By JUDITH PENTZ MD
Integrative psychiatrist addressing mind-body medicine with hatha yoga and breath
At 42, a man I’ll call Evan found entering his new job promotion to be more stressful than anticipated. Even though he was excited about it, he faced unexpected challenges with a co-worker who had vied for the same position. He noticed he had tightness in his chest and found he was more irritable when he arrived home. His wife had expressed concern because it was impacting their lives.
Given how high-powered his job was, he did not want a prescription that would sedate him or dull his thinking. He recalled using a medicine for anxiety called lorazepam once or twice for anxiety he had experienced in his twenties and did not want to risk his performance.
Evan came to me to find out what options were available for anxiety and occasional insomnia. He was concerned that his anxiety was interfering with the quality of his relationships and work. He noticed he had small triggers that would send his mind down corridors he found increasingly uncomfortable.
We discussed ways to become more aware of his triggers and to do so with the power of observation. I asked if he had ever attempted meditation. He shared that he could not sit still enough to pull it off. I shared with him the story of the Buddha who had been eager to learn breathwork known as pranayama but was told until he achieved full knowledge of the asanas (postures in yoga) that he would have to wait.
A way in: The power of yoga
So we discussed the power of hatha yoga (one of the eight limbs of yoga specific to asanas) as the first-step resource to quiet the body and settle the nervous system. This, in turn, impacts the mind. As the body becomes quieter, the brain does, too. So does the mind. It is that simple!
Evan was intrigued. He was fit, and he biked regularly, so I recommended he start with one-hour yoga classes at the beginner level. “The basic poses are best learned with instruction,” I told him. “Yet, the impact of the practice is often felt immediately.” In addition to the physical movement, there is an attention to breath and being present on the mat. When combined, these two practices assist in quieting the mind.
Focus on the breath allows for the beginning stages of awareness of the thoughts and body sensations present. “Watching thoughts go by” is often a phrase shared to be aware of the thoughts AND NOT go down the rabbit hole. Then there is the possibility of a release of the mind.
A ‘prescription’: Breathwork
We practiced the breathwork. I instructed him, “Place your hands on your belly. Bring breath in through your nose. To a count of four for each part of the breath in, hold and release. Belly breath can now happen.”
He slowly relaxed. Five minutes later, I queried him as to what had evolved for him. He was quiet at first. Then he shared, “I noticed a difference. I feel calmer, more aware of the surroundings I had not noticed before.”
The prescription: Ten minutes of quiet breathing into the belly one to three times a day. Once a day is enough to start. And five minutes will do as well. The most important part is to do it DAILY. This is how a new and good practice becomes a habit. And three yoga classes a week.
On his way: Without a prescription
Evan returned two weeks later. He already noticed a reduction in the overall tension in his body and in particular, he found his mind was no longer feeling triggered like before.
He liked the new feeling and was excited about continuing with the yoga and the daily breathing.
He left my office without a prescription for lorazepam. There were other tools that we discussed to further support him and we will explore those later!
Judith Pentz MD
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By JUDITH PENTZ MD