The Yoga Effect

A Proven Program for Depression and Anxiety


By Liz Owen

By Holly Lebowitz Rossi

With Chris C. Streeter, MD

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Based on cutting-edge NIH studies, a practical, accessible guide to yoga for reduction in stress, anxiety, and depression, with the goal of balanced emotional health.

The Yoga Effect helps readers overcome the de-energizing effects of depression and move into a state of calm and focus. Based on the program developed through three NIH-funded studies at Boston University School of Medicine, these sequences are medically proven to trigger a physical and mental release of fear and worry. The book offers:
  • A customizable prescription for maintaining centeredness, confidence, and balance
  • Straightforward, accessible sequences, with 40 black & white photos clearly illustrating the poses
  • A short, well-rounded practice that includes breath work and poses with clear explanation of how each sequence contributes to physical, mental, and emotional wellness
  • Differing levels of practice for readers’ varying levels of physical abilities
Written with an MD, The Yoga Effect is a proven pathway for cultivating inner strength that can be accessed at any time, offering hope and a solution for anyone looking to transform their mental and emotional health.


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This book is not intended as a substitute for medical advice or treatment. Before beginning any yoga or other exercise program, please consult a physician.

The yoga practices in this book, and in the studies that the book is based on, were created to be as accessible to as many people as possible, so that anyone living with depression or anxiety may find yoga to be a meaningful tool on a healing journey. The Iyengar style of yoga, because of its comprehensive teacher training protocols and its use of props and pose modifications, is the basis of the yoga in both the studies and the book.

In this time of much-needed and appropriate scrutiny of human interactions within organizations and society, we unequivocally state our support for victims and survivors of any form of abuse, both within and outside of the yoga community. Our mission is to promote a sense of safety and encourage self-exploration, recovery, restoration, and self-actualization for all who open this book, and indeed, for all who come to yoga for help.

If you need emotional help, please contact a mental health professional in your area. If you are in crisis, please call the National Suicide Prevention Lifeline (1-800-273-8255) or 911.

The names and identifying details of individuals who participated in scientific research described in this book have been changed to protect their privacy.


In ninth grade, I took my first yoga class, and I have been intrigued by the mind-body relationship ever since—so much so that the opening sentence in my medical school application was, “I want to study the mind, body, soul interface.” This led to a path that included training in neurology, behavioral neurology, and psychiatry in the pursuit of understanding how yoga practices affect how we feel and how yoga might be useful in treating mental illness, specifically depression.

I have long been interested in what I call the “round-peg-square-hole dilemma” of trying to understand yoga philosophy through the lens of Western science, because if both disciplines are correct, they should not be in conflict. I am delighted that Liz Owen, a gifted yoga instructor and my longtime collaborator, along with her writing partner Holly Lebowitz Rossi, have taken the opportunity to meld Western scientific research and yoga philosophy and practice into a book that people can use to understand and improve the symptoms of depression and anxiety.

Over the course of three scientific studies I’ve collaborated on with Liz, we developed a protocol that focused on the yoga postures thought to be beneficial for improving the symptoms of depression. Our first study’s participants had no diagnosis of depression, while the second study involved people with Major Depressive Disorder and added a breathing exercise to the yoga postures. Our third study is a randomized, controlled trial comparing walking to yoga as a treatment for depression. All of these studies used magnetic resonance imaging (MRI) technology to measure chemical changes in the brain before and after the yoga practice. Our approach has allowed us to observe improvement in mood in a healthy population and improvement of depressive and anxious symptoms in individuals diagnosed with depression. This book provides a practical manual that is based on the program Liz and I developed.

Through my collaboration with Liz, over the course of more than a decade, I had the privilege and honor of also collaborating with many wonderful and skilled yoga instructors, including Patricia Walden, an internationally recognized expert in the teaching of the Iyengar method of yoga, who has long advocated for using yoga to treat depression.

Although it is my observation that the different schools of yoga are more similar than different, I chose the Iyengar method for the studies. Iyengar yoga instructors are required to undergo a rigorous training and certification process, which leaves them highly skilled in how to modify the postures to meet the ability of each student, frequently using props such as blankets and blocks. This allows the protocol Liz and I developed to be accessible to a broad audience, amplifying the potential for its widespread use and benefit.

Yoga is not a substitute for antidepressant medications, but the addition of a yoga practice to a treatment plan incorporating antidepressants can enhance and expand your toolkit of treatments. People in the United States are practicing yoga in greater and greater numbers, and there is considerable evidence that they use it to treat medical problems as well as to foster overall wellness. I look forward to working on more multidisciplinary studies that will add to the current body of evidence on how to integrate yoga into medical treatment.

I hope that you find this book as accessible and helpful as I did. It melds the findings of Western science and yoga philosophy in a way that is both useful as a guide to practice and illuminating in terms of understanding why a yoga practice can foster an emotionally healthy lifestyle.

Chris C. Streeter, MD

Boston, Massachusetts


How to Use This Book

Living with depression and anxiety is challenging enough—this book is meant to help ease your symptoms, not add to your mental load. To this end, I have organized the book in a way I hope is accessible, interesting, and inspiring. Before you turn to Chapter 1, I want to lay out the book’s structure so you can get the greatest benefit from it.

First, you will note that there are two authors’ names on the cover, but to make your reading experience easier, we have chosen to use a collective “I” pronoun throughout the book.

As you read, you’ll note that the first four chapters are grouped under the heading, “Science and Yoga for Emotional Health.” In Chapter 1, I review the science that makes yoga a powerful tool in the journey toward emotional wellness—something Amy Weintraub, in her book Yoga for Depression, calls “preventative and positive medicine.”1

In Chapters 2 and 3, I explore the philosophical concepts that undergird our work together, from ancient ideas about energy and emotion to the relationship between your physical and mental bodies. In Chapter 4, you will prepare for a series of yoga practices that directly address each of five emotional goals—centeredness, empowerment, energy, calm, and balance. Then you will be ready to step onto your mat and explore each of these attributes in depth.

The second section of the book, “Yoga Practices for Depression and Anxiety,” contains what I call the five “practice chapters,” each of which aligns with one of the emotional attributes you were introduced to in Chapter 4. Each chapter presents a sequence of yoga poses and breathing exercises that will help you on your journey toward emotional wholeness. I offer modifications and tips for how to practice poses in complete comfort throughout—you should not abide pain as you practice. You can expect each practice to take you between twenty and forty-five minutes, depending on your pace, energy level, and general comfort.

While I recommend you read the book from cover to cover, I understand that you might be eager to get started with your practice as soon as possible. If that’s the case, please be sure to read Chapter 4 first so you are physically and emotionally prepared for the journey ahead. Alternatively, you might wish to read Chapters 1–3 separately from the practice chapters, so you can absorb the scientific and philosophical information they contain.

Each practice chapter features “Three Questions to Prepare You for Practice.” These questions are meant to plant seeds for thought, reflection, and insight that might change and develop as you move through each pose. It can be very helpful to take a moment to consider the questions at the beginning of the chapter. After you have finished your practice, we will ask you to reflect again. You might have some true aha moments as your yoga practice influences your thoughts and feelings.

Throughout the book, you will notice sidebars, which I’ve called “A Deeper Exploration” because they give me the opportunity to share extra tidbits I think might illuminate your journey. As you move through the practice chapters, feel free to integrate the additional information into your understanding of each emotional attribute—or skip them and come back to them once you are comfortable and familiar with the main material.

I have approached this book with understanding, empathy, and great respect for the challenges that come with the daily experience of depression, anxiety, or both. The many symptoms of depression and anxiety, or the side effects of medication, might have stopped you from attempting to develop a yoga practice before now. It is my deep hope that in these pages you can find your way into yoga—at your own pace, in whatever ways suit your needs in the moment—and that your practice becomes a source of support and peace in your life.



Mahatma Gandhi once said, “The future depends on what we do in the present.”1 If you are reading these words in the midst of a struggle with depression or anxiety, you have taken a brave and important step in this present moment, one that I earnestly believe will illuminate a path toward a more positive future.

What is this great act of courage? It’s nothing more complicated than the decision you made to pick up this book.

Now, let’s not get ahead of ourselves. As much as I wish it were, this book isn’t a magic wand that can permanently vaporize the weight of depression or tamp down the spiral of anxiety. No single book can do that, nor can any one therapy session, prescription, guided meditation, or yoga pose.

Why, then, is opening this book a healing act? How can it help you along the road back to wholeness from the stuck, uncomfortable place of depression and anxiety?

I believe the answer to that question lies in those words spoken by Gandhi. What stands out to me most in his statement is how vast, complex, and multifaceted those two categories of time—“the present” and “the future”—actually are. No single choice, no single action gets us from here to there. Instead, each of the myriad decisions we make in the here and now shapes the future we hope to see. It is my hope and intention that this book might become one healing choice among many that can set you on a path toward a better tomorrow.

All human beings struggle with difficult emotions at some point in their lives, whether they have a mental health diagnosis or not. And though so-called negative emotions like fear, sadness, and anger are often dismissed and discouraged in modern culture, those emotions serve a purpose in the big picture of our inner lives.

But those feelings aren’t serving their purpose if they feel unmanageable to you on a regular basis. According to the National Institutes of Health, 21 percent of American adults—that’s more than one in five—experience a mood disorder at some point in their lives.2 Your journey toward wholeness starts with an honest appraisal of what most challenges you here, now, in the present moment.

Which is where yoga comes in.


Yoga, like any system of thought, belief, and action, has a central set of teachings that define its purpose and perspective. One of these writings, compiled around the year 400 CE, is called The Yoga Sutras of Patañjali, and it describes the what, how, and why of the practice we understand today as yoga.

Let’s consider this collection by the numbers. There are 196 sutras. Three have to do with physical poses; five more describe breath work and its effects.3 The remaining 188 teachings focus on a single purpose—how to understand the mind and the human experience of consciousness, with a goal of becoming free from suffering.4

How remarkable that virtually the entire foundation of yoga is built around the philosophy of a disciplined mind, one that is organized, focused, present, reflective, discerning, and tranquil.

Given how fundamentally the practice is rooted in the mind-body relationship, it’s no wonder that for decades, scientists have been investigating the connection between yoga and mental health. Literally hundreds of studies have examined yoga practice and inquired about its effectiveness, especially those “how” and “why” questions Patañjali considered in the sutras.

As you keep reading, let each passing page anchor Gandhi’s suggestion more deeply in your mind. None of us can know or control the future, but by choosing to invest our time in healing actions again and again, here and now, in the present moment, we can take steady steps toward wellness, toward wholeness—toward our fully authentic selves.


Throughout my thirty years teaching yoga, I have seen it change the lives of my students in profound and permanent ways. I have seen pain resolve into peace. I have seen inflexibility evolve into elasticity. I have seen people open their eyes to their own bodies, seeing themselves in new, transformative ways. I have taught college students; expectant mothers; those living with chronic fatigue syndrome, scoliosis, and multiple sclerosis; and people struggling with chronic challenges ranging from breathing disorders to weight management to pain to depression and anxiety.

When I met Dr. Chris Streeter, an associate professor of psychiatry and neurology at Boston University School of Medicine in 2006, I got an opportunity to dive more deeply into what I already understood about how profoundly yoga practice affects people, however life has challenged them.

Dr. Streeter invited me to work with her on a series of scientific studies about how yoga impacts mental health. Over the years since, I have learned more about those “how” and “why” insights that have captivated philosophers and scientists alike over the centuries.

When I partnered with Dr. Streeter, she had already completed some research on this topic, including a promising pilot study that found experienced yoga practitioners had an increase in a brain chemical called gamma aminobutyric acid (if attempting to pronounce that is making your heart pound, fear not: it is also referred to with the simple acronym GABA) after just an hour of practicing yoga postures.5 GABA is a neurotransmitter, a chemical messenger that delivers information from one area of your brain to another. It’s known as an “inhibitory neurotransmitter,” meaning that when GABA attaches to receptors in the brain, it makes brain cells, called neurons, less likely to release other chemicals into your system or take another action.6 If you have taken or considered antidepressant medications, you might note that a popular class of drugs is called selective serotonin reuptake inhibitors. SSRIs also work in an inhibitory way, slowing the rate at which serotonin—another neurotransmitter we need to manage our moods—is reabsorbed into the brain.7

GABA has been the focus of Dr. Streeter’s subsequent research, as she’s investigated how GABA affects mental health and how yoga impacts GABA levels. Over the course of three separate studies, my role was to lead a team of yoga teachers, under the mentorship of the noted Iyengar yoga teacher Patricia Walden, in creating a manual of the precise sequences of yoga poses and breath work that participants would undertake during their twelve weeks of yoga practice.

As you will soon learn, these studies produced very positive results, making groundbreaking observations about the association between yoga practice and improved mental health. The book you are holding in your hands is based on the practices our study participants did on their journeys toward wellness.


Scientists have been interested in yoga for more than a century.10 But it’s only since the 1970s that more funding and widespread interest in the West has led to a substantial body of research exploring the science of how yoga actually works.

The question of whether and how yoga affects emotional well-being has been a much-studied topic; the studies discussed in this book were funded by the National Institutes of Health’s National Center for Complementary and Integrative Health and have been published in the peer-reviewed scientific publication the Journal of Alternative and Complementary Medicine. If you are reading this book because you are suffering from depression, anxiety, or both, know that a significant number of the hundreds of studies on yoga and mental health have yielded promising or positive results.

Good science is rooted in inquisitiveness, the willingness to pursue a question knowing its answer will lead to further inquiries to explore. Researchers have examined the connection between yoga and mental health around a number of questions, including the effects of different breathing speeds on stress, anxiety, and depression, the effects of yoga on post-traumatic stress disorder (PTSD), how yoga affects younger and older practitioners’ mental health differently, and so much more.11 New research is continuing to emerge even as I write these words.


So what has research contributed to the broader body of knowledge on yoga and mental health? In a nutshell… a lot. Its contribution zooms in from the broad concept of “the mind,” which so occupied Patañjali, and instead focuses on arguably the most complex organ in the human body—the brain.

Dr. Streeter’s research began with the observation that depression, anxiety, and epilepsy were all treated with drugs that increased the activity of what scientists call “the GABA system”—and the simultaneous observation that symptoms decreased in all three disorders during a yoga intervention. She wondered whether a yoga session might be associated with increased GABA levels and improved mood in healthy subjects. The premise was that low GABA levels were associated with lower mood and heightened anxiety. Some studies refer to GABA as a “natural antidepressant” because the more of it you have, the less depressive or anxious your moods are likely to be.12

To delve more deeply into the important role of GABA in mental health, Dr. Streeter set out to study this question: how, if at all, is the practice of yoga postures associated with changes in GABA levels?

Study 1: For Emotional Health, How Does Yoga Compare with Walking?

Our first study together was published in 2010.13 Thirty-four study participants were divided into two groups—nineteen completed a twelve-week program of twice-weekly yoga classes, while fifteen others did a twelve-week walking program. None of the participants was experienced in yoga, and none had a mental health diagnosis such as Major Depressive Disorder or Generalized Anxiety Disorder.

Dr. Streeter and her scientific team measured the participants’ moods using two techniques. One was a pair of self-reported tests: the Exercise-Induced Feeling Inventory (EFI) and the State-Trait Anxiety Inventory (STAI).14 The other was a brain scan called magnetic resonance spectroscopy, or MR spectroscopy (MRS). This scan is conducted on the same machine as an MRI, but it supplements the information provided by MRI scans with an additional measure of chemical levels in particular regions of the brain. Our MRS scans were designed to measure GABA levels in the thalamus, the region of the brain that has a high concentration of GABA and is connected to the circuits that modulate emotions and thoughts throughout the central nervous system.15

Both the walkers and the yoga practitioners completed the self-reported tests four times throughout the twelve weeks. They underwent the scans three times—once before the first session of either yoga or walking, and twice more after the twelve-week intervention was complete. Both those scans were done on the same day—once before and once after a final session of either yoga or walking.

The results of the study were extremely positive. Both groups experienced improvements in mood, but the yoga group had a greater boost—and only the yoga group showed an increase in GABA levels. This suggested that mood improvement is associated with increased GABA levels—and that yoga practice is associated with this positive correlation.16

Armed with this solid finding, but not yet able to assert proof that changes in GABA levels improve mood, Dr. Streeter decided it was time to ask more questions.

Study 2: Is More Better When It Comes to Yoga?


On Sale
Dec 17, 2019
Page Count
224 pages