Yoga or Medication? You decide...

In this post, I am only referring to those conditions related to or caused by stress. Knowledge offers choice; the choice as to whether you might either commit to a regular practice to prevent disease or replace medication for yoga if suitable. Speaking for myself; I exercised the choice to never take anti-depressants or anti-anxiolytic drugs for my mental illness. The journey may have been slower, but I believe I am far healthier for it. Certain medications are critically important and you should always speak to your GP before deciding to either refuse medication or come off medication. Yoga can always be an adjunct to medication and for certain conditions should only ever be such. But yoga can help in many ways. Read on to find out more...

The Autonomic Nervous System (ANS) consists of two branches. The sympathetic nervous system also known as Fight or Flight and the parasympathetic nervous system sometimes referred to as Rest and Digest.

The sympathetic nervous system excites the system for survival whilst the parasympathetic nervous system maintains homeostasis within the body. In my post, Stressed? Exercise, Yoga, Mindfulness, Repeat, I wrote about the impact of stress on the autonomic nervous system. In this post I wish to speak about some of the specific benefits Yoga can offer to the healthy maintenance of the ANS in particular.

Yoga can help to restore equilibrium to the Hypothalamic Pituitary Adrenal axis (HPA axis). This is a stress response whereby cortisol, adrenaline and noradrenalin are released into the body to deal with the stressor. This axis is consistently triggered by stress and can be overloaded whereby it does not switch off. We know that too much cortisol in the body causes disease.


Evidence shows that yoga has an immediate quietening affect on the HPA axis, largely caused by parasympathetic activation through the practice of Ujjayi and other pranayama techniques. The major parasympathetic nerve in our body is the Vagus nerve. Vagus means wanderer. This nerve wanders throughout the trunk sending and receiving messages from the organs to the brain and vice versa. When practicing pranayama that activates the parasympathetic nervous system, the vagus nerve sends a message of calm; it tells the organs and the brain that all is well; all can function normally, hence Rest and Digest.

Yoga activates Heart Rate Variation (HRV). You will no doubt have heard of interval training. This is an extreme version of HRV, whereby we get the heart pumping fast and then restore it to it's natural rate by resting. In yoga we exercise the heart through stronger, more active poses and then restore and relax it through quiet poses and calming pranayama. Exercise is in itself a sympathetic nervous system trigger. The more we practice variety, the easier it is for the ANS to understand that whilst the sympathetic nervous system may be triggered, we have the means of calming it. Each time we actively practice parasympathetic activity, the system calms more quickly. In yoga we often practice both simultaneously; when holding strong poses and using Ujjayi breath at the same time! With practice, a healthy heart responds quickly to being restored to it's resting rate which in turn teaches the ANS that we can return to a natural state of parasympathetic rest and digest after stress.

We know that Yoga reduces blood pressure. Hypertenstion by definition is abnormally high blood pressure caused in general by excessive stimulation of the sympathetic nervous system. Pressure sensors in the cardiovascular system called baroreceptors respond to changes in blood pressure upon stimulation of the sympathetic nervous system (fight or flight). Our friend the vagus nerve responds to messages from the baroreceptors by dilating blood vessels. Under continued stress however, baroreceptors lose sensitivity. Whilst blood vessels dilate due to sympathetic nervous system stimulation, blood vessels in other parts of the body constrict. Under continued stress there are more constricted blood vessels in the body than dilated ones, the net result being vascular constriction. When under continued stress, posture changes. In particular the shoulders protract and we develop a kyphotic pattern in the thoracic spine. We also go over the stressful situation in our minds which in itself triggers a sympathetic response and so we perpetuate the negative cycle. Long term hypertension can lead to cardiovascular disease...

Yoga helps in a variety of ways. It improves posture; lengthening hyper tense muscles for improved blood flow. We know that pranayama induces parasympathetic activity, negating the impact of sympathetic arousal. Furthermore, the practice of yoga focuses the attention on the physical body and the breath, diverting our attention from the busy mind. With the addition of mindfulness practices, it is easy to see how truly beneficial these actions will be on a person suffering from Hypertension as well as a number of conditions that have arisen as a result of long term stress. Whilst medication is often the first port of call and a necessary one for hypertension, particularly if blood pressure is dangerously high, it may be considered a short term resolution. Evidence shows that yoga can bring about powerful change on conditions relating to stress. So with advice from your GP, why not give it a try?

Further information on the benefits of yoga on our health can be found in the following article:

It should be noted that for certain conditions, a general class may not be suitable. Yoga should be taken in a one to one capacity.

In writing this article I referenced not only the article above, but also the wonderful teachings of Heather Mason of The Minded Institute with whom I trained in Yoga Therapy for the Mind and the brilliant book by Mel Robin: 'A Handbook for Yogasana Teachers'.

Stressed? Exercise, Yoga, Mindfulness, Repeat.

In the 1930's Hans Selye, an endocrinologist adopted the term 'stress' to refer to inadequate physiological response to any demand. Stress was something that required change within an organism. There is good stress and bad stress. Or put another way eu-stress from which we develop and grow and di-stress from which we suffer. We have to stress the immune system in order to build the immune system but too much stress causes disease.

We develop our tolerance to stress by encountering new stressors; that which causes stress such as encountering a new environment or situation. The more we learn to adapt to new environments or situations, the easier it becomes to stabilise oneself. This is what is termed Allostasis; stability under change. However, if stress continues to be applied, one's capacity to maintain stability is undermined. At this point we have reached our Allostatic Load. We can no longer tolerate stress and may become ill. In 2015/16 the total number of cases of work related stress, anxiety and depression in the UK was 488,000! The number of missed days due to stress related illness was 37% and 45% of all working days lost due to ill health were down to stress.

When we are stressed we release the corticosteroid (stress hormone) cortisol. This enables us to mobilise energy to fight or flee from a situation by activating the Sympathetic Nervous System. But imagine your boss bawling you out. Your entire being may be desperate to either punch him/her (I wouldn't recommend it) or flee from the uncomfortable situation. Your system still releases cortisol but instead of using it up by responding physically, it continues to circulate through your system causing problems.

Cortisol suppresses the immune system. Have you noticed how when you are stressed you tend to get more colds and bugs? It is much harder for the body to defend itself when stressed. Imagine your life depended on your running away from a situation. Which bodily systems do you require? Digestive? No, forget that. Urinary? Nope. Reproductive? Certainly not! So when we are stressed we also suffer from digestive complaints such as Irritable Bowel Syndrome (IBS). We may be susceptible to Urinary Tract Infections (IUT's). We may find it difficult to conceive after years of stress. Cortisol reduces the production of melatonin; a hormone produced at night to help us sleep causing insomnia. I could go on but I think you get the picture. Prolonged stress is bad for our health.

So how can Yoga and Mindfulness help? Firstly we need exercise to get rid of the build up of cortisol. Practicing strong poses that utilise the larger muscles in the body such as chair pose, warrior 2, lunges etc... helps metabolise cortisol. Alternatively daily exercise such as running, cycling or hill walking will work. Each time we exercise, we require the heart rate to increase, similarly to the experience of being stressed. Through controlling our breathing, we can control the behavior of the Autonomic Nervous System (ANS). There are two sides to the ANS, the Sympathetic Nervous System (SNS) or Fight and Flight and the Parasympathetic Nervous System (PNS) or Rest and Digest. When we inhale we activate the SNS and when we exhale, the PNS. So by practicing breathing techniques such as Ujjayi, we bring equilibrium to the ANS. If we alternate exercise with calming breathing, we teach the ANS that it knows how to bring balance to the body. In other words, with practice, if we find ourselves feeling stressed and we practice Ujjayi for example, the nervous system recognises a pattern, making the initial stressor somewhat easier to deal with.

In a particularly stressful situation, you may notice that your breath rises into your chest. This is because cortisol has been released and your body is preparing to run or fight. If we deliberately bring the breath down to the belly using the diaphragm to breathe and lengthen the exhalations using Ujjayi, we calm the nervous system; we override the SNS with the PNS. Instead of being in Fight and Flight mode, we enter Rest and Digest mode which as the name suggests means we are in a more healthy state. We are able to digest our food and the systems of the body return to homeostasis. Yoga teaches a number of breathing techniques or pranayama that control the Autonomic Nervous system so that we can bring equilibrium to the body. A recent article in the New Scientist explains how a type of brain cell that connects breathing rate to alertness has been discovered in mice and these have been dubbed "pranayama neurons". The research showed that when these neurons were killed in mice, they took a greater number of slow breaths becoming "super-chilled out".

Mindfulness is particularly useful for long term sufferers of stress. When we learn to notice the changes in our breath, we can actively alter the breath and change the way we feel. In time and with practice, we might also be able to recognise our behavioral patterns so as not to react in the same way to stress in the first place. It's a no brainer isn't it?

If you suffer from stress, the Yoga Therapy for the Mind course takes you through practices that teach you to develop awareness. So whilst on the course you may find your stress being alleviated, you may also learn skills that help you to manage it in the long run. Our Therapeutic Yoga class is the perfect follow on class to keep you on track. You may wish to speak to your GP if you suffer from Panic Attacks or have recently experienced a traumatic event. The Yoga Therapy for the Mind course or Private Yoga Therapy is suitable for those who are ready to cope alone.

Self Care.

This term we have been setting Intentions at the start of each class. My personal intention for some time now has been: "I am exercising self care." This means that during any yoga practice or when teaching, I take care of my body; I notice those moments when I am pushing beyond that edge of discomfort and I pull back. But since suffering from adrenal fatigue after the stress of my latest training, it has also meant that I am not pushing myself too far on a daily basis.

You may be wondering what adrenal fatigue is. Here's a brief overview but I will go into this more in next month's blog on Stress. When we are stressed, our body responds by sending a message to the adrenal glands to release stress hormones. The neurotransmitters adrenaline, noradrenaline and dopamine generate the stress response or 'fight and flight.' Corticosteroids such as cortisol control our sleep/wake cycle among other actions and it is these that remain in our bodies for a long time if we are consistently stressed, causing all manner of problems including difficulty sleeping. The adrenal glands also produce sex hormones and other hormones and neurotransmitters that play a vital role in homeostasis. After a period of chronic stress, the body runs out of the material to make these hormones and fatigue sets in. Sound familiar?

So unsurprisingly, I have not been sleeping well; my sleep is either interrupted or I just do not sleep for long enough. And my hormones have been awry. In spite of knowing that I wake most nights, I do not worry; instead I always get to bed around 10p.m. But now that I am exercising self care, I offer myself some sort of ritual. After teaching, I may take an Epsom Salt bath to relax my muscles. Whilst in the bath I may practice deep breathing or listen to a Radio 4 Drama (I have become an addict)! If I don't need to take a bath, I might soak my feet in Epsom Salts with a drop of Lavender Oil and follow this with a foot massage. Turmeric Latte is often a warming, soothing treat an hour before bed.

If I wake up dreadfully tired (and it's always worst when premenstrual), then I write off any plans I may have made for that day and go with the flow. I no longer beat myself up if I have an nonconstructive day; I tell myself that it is okay; I can only do what I have the energy to do on any given day. On particularly bad days, I may offer myself a little treat. This might be that I light my favorite scented candle and relax in the bath or with a magazine. I may take myself out for a cup of tea somewhere quiet. I often practice a very gentle, restorative yoga session or an energising one depending on my needs. Mostly, I slow right down and try to take pleasure in what I am doing. I practice mindfulness when hanging out the washing for example or tidying; simply noticing the process and just how often my mind switches off or when I go into a vacant stare!

Over the past two months, I have noticed considerable change. Mostly that I no longer feel guilty if I don't get jobs done. I am no longer a martyr; I ask for assistance. I am so much more relaxed and positive about life in general and lately, my energy levels have increased as has my productivity.

I have become painfully aware of just how many people do not exercise self care but rather keep on pushing until they get ill or burn out. This is not good. It is not good for ourselves, it is not good for our families or for those we work with and it is not good for the NHS! Taking care of ourselves should be the first intention of every day shouldn't it? After all, if none of us is taking care of ourselves, who is going to be there to take care of us when we really need it? Who is going to take care of the work we must do?

We mustn't leave it until it is too late. Act now! Why not try starting each day by silently stating your intention in the present tense; as if it is already happening: "I am exercising self care." If you do not feel worthy of self care, make this your intention and work with it for a while. "I am worthy of self care." When we repeat positive affirmations to ourselves often enough, we believe them. By setting the intention in the present tense, we make it appear that it is already happening rather than that we might think about it or that we intend to make it happen in the future. Affirmation is really a better word than intention I think!

It might help to write down the things that you do to harm yourself such as overworking, always saying yes, not exercising, overeating or eating the wrong kinds of food, drinking too much, being in a rush, driving dangerously, staying up late. This may be alarming but it is most important that you do not feel guilty. Think of this as an exercise in recognising and then be positive about change and you will experience change.

Write a list of things you would like to do such as read a book, meet a friend for a coffee (or better still, a herbal tea), have a massage or simple things like taking a long bath and the most important one of all; saying NO! Taking a walk in nature can do wonders for the mind; see my post Invest in Nature; Invest in Yourself

Set your daily intention of self care. Write it down, stick it on your fridge, in your car, on your computer. Don't expect immediate results; it takes time and effort. You will be rewarded by better health, wellbeing and perhaps even the kindness of others.

"I Am Exercising Self Care."

A good place to start may be with the Yoga Therapy for the Mind course which commences on Tuesday 23rd May from 10.00- 12.00. Some bosses accept that investing in the wellbeing of their staff may mean greater productivity in the long run. So ask for the time off; you never know, your boss might say YES!

And let me know how you get on. I wish you well.

Mindfulness? Easy? No!

Recently I achieved Level 1 in Mindulness with the Clear Mind Institute (CMI). This gives me the title of a Mindfulness Yoga Teacher which enables me to integrate some of the practices into my yoga classes. In January 2017 I will be offering a Therapeutic Yoga class which will do just that. We will include mindful movement,  breathing practices and formal mindfulness practices.

What's mindful movement I hear you ask? Well it's yoga but with really focused attention on the sensations of movement. We slow things down to notice. Mindful movement included in the Mindfulness Based Stress Relief (MBSR) course is based on research; the movements practiced are considered safe for all. However in the therapeutic yoga class we will include other movements as this is not a short course but an ongoing lesson.

I personally have been practicing mindfulness now for three years. I began with a Mindful Living course based on the MBSR course. I then practiced during the Yoga Therapy for the Mind training after which I found an online course through This amazing course with the fabulous Tara Brach and Jack Kornfield took me to a new level of practice. It was the first time this course had been run. We had online mentoring in groups which opened my mind to ways of communicating with my yoga therapy clients.

I found the formal sitting practices immensely challenging. When I first began yoga I was unable to sit for pranayama without feeling threatened and panicky. So the steady movement of yoga helped me immensely. In my yoga practice it is possible to slow things down so much that one develops such self awareness moment by moment. Jon Kabat-Zinn's famous definition of mindfulness is “The awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment.” Well yoga certainly offered the opportunity to do just that. However looking back, I didn't experience the same sense of calm and serenity, the change in my being or my behaviour that formal practice did.

I wanted to continue along the mindfulness path and delve deeper, so this year I undertook the first British Wheel of Yoga Mindfulness Module with Cathy-Mae Karelse of CMI followed by a conversion course to Level 1. I now practice nearly every day and feel enormous benefits from it. My mind has slowed down. I am able to pause before reacting (well most of the time; there are always some people who know how to press my buttons but I am getting better at pausing even with them). I am so much better at taking care of my needs. And I have many more moments in my day when I just notice.

The hardest thing for me along this journey has been finding a regular time to practice. I initially practiced straight after lunch but found it too easy to say 'Nah, I'm too busy'. At the moment I practice as soon as I wake up. I sleep in a pretty cold room so I don't feel like getting out of bed. Sometimes I fall back to sleep, I probably needed to and I will try to fit a shorter practice in during the day. But often I don't and I get up feeling better prepared for the day ahead.

I plan to continue training with CMI.

Research on mindfulness-based interventions is growing and now includes neuroimaging studies and more sophisticated research designs.

Effects include:

  • Reductions in depression, anxiety, substance abuse, eating disorders, stress and pain.
  • Increased immunological response, reduced blood pressure and cortisol.
  • Increased psychological well-being and enhanced cognitive functioning.

(Halzel, Lazar et al, 2011)

Invest in nature. Invest in yourself.

birchwood yoga studio


I don't know about you, but I always feel better after a walk in the countryside, both physically and mentally; particularly when surrounded by such stunning colours as we have been blessed with this autumn. This was one of the reasons why I chose to situate my studio amongst nature.
Birchwood Yoga studio is nestled into a copse from where it has a beautiful view of trees and flowers changing with the seasons and a multitude of wildlife that comes and goes. During the day the birdsong is delightful and at night we are often serenaded by tawny owls. I was interested to read in this article that much research has been carried out to discover whether there is any scientific basis for the sense of wellbeing that nature offers us and was delighted to discover that there is! Practicing yoga at Birchwood Yoga studio may be better for your mental health than you realised!


Suzie Johanson

studiojohanson was established by Suzie Johanson in 2013. The studio offers a range of design services, and develops creative projects under the studiojohanson brand. Suzie has 25 years experience as a designer working directly with small businesses and as a freelance designer in-house for design agencies and publishers. The studio has a diverse range of clients and has established relationships with photographers, illustrators, web developers, copywriters, editors and printers to achieve a professional and complete design service.