Yoga can help ease symptoms of anxiety in adults, but it’s not as effective or as long-lasting as cognitive behavioral therapy (CBT), according to a study published online this week in the journal JAMA Psychiatry.
Yoga does do a better job, however, at reducing anxiety than standard education about stress management, the study also found.
The authors of the study looked at yoga’s impact on a particular type of anxiety known as generalized anxiety disorder. This chronic condition is characterized by persistent and excessive worry about everyday occurrences and situations — a worry that people with the condition find difficult to control on most days. The exact cause of generalized anxiety disorder is unknown, but both genetics and life experiences are believed to play a role.
Generalized anxiety disorder affects an estimated 6.8 million adults in the United States, or about 3.1 percent of the population. One of the most effective treatments for it is psychological counseling — specifically, CBT, which focuses on teaching individuals specific skills to help them manage their negative thoughts and worries. Yet less than half of Americans with generalized anxiety disorder are receiving CBT — or any other kind of treatment.
For that reason, researchers have been searching for alternative treatment options, particularly ones that are low in cost and easy to access.
“Generalized anxiety disorder is a very common condition, yet many are not willing or able to access evidence-based treatments,” says Dr. Naomi Simon, the new study’s lead author and a psychiatrist at New York University, in a released statement. “Our findings demonstrate that yoga, which is safe and widely available, can improve symptoms for some people with this disorder and could be a valuable tool in an overall treatment plan.”
A randomized trial
To test yoga’s effectiveness, Simon and her colleagues conducted a randomized clinical trial, considered the “gold standard” of medical research. After recruiting 226 men and women with diagnosed generalized anxiety disorder (average age: 33), they randomly assigned each to one of three treatment groups: Kundalini yoga (a type of yoga that combines movements, breathing techniques and meditation), CBT, or stress-management education (a standardize “control” for these kinds of studies). All participants attended small, weekly two-hour group sessions, led by a trained practitioner, and received 20 minutes of daily homework.
The study ran for 12 weeks. During that time, the participants regularly filled out questionnaires commonly used by researchers to measure the effectiveness of treatments on symptoms of anxiety. At the end of the study, those in both the CBT and yoga treatment groups reported greater improvements in their symptoms, on average, than those in the stress-management group.
Specifically, 71 percent of the people in the CBT group and 54 percent of those in the yoga group described meaningful improvements in their symptoms, compared to 33 percent of the people in the stress-management group.
After six months, however, only the people who had undergone CBT treatment —not those who had taken the yoga classes — reported significantly greater improvements in their anxiety levels than the people who had learned about stress management.
That finding suggests that although yoga may offer benefits to people with anxiety, the effects are not as strong or persistent as those associated with CBT.
Limitations and implications
The study comes with caveats. Most notably, yoga and CBT were delivered to the study’s participants in ways that do not necessarily reflect how people would experience them in the “real world.” Future studies should use community-based programs, the study’s authors point out. In addition, the study’s participants learned Kundalini yoga. The findings may not be generalizable to other types of yoga.
Still, the study’s results are in line with other research on this topic, including a smaller randomized clinical trial conducted in 2018. It found that women with general anxiety disorder who took eight weeks of Kundalini yoga classes reported lower levels of anxiety than women who received the usual treatment for the condition.
“Many people already seek complementary and alternative interventions, including yoga, to treat anxiety,” says Simon. “[Our] study suggests that at least short-term there is significant value for people with generalized anxiety disorder to give yoga a try to see if it works for them.”
“We need more options to treat anxiety because different people will respond to different interventions, and having more options can help overcome barriers to care,” she adds. “Having a range of effective treatments can increase the likelihood people with anxiety will be willing to engage in evidence-based care.”
FMI: You’ll find an abstract of the study on JAMA Psychiatry’s website, but the full study is behind a paywall.