Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d’appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé
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Objective: Patients with depression frequently experience persistent residual symptoms even with optimal interventions. These patients often use complementary treatments, including yoga, as a preferred alternative or adjunctive treatment. There is evidence for the benefit of yoga for depression, but this has not been rigorously evaluated, particularly in bipolar depression. We aimed to determine the feasibility and benefit of manualized breathing-focused yoga in comparison to psychoeducation as augmentation to pharmacotherapy for improving residual symptoms of depression in unipolar and bipolar patients. Methods: Using a randomized single-blind crossover design, 72 outpatients with unipolar or bipolar depression were augmented with the two 8-week interventions at separate times, as add-ons to current first-line antidepressants and mood stabilizers. The primary outcome measure was the Montgomery-Åsberg Depression Rating Scale (MADRS). Due to the high dropout of participants after crossover at Week 8, analysis focused on between-group comparisons of yoga and psychoeducation during the initial 8 weeks of the study. Results: There was a significant decline in depressive symptoms, as measured by the MADRS, following 8 weeks of yoga. However, there was no significant difference in MADRS ratings between intervention groups. Similar improvements in self-rated depressive symptoms and well-being were also observed across time. Conclusions: Both yoga and psychoeducation may improve residual symptoms of unipolar and bipolar depression as add-on to medications. In-class group sessions and long study durations may reduce feasibility for this population. Larger trials with parallel group design and shorter duration may be more feasible.
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In Ravindran et al.'s study focusing on fast-paced breathwork in unipolar and bipolar depression, a small subgroup of participants reported side effects such as hot flushes, shortness of breath and/or sweating.
“Nonetheless, regarding safety and tolerability, a small subgroup of participants in Ravindran et al.’s study71 focusing on fast-paced breathwork in unipolar and bipolar depression reported side effects such as hot flushes, shortness of breath and/or sweating.”
From Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials (2023) · cites this paper as [71]
These participants opted to continue the intervention and no participants dropped out of the breathwork group due to adverse effects.
“However, these participants opted to continue the intervention and no participants dropped out of the breathwork group due to adverse effects.”
From Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials (2023) · cites this paper as [71]
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- Authors
- Ravindran, A. V., McKay, M. S., Silva, T. D., Tindall, C., Garfinkel, T., Paric, A., & Ravindran, L.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Toronto (CA)
- Native Child and Family Services of Toronto, Ontario, Canada
- Corresponding author
- Ravindran, Arun V.
- ORCID
- Ravindran, Arun V.
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2020-07-17
- Volume
- 66
- Issue
- 2
- Pages
- 159-169
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- PMC
- PMC7918867
- OpenAlex
- W3042697569
- Cited by
- 22
- References
- 46
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 1
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Anonymous Donor
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- major depressive disorder, bipolar depression, residual depressive symptoms, adjunctive therapy, psychoeducation, antidepressants, mood stabilizers, feasibility, well-being, complementary therapy
- MeSH terms
- Antidepressive Agents, Bipolar Disorder, Humans, Respiration, Yoga, Single-Blind Method
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