peaked to the point that she is now having to rely on sleeping pills (not sure what type) to get to sleep. She also confided that she has now started having regular panic attacks because of this anxiety. She told me that without the sleeping pills, she does not get to sleep at all, and then spends a couple of days with a sort of knot in her stomach and suffers from panic attacks...
I was trying to recommend alternative methods of controlling this anxiety so that she might successfully fall asleep. She claims she has tried relaxation before without success, as well as natural remedies (don't know what - something she got at the natural health store).
I don't think she has any interest in taking on a complete yoga practice, but I thought that perhaps she could still learn to practice savasana or other meditation techniques to regain some control and perhaps be able to think more calmly about the things that are making her anxious. There isn't much that I can tell her myself about the subject, although I could demonstrate and explain basic seated meditation... Is there some good resource that you could direct me to? Perhaps a book, a DVD, or an audio CD that guides a beginner through the steps of relaxation? Or can you suggest some specific asanas that a beginner could practice on their own in order to help still the mind?
Do you know whether such yoga practices can successfully help someone overcome panic attacks and anxiety disorders? I'd really love to help her and give her tools so that she can wean off the drugs. I think she will be receptive to this as she is concerned about having to take the medication.
Thanks for any tips and suggestions.
sp
Edited by slowpie6 2007-01-20 8:23 AM
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| Here's an article I found when I did a quick search at YogaJournal.com for anxiety. They recommend pranayama, which was my first thought as well. A while ago I remember reading somewhere once about how to settle into a simple countdown breathing meditation (pretty much Meditation 101) but I don't remember where I had read it. The gist of it was this: - Sit comfortably with eyes closed in a quiet place (floor, chair, anywhere, but preferably not lying down because you might fall asleep).
- Slowly inhale and mentally count 50.
- Exhale and mentally count 49.
- Later, rinse, repeat ;)
- Once you reach 25, only count on the exhales.
- If you get lost in the numbers, it's not important, just focus on following the breath and pick up in the count again wherever it seems you were.
- The length of the inhales and exhales should be long enough to eventually calm you, but not so long as to make you feel like you can't catch your breath -- you don't want to cause more panic and anxiety! Long deep breathing is something you want to work up to, never rush right into, no matter how skilled or inshape you might be.
- There is no wrong way to do it, so no worries there, especially since your always have your breath with you; it's yours, so enjoy knowing it can help you find peace.
I remember the first few times I did this meditation, my mind would start to go all over, but then I'd remember to just follow the sensation of breathing as my focus, and then I'd return. (You waver, you return, you waver, you return, it's the nature of the mind.) I don't think I ever even made it down the entire countdown to 1, but again, that doesn't really matter. It's the focus that's the goal, not the breathing a certain number of breaths. You stop when you feel you're complete, no rules there either. And if you hate it, just leave it for that day, and maybe come back the next. It's all OK. Hope your friend feels better. |
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| Thanks for your encouragement OM. You're suggestion on the deep breathing had me thinking about a meditation we did at the end of one class... I seem to recall we did this with ujjayi breaths, not just regular deep breaths, but my memory is fuzzy... After preparing ourselves for seated meditation (we go through seven steps to do this, bringing awareness to different parts of our body in this way), my teacher had us doing a cycle of breaths that involved first inhaling through the right nostril, then out thru the right, then in thru the left and out left, then both nostrils. After a few rounds of "practice", we were to do these cycles while counting down from 99, and if we lost track of the numbers, we were to start over at 99. I think we were suppose to count each complete cycle, not each breath, but I might have been mistaken. I presume that the reason we were to start the countdown over was to force a deeper concentration, so that maybe in time, a person could actually do this all the way down to zero. So maybe I can try to show her how this works too, although it might be easier for her to start with just simple deep breathing without the added concern of the nostril thing, which I suppose might be frustrating if you feel like you can't do it (I personally have the feeling that I am doing it, but it might be in my head - although the teacher said that it was okay if we were doing it only in our imagination and that eventually, we'd actually be able to do it...).
So I'll start by telling her about that. I'm sure other folks have other ideas, I'd appreciate more help... I think my friend is at a point where she has given up on overcoming this, as she is currently spiraling deeper into panic, and nothing she has tried on her own has helped, so the more options and ideas I can come up with, the better it will be I think. Hopefully one thing or another will work for her.
I was thinking of also recommending that she create a space for herself where she can do this. I know that for me, the ambiance set at the studio has greatly affected me and I've taken some of those ideas with me and started using them at home. The teachers light tea light candles and burn incense before class begins while we are individually relaxing, stretching, and centering ourselves. At the end of class during savasana, they also play some gentle music with chanting in sanskrit that is quite soothing... not sure my friend would be interested in that, mind you. Anyways, I find it very peaceful and relaxing. I was also thinking of other things that are not yoga related, like specific types of herbal teas, or scented oils for aromatherapy, but I don't know much about that either. If you have ideas in respect to that, I'd welcome it too. Perhaps I should ask that in a different forum though...
Thanks, sp |
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| OM, thanks for the article, I found it helpful and I think I will print it up for my friend. In fact, what I think I want to do is to put together a little basket of goodies that I can give her so she can explore the different options with regards to meditation and relaxation. So far it would include the article you found for me, some incense and tealights, and hopefully if I get ideas about this, some essential oils and teas - but I'd rather not just get the basic camomile and lavender, since everyone already knows the effects of those and I assume she's tried them... I'd like something different, which is why I'm hoping for some suggestions.
The article mentioned those eye pillows that I've seen around yoga stores and classes, and said they could be particularly helpful. Can any one give me feedback on those things, and in what way they have enhanced your meditation or relaxation? Perhaps I could make her one, and even scent it with some sort of aromatherapy oil... but maybe that's not such a good idea since it's going to rest on her eyes, not her nose. Let me know what you think.
sp |
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| Hm, maybe I could also throw in a CD of sounds of nature or something. Like waves, or forest sounds. Or rain. Or birds chirping... She'll probably find that silly, but it might work for her. And she might be better able to connect with that than she would with the yogic chanting that we listen to in class.
sp |
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| Errrg, #4 on my list should read "Lather, rinse, repeat", not "Later, rinse, repeat", but I'm sure you got my meaning there. Sorry about the typo, hate when that happens! |
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| The alternate nostril breathing that you described is a variation of nadi shodhana, a pranayama practice that happens to be one of my favorites. Except in this version you actually close off the nostrils (one at a time) with a finger of the right hand: - close off right nostril with the thumb as you inhale left
- close off left nostril with ring finger as you exhale right
- keep left closed as you inhale right
- close off right as you inhale left
- repeat (lathering and rinsing is optional ;) )
Your pointer and middle fingers can stay tucked into your hand in a loose fist, or be gently touching the third eye point (the pinky isn't involved here). Four to five rounds should be sufficient, finishing as you exhale left to breath normally. As you progress here you could retain the breath as you switch sides, but I wouldn't go there as a beginner, certainly not without a teacher to guide you. Alternate nostril breathing helps to balance you, since the left side breathing is cooling and right side is heating. The version you described is to visualize breathing only through one nostril or the other without actually holding the nostril closed, yes? Much harder to accomplish, I believe, especially for a beginner. Though it's much less conspicuous when done in a public place (on the bus, waiting on the checkout line)! I think it's fabulous that you want to help your friend so much, I really do. But sometimes an overabundance of help and suggestions might actually overwhelm someone even more, especially if their issues happen to be being overwhelmed by life. Maybe one or two simple suggestions for breathing would be great for her, especially if you would be with her to help her learn how to do it. Though for some being left alone with materials and ideas is best for them, do things in their own time, so it really does vary. I think the best thing for you to keep in mind is that you convey to your friend that there's no pressure on her part to "perform" or do anything at all ('cause isn't that the goal of relaxation here, just to be?). Just keep thinking positive thoughts toward her, even if she doesn't take any of your well-intentioned advice: may she be happy, may she be healthy, may she be free from suffering. Good luck. OM |
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Expert Yogi
Posts: 5098
 
Location: Somewhere in the Mountains of Western NC | OrangeMat - 2007-01-20 2:08 PM The alternate nostril breathing that you described is a variation of nadi shodhana, a pranayama practice that happens to be one of my favorites. Except in this version you actually close off the nostrils (one at a time) with a finger of the right hand: - close off right nostril with the thumb as you inhale left
- close off left nostril with ring finger as you exhale right
- keep left closed as you inhale right
- close off right as you EXHALE left
- repeat (lathering and rinsing is optional ;) )
I would like to point out that this is a very common Pranayama practice. Always end this pranayama by exhaling the left side. Your original post says to close off right as you inhale left. I changed it above, notice the caps. Also, when you inhale, it is better to try and hold the breath for as long as possible and what is comfortable, then exhale. You build up to the amount of time to hold the breath, slowly. This is done at your own pace and what your body can handle. It's not something that you should be alarmed at, you may not be able to hold very long in the beginning...honor that and become aware of it. Then find some consistency with it. That is how you benefit from Pranayama and this little exercise can help you with the consistency of your breath, if you let it. Your inhale should be held longer than your exhale, but at the same time, your exhale should be slow and smooth. Don't rush it. You should build your practice this way to get the most benefit from this type of Pranayama. This is how I was taught. I go crazy when I'm in studio where they are doing this breathing so fast that I get dizzy. This is when I back out of the practice and do it alone. That is also NOT how this should be performed, although, is in fact how most do anyway. You should sit in lotus position, with your left hand facing up in your lap. Right hand let it rest on your right leg. When you are done, place your finger under your nose and exhale through both nostrils. You can figure out at this point which side of your body is out of balance, by the amount of air that is being exhaled. Just notice it. You can either continue to keep practicing, or just notice and be aware next time what's going on. Sometimes it will balance out with more practice, although, sometimes not.
Edited by Cyndi 2007-01-20 3:09 PM
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| There is an interactive video called The Wilde Divine It uses biorythems. Check it out.
M. |
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| You are absolutely right in your correction of my typo re the last step exhale. Thanks for pointing it out!
Edited by OrangeMat 2007-01-20 4:14 PM
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| I guess there are lots of variations to this practice. I'm surprised to hear that it's done quickly at your studio, because that's definitely not how I was taught either. Though I've never heard of the inhale being held longer than the exhale (either the same or the exhale is longer), but maybe it's done differently to achieve different results, I don't know. I am still very new at this (only practicing 2 1/2 years and halfway through my teacher training). Also, I was taught that the left hand is in gyan mudra (thumb and index finger touching), palm up, on the left knee, while the right hand does the nostril blocking as I had described. You can sit in lotus or sukhasana, or even vajrasana or virasana, which ever is the most comfortable in keeping the spine straight. I've never heard of the part that you describe when you finish, to test the left and right balancing. Very interesting. It just fascinates me to no end how much is out there with something as "simple" as just breathing. Again, thanks for fixing my typo. I really hate when that happens!
Edited by OrangeMat 2007-01-20 4:30 PM
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| Much to the chagrin of my peers I am sure, I am going to discourage you.
A better way to say it is "paradigm shift" as I have no intentions to take away your courage.
It sounds to me as though the person you mention has already found her own resolution. So I'm not sure who's interested in an alternative, you or her? It sounds to me as though you're more invested in alternatives.
I realize this is a tough perspective to swallow.
Your friend may have just wanted to be heard when confiding and we all know how trecherous the "fixing" waters can be. Do we know she's asking for help or intervention?
Of course there are ways to deal with anxiety through a robust yoga practice, not through some simple asanas shared from friend to friend. It's a serious isssue requiring serious remedy. It's complicated by prescription meds. You have to start the work with the student and be very carefull about the hows and whens of weening themproperly off the medication.
If she's having anxiety attacks so severe that she is depriving of sleep then I would say simply telling her "pranayama" and giving her a handout , pamphlet, or dvd would not be remedy. It might feel better but I don't think it is close to approaching "remedy".
Edited by purnayoga 2007-01-20 5:36 PM
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Expert Yogi
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Location: Somewhere in the Mountains of Western NC | OM, Sorry about the right hand location...I went from Pranayama to sitting meditation, mentally, while I was typing. OOPs. Yes, use your right hand with your nostrils...duh! What's the deal with these instructions...I'm getting so friggin confused,  YES, there are so many variations to these Asana's and Pranayama's. As for the length of time of holding the breath on the inhale/exhale...there is a way to calculate it, I'll have to go back to my reference to give you the details. It's not convieniently located at this moment. It's something that I do naturally due to the practice, but there is a 'science' behind it and the way it is taught in the beginning. Also, sometimes we really do not need to know the details about our anxiety/insomnia/panic attacks, what causes it, the reasons. I truly feel that by practicing these simple pranayama's and doing the yoga asana's, these kinds of symptoms seem to disappear and vanish on their own..like magic. I think sometimes people tend to put too much energy and focus into their situations, when they really just need to learn how to relax and just simply breathe!!! Take care,
Edited by Cyndi 2007-01-20 10:48 PM
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| I've been told by my instructors that the practice of relaxation and various little details (like the position of the hands) varies from one tradition to another. We have been given the choice of cupping both hands in the lap (right hand beneath, if I recall... this is from another tradition that I couldn't name), or to hold index and thumb together with hands resting on the knees upwards, or my teacher's prefered way which is simply resting the hands, fingers towards the ground, over the knees. The idea, from what I have been taught, is that we must find a comfortable position. In this light, we are also told to sit comfortably, and if that is not lotus (the ideal position) then so be it. We've been shown other proper ways to sit. If your body is uncomfortable, it will interfere with your relaxation... We also do not practice this alternating nostril thing with any fingers involved; instead, we are supposed to focus on alternating the nostrils in our mind, whether it is actually happening or not is secondary to the focus we put on thinking about doing it - in time, apparently, we can actually control the passage of the air, physiologically. But it's all a question of minute differences that are not of a major impact on the effects of the practice, I think.
Purna, your concerns about whether my friend actually wants the help are justified. However, I know that she is seeking alternative methods because she has brought this up to me in the past, asked me to talk to my mother (who is a pharmacist) about the harmful effects of pharmaceutical aids to help her overcome her problem, and has expressed serious concern about having had to resort to medication which she considered as a final solution. She is worried about the possible effects and about the fact that she can not seem to acquire the coping skills or mechanisms to deal with this on her own. When she discussed it with me yesterday, I told her about my idea that yoga might help and she was interested in the possibilities. I told her I would try to find info, so she knows this is coming. I completely agree with you, on the other hand, that this is a serious problem that handouts or breathing techniques cannot fully conquer, but if it can help her move towards recovery a bit, then I would like to try. And certainly I would not tell her to take or not take any medication, that is something that requires the following of her doctor.
About the lengths of the inhalation or exhalation. The article that OM referred me to suggests that varying this will have different effects. Lengthening the exhalation is the way to handle anxiety, apparently. I seem to recall that they do not suggest holding the breath, but rather simply noticing the silence that follows the end of the in/exhalation, and then letting the breath come to you (or out of you). The longer inhalations were recommended for treatment of depression. But this is all simply repeating what I read.
And finally, I really agree with Cyndi's final comment about the power of breathing. I hope that I can help her learn to just relax and breath... and even if this doesn't really solve her problem, I think it can not do any harm to try and it should bring her some positives, if only momentary.
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Expert Yogi
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Location: Somewhere in the Mountains of Western NC | OM and Sloepie, This is the deal with the Pranayama practice that I mentioned in my earlier post. This Pranayama is called Sukha Purvak Pranayama. It has 3 parts, Purak (inhalation), Kumbhak (retention) and Rechak (exhalation). It is said, and I quote, that if you do this practice on a regular basis, "it bestows radiant health, a powerful memory, an abundance of energy, a lustrous face, a magnetic personality, peace of mind and purification of the heart. It is very effective in arousing the mystic powers of the spirit and is one of the most important Pranayamas for your practice." For beginners, you should practice this in five cycles and gradually increase it to thirty in one sitting. Notice I said gradually, and please take your time so that way you get full benefit. Your inhale, retentions and exhales should be comfortable, not strenuous and no strain. There should be a steady, rhythmic cadence for each inhale, retention, and exhale. The period of retention should be four times longer than the inhalation and twice that of the exhalation. For example, if you inhale for 8 counts, you should retain for 32 and exhale for 16. The ratio between inhalation, retention and exhalation should be 1:4:2. For beginners, you can use the ratio of 1:2:1, as you advance you should begin to adopt the ideal ratio. This can take years to reach advancement, depending on the person, their capabilities and their devotion to a regular practice. Your mental focus should be like this; on the inhale you are drawing divine qualities such as mercy, love, forgiveness, peace and joy into yourself, assimilating them as you retain. When you exhale, you expel lust, anger, greed, imperfection, etc. Have fun. This is my very favorite Pranayama. Earlier we talked about how fast this is done in some of the yoga studios I've been to. In the beginning, you'll be real surprised how difficult it is for most people to retain their breath for any length of time. I think this is why in a studio it seems faster. I really feel this should not be a group type practice, it is a very personal one as every individual is different. However, I think teachers could give the instruction, then have everyone practice at their own pace, not to the pace of the group. Then of course, the real practice is at home or alone. |
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Expert Yogi
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| sp - I think you should keep it simple. Complicated pranayama is something to be taught one to one with someone experienced. While I agree with purna that more help is needed for this friend, a few simple asanas and an idea of how to begin to open the chest and breathe might be a gateway for her into yoga. Maybe no more than 5 things - urdhva hastasana, pascima namaskar, downdog, legs up the wall and following the breath in savasana, for example. |
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Expert Yogi
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Location: Somewhere in the Mountains of Western NC | Actually, I wouldn't worry too much about that particular Pranayama style, it's a common classic Pranayama. It's taught by every Swami in the very beginning stages of Yoga. It's also the one with less complications, another words, it's kinda hard to screw this one up, and its a good one to practice, especially when you want to get in touch with your breathing habits, which IMO, is one of the basis of anxiety disorders. |
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| Yeah, I guess the simpler the better, and besides, I am in no position to instruct anybody about any yoga practice, be it prayanama or other, whether it is complex or simple. So I will aim for simplicity. I might also suggest to her that she attend a group meditation session (there is one every Tuesday at my studio that I wish I could try, but unfortunately I work...), so maybe then she can acquire these relaxation skills with the guidance of someone who actually knows what they are doing. Unfortunately, she lives a good ways away, and would have to plow through a great deal of traffic in order to attend, so she might not be interested.
Tourist, there must be some sort of typo because I can't find out what pascima namaskar is, googling it (and any variation of the phrase I can come up with) is not helping. I really don't think I could suggest that she practice downdog, simply because by all appearances I'm personally displaying terrifyingly bad form in this posture. My teachers come to adjust me practically every single time that we do it. Although perhaps it isn't all that bad if you just do it, even if it isn't exactly performed properly? So long as you don't collapse in the upper body, maybe? Let me know what you think... Legs up the wall is probably an excellent suggestion; since we both work as waitresses, we hold a ton of tension in our legs at the end of a busy night. I spend most of my time at home with my legs up in the air, much to the dismay of my hubby, . He's even left a spot blank on the wall about the couch so that I don't knock down his paintings (every other spot is blanketed with his artwork, literally all the way up to the ceiling  ... we need to move into a museum, methinks).
So I guess no one has any ideas about smelly stuff and teas?
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| I googled pascima namaskar and found it right away (a little more than halfway down the page): it's the same as reverse Namaste. Here's another link with more information, if you'd like.
Edited by OrangeMat 2007-01-21 8:05 PM
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| Oy, sorry... I googled it in the images section, which is what I usually go to for quick translating of the poses because I instantly recognize them from seeing them and don't have to look at a gazillion pointless sites... nothing came up that way. Sorry! Should have tried the regular google method.
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| Very well then.
Since the student has an issue involving disruption of the nervous system rather than the circulatory system or respiratory system, though they are certainly in relationship in the body...
I personally do not advise breath retention or breath of fire (or kapalbhati for those who find it different than Breath of Fire). I think these are, at best, questionable with a nervous system disorder.
If this were my student and he/she had anxiety (not depression):
Asana: Sarvangasana, Viparita Karani, Supta Baddha Konasana, supprted Janu Sirsasana, supported Balasana.
Breathwork: simple two-part breathing. The exhalation twice the duration of the inhalation. Do 108 breath cycles. So inhale for 4 exhale for 8, as an example. Keep the ration 2:1. Also the student can do Brahmari.
Nutrition avoid caffeine after 10am. As our students and teachers use the Sunrider nutritional program there are three things to take just before bed; NuPlus, Sunnectar and Ese.
Body Epson salt baths, oil massage of the body, and cranio-sacral treatments.
And as I've said several times, in the three prong approach to helaing through yoga, the student has to do the emotional work too!
Purna, your concerns about whether my friend actually wants the help are justified. However, I know that she is seeking alternative methods because she has brought this up to me in the past, asked me to talk to my mother (who is a pharmacist) about the harmful effects of pharmaceutical aids to help her overcome her problem, and has expressed serious concern about having had to resort to medication which she considered as a final solution. She is worried about the possible effects and about the fact that she can not seem to acquire the coping skills or mechanisms to deal with this on her own. When she discussed it with me yesterday, I told her about my idea that yoga might help and she was interested in the possibilities. I told her I would try to find info, so she knows this is coming. I completely agree with you, on the other hand, that this is a serious problem that handouts or breathing techniques cannot fully conquer, but if it can help her move towards recovery a bit, then I would like to try. And certainly I would not tell her to take or not take any medication, that is something that requires the following of her doctor.
Edited by purnayoga 2007-01-22 12:26 PM
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| Thanks for your suggestions purna, I think they are to the point. I have read various cautions with regards to breathwork that is a bit more "forceful", such as breath retention, and I'm not sure that I want to suggest that to my friend either. Besides, I think what really matters is basic: if she is experiencing a panic attack, odds are that she is hyperventilating, so any sort of attention that she gives her breath and any attempts at slowing it down and breathing deeply and calmly would probably have a beneficial effect. I don't think it has to be terribly elaborate in order to help her. So I'll stick to very basic recommendations when it comes to breath work. If she finds that simple breathing exercises are helpful, she can consider attending a yoga class that is meditative in focus in order to explore other, more elaborate or complex practices.
I would invite her to join me for a class at my studio, but I'm really not convinced that ashtanga yoga would be the best choice for her in her current condition. I'm almost certain that she isn't interested in initiating a complete yoga practice yet anyways, but perhaps finding some beneficial effects from a few restorative poses and meditation and breathing exercises will trigger an interest by showing her other sides of yoga that don't involve attempting to create in intricate marine knot with your limbs.
I think we will have the opportunity to get together for breakfast in the next couple of weeks, so I'll be talking to her about this then... I'll let you know what comes of it and if she's found any of this stuff to be useful.
Thanks again for all the help!
sp |
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Expert Yogi
Posts: 8442
| One simplistic thing I heard (I think it was Shirley MacLaine) was to not even think about your inhale when you are panicky. You WILL inhale - the body won't let you do without oxygen if it can help it. Just lengthen the exhale. That has pulled me through some crazy moments over the years  |
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| I used to get panic attacks. I still do, although not as much. I try to breath yet unless you suffer through this you do not know how hard it is when you get one to remember to do this. Yoga has taught me the value of stillness and when I cannot sleep half Tortoise for about 5-6 mins. it is harderd than it sounds.
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| Hey SP, hope your friend feels better. I can relate to the anxiety!
I don't know much about tea, but as far as smells go, I find lavender is a very soothing herb at bedtime. I've been known to soak in a bath of lavender oil or lavender "bath therapy" from my local co-op when I'm stressed. An oil burner or diffuser with a relaxing scent could be helpful too.
Also, a face steam could help reduce stress levels before bedtime. And it feels great on the skin. I just simmer some water in a medium sized pot, remove from heat, add herbs (lavender or lemon verbena/lemon balm, mint, chamomile), then throw a towel over my head and the pot and breathe.
One more thing, just throwing this out there... Lush massage bars. I think you can order them online. They are bars made of lotions and oils that almost melts on contact with skin. I use the one that smells cinnamonny before bed, but I think they also have one meant specifically for bedtime. Sooooo good.
I hope your friend can fight this out and overcome her anxiety - without drugs. I have been prescribed some meds for anxiety, and I have to say, nothing helps like yoga does!
You're a great friend for making these efforts to help her, best of luck! |
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Anxiety/insomnia/panic attacks
