yoga | Dr. David Gratzer

From the Editor

Anxiety disorders are common, and often disabling to our patients. While treatments have improved, there is unmet need – and the desire to find new, scalable interventions. Increasingly, our patients look to different types of treatments, like yoga. But is trendy effective? Is yoga the not-so-new intervention we need?

Dr. Naomi M. Simon (of New York University) and her co-authors look at the treatment of generalized anxiety disorder with a sophisticated study. They compare yoga and cognitive behavioral therapy (CBT) against a psychological control condition, and against each other. So how do the treatments compare? “Kundalini yoga can reduce anxiety for adults with generalized anxiety disorder, but study results support CBT remaining first-line treatment.” We look at the big study and its big implications.

What have we learned about COVID-19 and mental health? In the second selection, we consider a new editorial from The Lancet Psychiatry. Mulling the state of the literature after almost a year of the pandemic, they write: “The good news is that by October, 2020, mental health was top of the charts in terms of published papers and preprints on the effects of COVID-19. The bad news is that the quantity of papers is not matched by quality.”

And in our final selection, we consider an essay by Rob Whitley (of McGill University). He notes that 27% of Canadians had used cannabis in the last year, about half of them for medical reasons. He worries about the stigma around medical cannabis and champions more public education. “This can help create a climate of acceptance and inclusion for the growing number of Canadians with mental illness who use cannabis to improve their well-being.”

On another note: in a past Reading, we featured an essay by Toronto filmmaker Rebeccah Love who wrote about her mental illness. Her new film, “Parlour Love,” has its premiere this Saturday at 7 pm EST through Zoom. In this short, powerful film, she draws from her own experiences of bipolar mania and psychosis, and paints a portrait of a woman in crisis. RSVP – palmpremiere@gmail.com.

From the Editor

Complementary and alternative medicines are trendy – but are they helpful?

“Depressed patients… often perceive CAMs [complementary and alternative medicines] as safer, accessible, more tolerable, and easily acceptable compared to pharmaceuticals. It has been estimated that 10% to 30% of depressed patients use CAM therapies, often in tandem with conventional treatments and frequently without the knowledge of their physician. This percentage is even higher amongst those with bipolar disorder (up to 50%) and in clinic populations (up to 86%).”

So writes Dr. Arun V. Ravindran (of the University of Toronto) and his co-authors in a new Canadian Journal of Psychiatry paper. That study – our first selection this week –considers the use of one type of CAM: yoga. They find that it “may be helpful as an adjunctive intervention.”

yoga-beach-sunset-relax

In the second selection, writing in JAMA, Dr. Linda Brubaker (of the University of California, San Diego) considers gender and roles in medicine. While she is careful not to over-generalize, she notes that: “As a group, women physicians spend proportionately more time on home and family care activities.” With the disruptions of COVID-19, she wonders what must be done to support all physicians. “Women and men physicians should be able to share the joy and the work of their lives equally.”

And, in the third selection, University of Toronto psychiatry resident Dr. Erene Stergiopoulos considers masks – and humility – in a time of COVID-19. In a personal essay that turns on a split-second decision, she notes: “These days it’s hard to remember a time before masks. And some days, it’s just as hard to imagine a future without them.”

Dr. David Gratzer

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Reading of the Week: Yoga vs CBT – What’s Best for Anxiety? (JAMA Psych) Also, COVID & Mental Health (Lancet Psych) and Whitley on Cannabis Stigma (Van Sun)

Reading of the Week: Is Yoga Useful for Depression (CJP)? Also, Women & COVID (JAMA) and Stergiopoulos on Masks & Medicine (UofTMed)