Childhood is supposed to be a time of joy and exuberance, though many children and adolescents are instead suffering during this time of growth. Stress, anxiety, depression, and suicidal thoughts are a growing concern among school children. In the U.S., there were 4.4 million children and 1.9 million adolescents who were diagnosed with anxiety and depression, and this number could be higher given the lack of proper clinical diagnosis (Centers for Disease Control and Prevention, 2018). Between 7 and 16% of students in tertiary education experience mood or anxiety disorders every 12 months, and an additional 30% report experiencing moderate to severe stress levels (Bayram, 2008; Auerbach et al., 2018).
Stress & Anxiety in Children & Adolescents
The American Psychological Association (2023) highlights that children and youth experience stress from various sources, such as school responsibilities, financial issues, appearance concerns, family dynamics, relationships, and career choices. This stress can lead to severe chronic health problems, including sadness, hopelessness, and suicidal thoughts (2023). The COVID-19 pandemic, caused by SARS-CoV-2, has had significant adverse effects on global health and has also led to an emotional and psychological pandemic affecting people of all ages, regardless of economic status or physical health (Dalpati et al., 2022). Among the most impacted groups are students and young adults, who face uncertainties in their academic studies, limited outdoor activities, and disrupted routines caused by lockdowns (2022). Consequently, stress, anxiety, and depression rates have risen significantly among students worldwide.
Behavioral scientists are actively attempting to test interventions that help combat these mental health issues in the school population. Addressing poor mental health early on is crucial, as untreated symptoms can lead to poorer clinical outcomes, including an increased risk of developing a clinical diagnosis or experiencing relapse (Patton et al., 2014). Unfortunately, only a few distressed students are aware, seek, or receive treatment due to various cultural barriers, such as stigma and lack of awareness of available services (Corrigan et al., 2014; Gee et al., 2020). To overcome these challenges, tertiary education institutes have embraced mindfulness, meditation, and yoga as non-stigmatizing alternatives to traditional mental health support, according to a national health survey (Upchurch et al., 2018). Mind-body interventions involve yoga, which incorporates breathing exercises, mindfulness, and meditation. These practices draw from therapeutic components grounded in ancient spiritual traditions. However, it is essential to clarify that many interventions used in research settings often omit these spiritual elements. Instead, viewing and treating yoga solely as a physical activity is standard practice. The behavioral studies are designed based on this perspective.
Yoga-based Mindfulness in Schools and Colleges
Yogic practices are prevalent tools to reduce stress, improve productivity, and enhance general mental health in schools and universities (Sun et al., 2021). Moreover, Smith et al. (2020) found that research on school-based yoga programs suggests that yoga has the potential to enhance school culture and promote students’ well-being. Happier students who manage stress and anxiety are expected to have better attendance, behavior, and test scores. Similarly, Kanojia and Bhadane (2018) conducted a literature review on college students, examining emotional health, academic performance, substance use, sleep, and physiological factors. The systematic review from 2000 to 2016 indicated consistent attention given to studying the effects of yoga on college students.
Fortunately, there is extensive literature on yoga and mindfulness interventions for school and college students, and therefore, this post will only look at recent systematic reviews and meta-analyses. A meta-analysis that identified 11,936 articles and screened 181 papers with 24 randomized controlled trials conducted a random-effects analysis with 23 studies with 1373 participants and found that the effects of meditation, yoga, and mindfulness on depression, anxiety and stress in tertiary education (beyond high school; including undergraduate and graduate) students found moderate effects of interventions when compared to the active control group (Breedvelt et al., 2019). Interestingly, the study concludes that it needed to be clarified whether meditation, yoga, or mindfulness affected academic achievement. Many researchers still need to be made aware of the fact that yoga includes meditation and mindfulness components. However, it is unfortunate that yoga is primarily seen as a physical activity that incorporates asanas, while meditative components are separated from the classical definition of yoga. One systematic review identified 1115 records, of which 80 text articles were screened, resulting in 16 studies for review (Sun et al., 2021). Results from 13 out of 16 studies showed improvement in a child’s social-emotional development, especially among children with lower baseline social-emotional functioning in early childhood settings when yoga and mindfulness practices were implemented for at least six weeks (2021). Yoga and mindfulness practices showed positive effects on several regulatory domains as well as attention capacity, peer and prosocial behaviors, and general well-being. However, more rigorous methods and studies are needed (Sun et al., 2021).
Another recent systematic review evaluated yoga as an intervention for reducing anxiety and depression symptoms in children and adolescents, and out of 1114 references, 27 were examined, and outcome measures to assess anxiety and depression symptoms were assessed (James-Palmer et al., 2020). The researchers point out that studies did not indicate which aspects of yoga were utilized; however, 70% of studies showed overall improvements, 58% of studies measuring both anxiety and depression showed a reduction in both symptoms, and 25% of studies showed an anxiety reduction. Also, 70% of studies assessing anxiety only showed improvements, and 40% of the studies assessing depression only showed improvements (2020). A significant obstacle in yoga research is a clear and consistent definition of yoga. Most, if not all, studies on yoga need to pay more attention to the spiritual elements that are inherent in traditional yoga practices. Despite this central challenge, a study by James-Palmer et al. (2020) highlights another issue: the specific type of yoga employed in research needs to be more well-defined and protocols listed. This lack of clarity extends to factors such as the length of sessions, the types of yoga poses involved, the duration of breathing exercises, the inclusion of meditative practices, and the frequency of sessions. Additionally, more research should be conducted regarding the individuals responsible for guiding participants through the yoga interventions.
Despite research challenges, yoga-based intervention studies are in full swing as it is crucial to assess the effects of yogic components on various psychological, emotional, and immunological factors that influence students’ academic performance and well-being. Despite increasing scientific evidence supporting the effectiveness of non-invasive, cost-effective, and easy-to-implement yogic practices, school districts and universities must fully embrace and implement these modalities to achieve institutional and academic success.
References:
American Psychological Association. (2023). Kids’ Mental Health is in Crisis. Retrieved from: https://www.apa.org/monitor/2023/01/trends-improving-youth-mental-health
Auerbach, R. P., Mortier, P., Bruffaerts, R., Alonso, J., Benjet, C., Cuijpers, P., … & Kessler, R. C. (2018). WHO world mental health surveys international college student project: prevalence and distribution of mental disorders. Journal of abnormal psychology, 127(7), 623.
Bayram, N., & Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety, and stress among a group of university students. Social psychiatry and psychiatric epidemiology, 43, 667-672.
Bhadane, M., & Kanojia, A. (2018). A systematic review of yoga for mental and physical health in college students. Int. J. Yoga Allied Sci, 7.
Breedvelt, J. J., Amanvermez, Y., Harrer, M., Karyotaki, E., Gilbody, S., Bockting, C. L., … & Ebert, D. D. (2019). The effects of meditation, yoga, and mindfulness on depression, anxiety, and stress in tertiary education students: A meta-analysis. Frontiers in psychiatry, 10, 193.
Centers for Disease Control and Prevention. (2018). Children’s Mental Health, Data, and Statistics. Retrieved from: https://www.cdc.gov/childrensmentalhealth/data.html
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70.
Dai, C. L., Sharma, M., Chen, C. C., Yesilyurt, E., & Godbey, S. (2021). Yoga as an alternative therapy for weight management in child and adolescent obesity: A systematic review and implications for research. Altern. Ther. Health Med, 27, 48-55.
Dalpati, N., Jena, S., Jain, S., & Sarangi, P. P. (2022). Yoga and meditation, an essential tool to alleviate stress and enhance immunity to emerging infections: A perspective on the effect of COVID-19 pandemic on students. Brain, Behavior, & Immunity-Health, 20, 100420.
Gee, C. B., Khera, G. S., Poblete, A. T., Kim, B., & Buchwach, S. Y. (2020). Barriers to mental health service use in Asian American and European American college students. Asian American Journal of Psychology, 11(2), 98.
James-Palmer, A., Anderson, E. Z., Zucker, L., Kofman, Y., & Daneault, J. F. (2020). Yoga as an intervention for the reduction of symptoms of anxiety and depression in children and adolescents: a systematic review. Frontiers in pediatrics, 8, 78.
Patton, G. C., Coffey, C., Romaniuk, H., Mackinnon, A., Carlin, J. B., Degenhardt, L., … & Moran, P. (2014). The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. The Lancet, 383(9926), 1404-1411.
Smith, B. H., Esat, G., & Kanojia, A. (2020). School-based yoga for managing stress and anxiety.
Sun, Y., Lamoreau, R., O’Connell, S., Horlick, R., & Bazzano, A. N. (2021). Yoga and mindfulness interventions for preschool-aged children in educational settings: A systematic review. International Journal of Environmental Research and Public Health, 18(11), 6091.
Upchurch, D. M., Gill, M., Jiang, L., Prelip, M., & Slusser, W. (2018). Use of mind–body therapies among young adults aged 18–24 years: Findings from the 2012 National Health Interview Survey. Journal of Adolescent Health, 63(2), 227-232.
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