This piece is part of in-Training Mental Health Week.
It should be no surprise that when I asked my fellow medical students their suggestions for ways to de-stress, one of the first answers I heard from all of them was: “Yoga.” I should admit that I have always been a bit skeptical of yoga — I enjoyed cardio-based workouts far more. However, after doing some research, I found a study by Bansal et al. which found that medical students in India who did yoga every day for just one month showed significant improvements in both their general and mental wellbeing. Other studies, such as one by Woodyard, showed that yoga helped to improve anxiety, depression, chronic pain, sleep patterns and stress in the general population. I was sold on the benefits of yoga at this point, but I was still skeptical about the slow pace of “regular” yoga, so some of my classmates persuaded me to try power yoga — a fast-paced version of yoga that still incorporated all of the mental health benefits that my regular treadmill exercise could not provide.
There are four basic principles underlying the teachings of yoga according to Desikachar et al., and these principles are why yoga is so beneficial for mental health — especially in medical students. The first principle is that everything in the human body is connected: poor mental health can cause poor physical health, and vice-versa. This was something I was introduced to within the first couple of minutes in my yoga class as instructor’s voice rang from behind me:
“Leave all the negative stuff behind! In these 60 minutes, forget about the plans you’ve made for next week, forget about the bills, forget about your phone, forget that it’s a Monday. Tonight, focus only on yourself and YOU! This isn’t JUST for your body! This is for your mind too! I know you’re tired. I know it’s a Monday. But if you take this time for yourself … I promise you, you’ll feel it in mind and body tomorrow!”
I realized, while curling myself into an up-dog, that this relates to my life as a medical student and to the lives of my peers. When was the last time I, or one of my friends in medical school, had taken a day off for their mental health? How about their physical health? Medical students in general are so driven and persistent that taking a break isn’t really a thought that enters our minds. But, as my instructor spoke, I wondered if maybe taking a break was precisely what we need. He continued to emphasize the importance of refreshing oneself, and giving oneself time to recharge. It’s been a long time since I’ve heard from anybody that it is okay to give myself a break. I began to understand that needing a break doesn’t mean there’s something wrong with me, and that in fact, his words were exactly what I, and all my fellow medical students, need so desperately to hear.
“Feel that strength in you! Can’t you feel it rising, growing in your chest?” he shouted, passing by me as my legs wobbled in an attempt to press my right knee down into a 90 degree angle to reach Warrior 1. “You are strong, you are powerful!” It was ironic, really, because the minute he said that, was the moment my leg gave out on me and landed as a muffled “flump” on the mat. My face flushed red with exhaustion and embarrassment and I quickly looked around me, fully expecting to be met with judgmental faces.
This is where the second and third principles of yoga, again defined by Desikachar et al., come into play. Everyone is different, and therefore everyone’s yoga practice is unique. The other fact is that yoga is self-empowering, which requires that one’s healing should come from within rather than from comparing oneself to others. As a beginner yogi, I have to realize that I can’t sink down into poses as well as the person next to me, and I definitely can’t do positions involving standing on my head or balancing my entire body on the weight of my hands, yet. But, as the instructor reminded us, no matter what one’s level of expertise is, everyone can get something out of yoga. If you can’t do what the person next to you is doing, you can always make modifications that will still empower your technique. The most important thing is to concentrate on ourselves, and on how we can make our practice better without comparing ourselves to anyone else.
As driven medical students, it’s not surprising that many of us often compare ourselves to our peers. The problem with this, however, is that success isn’t formulaic. Our peers may have achieved different things than we have, but that shouldn’t diminish how we feel about our own success. As yoga has shown me, comparing myself and trying to judge a sense of my worth or success through the lens of others’ accomplishments will neither help me improve nor make me feel any better.
Furthermore, the concept of concentration also plays into medical student’s lives; yoga helps us to concentrate, to notice the little details about ourselves and our practice that can be easily missed. In yoga, things such as footwork and the curvature of the body are extremely important, as I quickly learned after feeling the instructor correct my posture for the fourth time. By the end of the session, I was much more aware of the position of my body and how it affected my technique. Since my yoga class, I have taken more time to concentrate on how to fine-tune my studying, and I’ve started noticing little things like the fact that I study better after only a small amount of caffeine instead of my usual grande sized latte. Yoga is about constantly improving one’s own practice, and this, I believe, is what medical students can take away from the practice of yoga.
At the end of my first session, after 75 minutes of equal torture and joy, we were asked to lie down flat on our backs, our palms to our side, and to close our eyes in shavasana, or corpse position. This is where the fourth and final principle of yoga by Desikachar et al. comes into play. According to the principle, if you have a positive attitude towards something, you heal faster, and vice-versa. If I had dreaded every minute of the yoga class, concentrating more on the aches and pains of my body rather than the amazing workout and life advice I was getting, I would have hated it. Medical school is the same way. Yes, it’s exhausting, and yes, sometimes I feel so overwhelmed that I just want to burrow under my covers and not come out. However, it is important to remember all the good aspects of medical school: going through the difficulties together with my peers, finally understanding a difficult concept in cardio, talking to patients and understanding that you can really make a difference. These reasons are what push me through hard days and remind me why I wanted a career medicine. I think lying on the yoga mat, boneless and lost in my own thoughts, gave me the opportunity to remember that.
Medical students can benefit greatly from yoga, “regular” or otherwise. Regardless of one’s fitness capability, yoga is meant to be beneficial to any individual. It can not only be a great workout, but as I also learned, it can be an excellent boost to mental health. I ended up taking away far more from my session than I had originally anticipated I would.
Now I know that I was lucky in terms of time, money and transportation. The studio was only five minutes away from my medical school and was only $6/class; many may not have the same benefits. But, the great thing about yoga is that while going to a studio and soaking in the company of fellow yogis and the overall atmosphere may be helpful, all you really need is your body, as there are several free videos online that demonstrate the poses. You can do yoga anywhere: a park, your home, maybe even an unclaimed study room in your medical school! I would highly recommend trying it out, and seeing what you can take out if it as well.
A very important topic is that of mental health in medical practitioners, notably medical students. According to a study in the Student British Medical Journal, 30% of medical students report having a mental health condition — with a majority of 80% stating the level of available support was poor or only moderately adequate. This column was born from these alarming statistics and aims to stimulate conversation on mental health in medical students, from providing suggestions on how to maintain one’s mental health to discussing the taboo and stigma surrounding conversations on mental health in practitioners and students, and how to eliminate it.