Evidence-based benefits of a mindful movement practice
According to Mind (1), 1 in 6 people experiences a common mental health problem in any given week in England and worldwide global prevalence of anxiety and depression increased by a 25% in the first year of the pandemic (2).
To respond to the raise of mental health conditions, specialists and GPs have been increasingly recommending mindful movement practices such as Yoga and Pilates as effective complementary strategies to improve our resilience and support our emotional wellbeing.
Several studies have been revealing a great efficacy of both practices in stress reduction, mood elevation and brain health.
For instance, a research project from 2018 concluded that practicing Pilates resulted in a statistically large reduction in symptoms of depression and anxiety, and in feelings of fatigue and lack of energy (3). Another study from the same year found out that Yoga and Meditation practitioners presented a smaller right amygdala (the alarm bell of the brain) volume over time, proposing that these interventions can help us reduce our reactivity to stress (4).
It also seems that both Pilates and Yoga can increase HRV (heart rate variability), which is an indirect measure of how well our autonomic nervous system copes with stress (5,6).
Why are these practices so powerful in supporting our mental health, even if they originated in very different historical and cultural contexts, and with very different goals at their core?
In part, this comes down to their shared emphasis on the mind-body connection, the understanding that the state of our body influences the state of our mind and viceversa. In the words of Joseph Pilates, “a body free from nervous tension and fatigue is the ideal shelter provided by nature for housing a well-balanced mind, fully capable of successfully meeting all the complex problems of modern living”.
More research is needed to help us understand the precise mechanisms of how Yoga and Pilates work in improving our mental health, but here are some of the elements, which overall seem to contribute to their efficacy.
1) Yoga and Pilates help us cultivate mindfulness and therefore increase our tolerance to distress.
Yoga and Pilates are extremely beneficial for those of us, who struggle with mental health conditions and find mindfulness practices requiring stillness too challenging, as we can achieve similar benefits while maintaining our body busy: when we concentrate on the precise execution of a movement or on the physical sensations produced by a certain pose, our mind learns how to cultivate a clear focus more effortlessly.
By training our capacity to observe our experience and practicing mindfulness of our body and breath, whether we are holding a plank or chair pose till our body shakes a little, or we enter the last minute of a Yin Yoga pose - we learn how to gradually decrease our emotional reactivity to things that challenge us and to better tolerate safe discomfort.
The movements and sensations that once would have us hold our breath and our fear response or frustration rapidly kick in, can slowly be embraced with a more open mind. We get used to notice that pain and discomfort, like everything, are transitory, and that things that felt out of reach at first, are actually possible.
2) They offer us self-regulation tools to create physiological and psychological changes in our internal landscape, both in the short and long term.
Most mental health issues present with imbalances in the autonomic nervous system, like altered levels of certain chemicals, increased activity in the brain regions connected to fear and decreased activity in those area that support regulation and decoding of threats (7).
On the contrary, when self-regulation works properly, we can easily return to our homeostatic balance, feeling grounded, centred and in the moment, even in difficult circumstances.
Both Joseph Pilates and the Yogis recognised that the state of our body and breath have a huge impact on the state of our mind: by altering the tone of our muscles, the rhythm of our heart beat and the quality of our breath, we can alter the way we feel mentally and emotionally.
This is coherent with most recent views in Neuroscience: by changing our chemical and physical basis, movement allows us to change the inputs to the global emotional moment, leaving us with a different sense of how we feel (8).
Current research is still trying to grasp the complexity of how Yoga and Pilates facilitate self-regulation.
Exercise in general helps reduce the production of stress hormones (adrenaline, cortisol..), and to increase the production of feel-good hormones (dopamine, endorphins).
But compared to other generic forms of physical activity, Yoga seems to offer further benefits at the level of our brain. For instance, a famous study from 2010 (9) documented a higher increase in the level of GABA, a key neurotransmitter, which often is reduced in mood and anxiety disorders, and which has with the important role of repressing fear-based pathways after a 12 weeks Yoga intervention, compared to walking with the same calories expenditure. The authors proposed the hypothesis that Yoga poses and breathing patterns could stimulate our vagus nerve in specific ways, which resulted in a shift towards the parasympathetic state of our autonomic nervous system (the calm “rest and digest” state).
Indeed, both in Yoga and Pilates breath focus is one of the key elements.
When we feel agitated, our breath becomes shallow, chest-focused and fast, while when we feel relaxed we usually tend to breathe slowly and using our lungs completely, allowing our diaphragm to move freely.
By consciously slowing our breath down and deepening it through the practice, we have the opportunity to down-regulate our nervous system, calming our body mind.
Alternatively, when we feel numbed and sluggish, breathing slightly faster and emphasising the inhalation can help us quickly lift our energy up and feel more vital and active.
The stretching component that both Yoga and Pilates offer, especially when this is done in a gentle, more passive way, also plays a big role in inducing a relaxation response and shifting us into the parasympathetic state: releasing muscular tension from our body signals our brain that we are safe and don’t need to escape or fight, so we can settle and ground more easily.
3) They helps us improve our concentration.
Pilates and Yoga demand constant focus. When we are invited to clear our mind of other distractions and to be 100% present, little space is left for rumination and obsessing about the future or the past.
This is one of the biggest additional benefits of movement done with purpose in stress management: any activities which require paying attention with purpose help us strengthen our prefrontal cortex, which is the area of the brain dedicated to analysis and decision making. In many mental health disorders, the prefrontal cortex is usually weaker and the capacity to rationally decipher threats compromised, so strengthening this area means improving our skills to decode our environment skilfully and to reduce our emotional impulsivity.
4) They give us a sense of agency, self-affirmation and confidence
Poor mental health is often accompanied by feelings of unworthiness and not being able to meet our life’s demands. One of the benefits associated with dedicating time to practices, which help us develop strength and master new skills like Pilates or dynamic forms of Yoga, is precisely an improved sense of confidence and agency: feeling capable and in charge is the opposite of feeling anxious or depressed.
As Caroline Williams writes, any movements that strengthens muscles and bones can change the content of our inner commentary for the long haul. Moving in a way that makes us stronger can dramatically change our sense of who we are and what we can achieve in life.
Indeed, people who do more physical activity tend to score higher on a scale of global self-efficacy, which measures the sense of how much control they have over their lives.
Studies using weight bearing exercise as a treatment for anxiety have found that getting stronger seems to make at least some of the angst go away, boosting self-worth while reducing symptoms of stress and improving sleep.
Interestingly, the improvements happen regardless of significant changes in the size of the muscles (10).
Other studies looking at how training our muscles can improve our overall mental and emotional wellbeing have suggested that specific substances, labelled “hope molecules”, could play a significant role.
When they contract, our muscles produce proteins, the myokines, which are key in the health of our brain and in preventing depression.
“Hope can begin in your muscles. Every time you take a single step, you contract over two hundred myokine-releasing muscles. The very same muscles that propel your body forward also send proteins to your brain that stimulate the neurochemistry of resilience”. (11)
5) They improve our mental outlook and offer social connection opportunities.
On the individual level, stepping on a mat and building a regular routine is an act of self-care and self-compassion - we internalise the idea that we are worthy and we deserve time for ourselves.
When this act is shared with other people, additional benefits arise.
Given that social isolation increases both the risk of developing and the severity of presentation in many mental health issues (12), practicing in a safe space, which favour a sense of community, can further improve our wellbeing.
And this doesn’t have to happen in real life only: even virtual space can create a sense of belonging and connectedness, which can have a ripple effect in any other relationships and interactions.
Yoga and Pilates can have a significant impact on our health and quality of our life, and make our emotional challenges feel more manageable.
Want my guidance and support to create a consistent movement routine that help you improve your resilience to stress and mental focus?
(1) Mind website: https://www.mind.org.uk
(3) Fleming, K. & Herring, M. (2018) The effects of pilates on mental health outcomes: A meta-analysis of controlled trials. In Complementary therapies in medicine, vol. 37.
(4) Gotink, R. A. et al. (2018). Meditation and yoga practice are associated with smaller right amygdala volume: the Rotterdam study. Brain Imaging and Behaviour Dec 12(731).
(5) Cavina, A. et al (2021). Effects of 12-week Pilates training program on cardiac autonomic modulation: a randomized controlled clinical trial. In Journal of comparative effectiveness research, Vol 10, n. 18.
(6) Tyagi, A. & Cohen, M. (2016). Yoga and heart rate variability: A comprehensive review of the literature. International Journal of Yoga Jul-Dec 9(2), 97–113.
(7) Mason, H. & Birch, K. (eds) (2018). Yoga for Mental Health. Handspring Publishing Limited.
(8) Williams, C. (2021). Move. The new science of body over mind. Profile Books.
(9) Streeter, C. C. et al. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. The Journal of Alternative and Complementary Medicine 16(11), 1145-1152.
(10) O’Connor, P. J. et al. (2010) Mental health benefits of strength training in adults. In American Journal of Lifestyle Medicine, vol. 4(5), 377-96.
(11) McGonigal, K. (2019). The joy of movement. San Francisco, CA: Avery.