As a yoga therapist specialsing in yoga treatments for anxiety and post traumatic stress disorder, I find many of my clients are already taking anti-depressants as a result of their anxiety disorders and traumatic experiences, given that depression can be a side effect of the two conditions for many (although obviously, depression arises independently of anxiety and trauma too). Many of my clients seem to feel no joy for their obvious achievements and having sought various treatments before coming to me, I guess I am interested to know how come their medication suppresses the anxiety to a certain extent, prevents them from sliding into deeper depression but masks their ability to feel hope, happiness and for some, heartfelt love for their families.
Trauma survivors are often stuck in fight and flight as a result of the terror encountered at the time of the threat (which may have been a one off life-threatening or certainly frightening event, or may have involved threat and terror over a prolonged period). However, many are hypo-aroused instead, which is another disregulated nervous state that has either resulted from exhausted physiology following prolonged fight and flight, perpetuating cortisol production that the adrenals just can’t suppress, (eventually causing hormonal chaos), or is the result of the freeze response they encountered in the instance of the trauma. This latter response can in some circumstances suppress any other cortisol and testosterone production from reasserting themselves to a normal level. In both circumstances, the hormonal imbalance, coupled with sustained painful and negative beliefs and thoughts (which themselves will further disrupt healing), can induce feelings of loss and fatigue, along with desolation, dejection and sadness.
One of the treatments I offer at Paths to Peace for trauma, anxiety and fatigue, as well as depression, is marma therapy, an ayurvedic approach that is similar to Chinese acupuncture in some ways, although, we use hand touch only and some massage strokes rather than needles. Similar to the idea of meridians in Chinese medicine with certain points on the body termed acupressure points that when palpated or penetrated by needles enliven muscle tissue, organs and glands, marma therapy works along the same lines, although meridians are called nadis in sanskrit (the language used in Ayurveda and yoga) and the acupressure points are called marma points. Some of the marma points located in the legs, abdomen and feet are the same as those in Chinese medicine but there are differing opinions as to whether they correlate to the endocrine glands and organs in the same way.
Palpating the marma points can help regulate hormone production in certain instances, if the endocrine system is functioning well apart from the hiccups of disregulation arising from the trauma or anxious state (hormonal imbalances arising from thyroid or pituitary conditions are of course a matter for the doctor). Furthermore, touch therapies such as marma are often coupled with talking therapy as naturally, the therapist must ask questions relating to health, emotions, family circumstances and life events that are relevant to the health conditions (mental and/or physical). Such a process of relaxing touch therapy either following initial discussion or during questioning, is conducive to helping the nervous system de-escalate, whereas purely talking about a traumatic or stressful event will usually increase cortisol production and potentially re-trigger fight and flight or cause the client to dissociate. Adding touch in a therapeutic sense is becoming recognised in some areas of psycotherapy and certainly a number of psychiatrists and psychologists in the USA such as Bessel Van der Kolk and Peter Levine are involved in research into alternative approaches including massage, yoga and mindfulness in the treatment of mental health.
Here at Paths to Peace, marma therapy is often the first port of call for anxiety and PTSD, given that cortisol and testosterone levels may be causing disturbances in the body, particularly in the heart and abdomen, as these are the two areas where cortisol in particular remains (giving rise to those awful sensation of a tightening chest and panic in the guts). Many people will feel calmer following a course of four sessions but may then benefit from compassion focussed therapy and yoga therapy, aimed specifically at PTSD and anxiety.
However, I began with musings about depression and why my clients are not feeling overjoyed when they are coping so well with their underlying issues of fear and trauma, recovering from feelings of nausea, sleeplessness, panic attacks, etc. having had successes in their treatment programme – and are perhaps on a dose of prescribed anti-depressants or anti-anxiety pharmaceutical drugs. The anti-depressants may well be a cause in some instances, as it seems that a named brand that is favoured by GPs often, seems to have the effect of covering all emotion (positive and negative) in a kind of blanket type fashion. Given that I am not a pharmacist, I don’t know enough about how the drugs work to fathom out why this could be. You may have a medical background and be able to shed some light here. My feeling is that while it is a relief for many people to feel less emotion and bodily sensation, especially those associated with fear and panic, the emotions that are nourishing them in normal circumstances and obviously are endorphin promoting, won’t be recognised by the pituitary gland or hypothalamus.
In the next blog, I will be looking at ways to increase serotonin with yoga therapy practices and using some techniques based on Professor Paul Gilbert‘s work on smiling and yawning.
These techniques are taught in the Paths to Peace Garden Yurt in Boxted, Colchester, Essex in the form of a ten week course. The next course starts in February 2018. Contact Paths to Peace on firstname.lastname@example.org for bookings and further information.