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Living with schizophrenia: treating mind, body and soul

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    Alongside the established role of medications and behavioural therapies, other complementary approaches are being used to provide a holistic approach to the treatment of schizophrenia.1,2 This article explores the possible benefits of mindfulness and yoga for someone living with schizophrenia.  


    Holistic treatment of schizophrenia

    In recent years, the importance of treating schizophrenia as a whole rather than individual symptoms has become apparent.2 Holistic treatment of schizophrenia means that care should not only focus on managing schizophrenia symptoms and the physical side of health but also look at how well someone is able to function in their daily life.2 Depending on the person, holistic care might incorporate guidance on diet and exercise, tackling alcohol and substance use, tips on how to build healthy relationships, gain independent living skills, financial advice, help with training or finding employment, and recognising and dealing with stress and anxiety.2,3
     
    Practicing mindfulness and yoga may help in the all-round treatment of someone with schizophrenia.1,2


    Mindfulness and schizophrenia

    Mindfulness is a state of being conscious and aware of the present moment.4,5 It is about calmly accepting one’s feelings, thoughts, and bodily sensations without passing judgment on them.4,5
    Overall, it aims to help people become more self-aware, help them cope with difficult thoughts or feelings, make them feel calmer and less stressed, and generally just help them learn how to become kinder to themselves.5


    How might mindfulness help people with schizophrenia?

    Schizophrenia impacts on how a person thinks, acts, and perceives the world, which are all areas that mindfulness can potentially help with.4
     
    Indeed, mindfulness is thought to help people with schizophrenia by enhancing their attention, self-awareness, and self-compassion, and may help to improve how they handle their emotions.4 Mindfulness may also help them deal with negative thoughts and emotions, allowing people to view them as passing events and not something to be dwelled upon.4
     
    Through practicing mindfulness, individuals with schizophrenia may also be better prepared to respond to how they feel and gain greater control over their symptoms.4 This in turn may help avoid the need for hospital treatment and improve their ability to function both socially and in the workplace.4,6


    How is mindfulness practiced?

    Mindfulness is a skill that needs to be learnt and while it does not necessarily need professional help to master, it may help.5 A couple of simple exercises that you could try at home include:5
    ·  being mindful of how and what you eat – savoring the taste, texture, temperature, smell, and sound of the food as you chew. Taking your time to eat and to enjoy and appreciate your food and how it makes you feel
    · being aware of how your body moves in its surroundings – such as feeling the ground beneath your feet as you take a walk, noticing the warmth of the air on your skin, the smells that surround you, the sounds of the birds in the trees or traffic passing by, and a glimmer of rain on your shoes
     
    More formal mindfulness practice that is led by an expert practitioner might consist of short (15 to 45 minute) individual or group sessions that occur over several weeks, each may be on a different topic.7 For example, while one session might look at mindful eating or movement as outlined above, another might focus on how to think differently and try to accept certain thoughts.7 
     
    While mindfulness may help some people with schizophrenia, it may not be for everyone.3,5 It’s always worth checking with a healthcare professional to see what services are available in your area and if it is something that might help you or a someone your care for.

    Yoga and schizophrenia

    Yoga is perhaps a more familiar practice than mindfulness as it has been practiced around the world for centuries.8 Like mindfulness, yoga considers the body and mind together, but it also includes the soul or spirt, aiming to bring close harmony between them.1,8 Yoga may have spiritual roots, but its controlled movements and breathing made it become more of a form of exercise in the Western world.1,8,9

    How is yoga practiced?

    Very generally, yoga consists of a group of physical movements (asana), special breathing techniques (pranayama), and sometimes deep concentration or relaxation (meditation).1,8
     
    There are several different types of yoga that incorporate these in different ways.8,9 For many, Hatha Yoga, which is mainly about different asanas (postures) is the most common type practiced.8 The best way to start practicing yoga is to join a class and receive proper instruction on how to properly carry out the poses and breathe during the exercise.9
     



     

    What are the benefits of yoga for people with schizophrenia?

    Yoga has been studied as an add-on treatment in schizophrenia and was shown to improve both positive and negative symptoms.1
     
    Of note, there have been improvements recorded in abstract thinking, memory, and attention.1 The latter finding makes sense if you consider that paying attention is a central component of yoga as it involves synchronising movement with breathing.1 The benefits of yoga on thinking (cognitive function) may be due to the level of mental concentration that is required to control the various body movements.1
     
    Evidence suggests that practicing yoga for just a few short months can have a positive impact on how well people are able to function, both socially and in their working lives.10-12 Indeed, one study found that after 4 months, people who had undertaken regular yoga classes had better communication skills and were more interactive with other people; two things that can contribute to overall well-being and quality of life.1, 10
    Moreover, participants in that study were reportedly less stressed, which is known to be associated with the worsening schizophrenia symptoms.10

    Time to integrate mindfulness and yoga into your daily life?

    Mindfulness and yoga are potentially beneficial ways to completement the effects of traditional schizophrenia treatments.1 Both may take patience and practice to learn and can be done at home or under the guidance of a suitably qualified practitioner.5,9
     
    If you would like to find out more, there are many books and online sources that can guide you in the practice, or help you find classes in your area. Your local healthcare team may also be able to recommend mindfulness practitioners and yoga teachers to you.

    References

    1. Sathyanarayanan G, Vengadavaradan A, Bharadwaj B. Role of yoga and mindfulness in severe mental illnesses: a narrative review. Int J Yoga. 2019;12(1):3–28.
    2. Ganguly P. Holistic management of schizophrenia symptoms using pharmacological and non-pharmacological treatment. Front Public Health. 2018;6:166.
    3. Living with Schizophrenia. Coping with stress. Accessed February 2022.
    4. Ganguly P. Mindfulness in holistic management of schizophrenia. Int J Psychol Behav Anal. 2018;4:155.
    5. Mind. Mindfulness. Accessed February 2022.
    6. Wang X, Beauchemin J, Liu C, Lee MY. Integrative Body-Mind-Spirit (I-BMS) Practices for schizophrenia: an outcome literature review on randomized controlled trials. Community Ment Health J. 2019;55(7):1135–46.
    7. Shen H, Zhang L, Li Y, et al. Mindfulness-based intervention improves residual negative symptoms and cognitive impairment in schizophrenia: a randomized controlled follow-up study. Psychol Med. 2021;1–10.
    8. Basavaraddi IV. Yoga: Its origin, history and development. Ministry of External Affairs. Government of India, 2015. Accessed February 2022.
    9. NHS. Guide to yoga. Accessed February 2022.
    10. Duraiswamy G, Thirthalli J, Nagendra HR,  Gangadhar BN. Yoga therapy as an add-on treatment in the management of patients with schizophrenia – a randomized controlled trial. Acta Psychiatr Scand. 2007;116(3):226–32.
    11. Varambally S, Gangadhar BN, Thirthalli J, et al. Therapeutic efficacy of add-on yogasana intervention in stabilized outpatient schizophrenia: Randomized controlled comparison with exercise and waitlistIndian J Psychiatry. 2012;54(3):227–32.
    12. Vancampfort D, Vansteelandt K, Scheewe T, et al. Yoga in schizophrenia: a systematic review of randomised controlled trials. Acta Psychiatr Scand. 2012;126(1):12–20. 
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