As a follow up to our last post about COVID-19, it is now more apparent than ever that quarantines, remote learning and general social distancing have significantly impacted the lives of adolescents, even more so than adults. Teens have suffered negative psychological effects including confusion, anger and post-traumatic stress.
In this paper, we illustrate that yoga-based techniques can serve as an ideal complementary therapy for therapists who seek to help teens improve their mental health and reduce the feelings of loneliness that arise from social isolation. Our review of current studies, as well as our first-hand experience, reveal that yoga therapy is a powerful tool for helping teens counteract not only the current stress of isolation, but the long-term mental health effects induced by COVID-19 as well.
Two Real-life Cases Treated with Yoga Therapy
19-year-old ‘Rachael’ learned to use yoga and breathing practices to help her successfully cope with her mental health symptoms. She just got a job in a daycare center and is very proud and excited about it. She quit the waitressing at a bar where unruly patrons triggered her childhood trauma. Rachael has come a long way since December 2020, when the isolation of quarantine made her feel suicidal. For the longest time, she felt like her parent’s abusive treatment was her fault. In Spring 2021 she cut off contact with the parent responsible for her trauma. And she’s been using the yoga and breathing practices she learned from her therapist more frequently. She says these practices help her feel more in control of her life and her symptoms.
17-year-old ‘Claudia’ now utilizes yoga-based breathing techniques to help alleviate depression and suicidal thoughts. Earlier, she had felt confused and sad about a classmate who had died by suicide. She could relate. She too had felt suicidal. Even when she was discharged from the hospital for mental health issues, her main emotional support was through school and her therapist because she didn’t receive adequate support at home. Then COVID-19 hit, and she had no access to her school support system and only online access to her therapist. But these days she says she’s no longer suicidal. She says her pet snake, her kid sister and her boyfriend give her reasons to live. She says she’s learned to manage her depression through breathing practices, affirmations and caring for her snake.
These stories of teens’ struggle are true, though their names have been changed to protect anonymity. Their stories show how the COVID-19 pandemic has had an outsized impact on our teens everywhere.
COVID-19 Causes Trauma by Disrupting Normal Life Rhythms
Quarantines mandated to contain the virus have significantly impacted the lives of many around the world. Even adults subjected to quarantine suffer “negative psychological effects including confusion, anger and post-traumatic stress,” according to Loades et al (2020). Adolescents have suffered the same negative conditions but in greater doses. For instance, Loades et al (2020) notes that teens worried about infection, dealt with boredom and frustration, and watched on helplessly while parents or caregivers struggled with financial loss.
These negative impacts constitute a disruption in our normal rhythms of life, according to Dutch psychiatrist and pioneering trauma researcher Bessel van der Kolk (talk, 2020). Van der Kolk notes that as babies we learn about reciprocity with our caregivers through rhythm, engagement, and harmony on a physical, nonverbal level. He demonstrated this by showing a video of a mother interacting with her baby where the mother mimicked the baby’s coos, and the baby smiled back at her. When this kind of reciprocity is established early in life, it allows us to not only relate well with others but bolsters our self-esteem and sense of self (Wu, 2009).
Trauma is the lack of reciprocity and rhythm, according to van der Kolk. Given the disruption that COVID and quarantines have caused in human rhythms, we are all at risk for trauma. But teens are at particular risk “given the strong associations between interpersonal stress and the onset of emotional difficulties in adolescence” (Magson et al, 2021). Adolescents experience interpersonal stressors more acutely than other age groups because 1) they are more aware of the stressors than their younger, school-aged counterparts and 2) they don’t yet have the emotional, psychological and cognitive resources of the adults who care for them.
Another impact of quarantine for all age groups is the loneliness of social isolation. Loades et al (2020) found that loneliness is associated with future mental health issues, especially depression. Again, few age groups are more negatively affected by social isolation and loneliness than adolescents. One of adolescents’ primary developmental tasks is to expand their social network (Magson, et al, 2021; Loades et al, 2020). When they are kept from socializing with peers, extended family and support systems, they are at risk for increased psychological disorders (Magson, et al, 2021). In fact, children subjected to enforced isolation were five times more likely to require mental health services and suffer from higher levels of PTSD (Loades et al, 2020).
Therapists can Use Yoga Therapy to Help Teens Improve Mental Health
Yoga therapy offers teens a great solution to improve their overall mental health, restore their rhythms, and decrease the loneliness of social isolation. First, yoga therapy is considered a mindfulness-based treatment, which extant research shows can be helpful in healing PTSD and related mental health conditions (Miller, Mendelson, Lee-Winn, Dyer & Khalsa, 2020; Strehli et al, 2021). Strehli et al conducted a 2021 meta-analysis of studies measuring the effectiveness of mindfulness-based treatments, and 80% of the treatments in eligible studies were yoga-based. They found that mindfulness interventions like yoga can help improve biological markers of stress (specifically, heart rate, cortisol and blood pressure).
Strehli et al (2021) also found that mindfulness-based treatments like yoga are especially beneficial for adolescents. Though they found statistically significant improvements in subjects’ overall heart rate, cortisol, and systolic and diastolic blood pressure, “these effects tended to be stronger in older students than younger students.” In other words, adolescents showed greater gains in physiological stress reduction than their younger counterparts.
Second, Bessel van der Kolk says that yoga helps us rebuild reciprocity, which he deems a key factor in healing trauma (van der Kolk, talk, 2020). He says that yoga helps us get “in tune” with our own rhythm. Essentially, yoga helps restore the very rhythms that the pandemic has disrupted. Consider the rhythms of deep breathing, the routine of doing a regular yoga practice, or the supportive relationship created between yoga therapist and student. These are all examples of how yoga restores rhythm and reciprocity to heal trauma.
Finally, yoga therapy can ameliorate the long-term negative effects of depression associated with the loneliness of quarantine. As noted earlier, kids suffer more acutely and for a longer period (up to nine years) as compared to adults when they struggle with loneliness. Yoga helps alleviate depression and long-term mental health symptoms through behavioral activation. Behavioral activation is a well-researched, highly personalized skill often used in Cognitive Behavioral Therapy to help someone in a depressive episode reverse the ‘downward spiral’ of depression and ‘bring enjoyment and meaning’ back to one’s life (University of Michigan: School of Medicine, online download, accessed Sept. 16, 2021). When a teen learns and embraces yoga tools, they are more likely to practice them and more likely to use them when feeling depressed. This empowers them to use those skills again and again.
This means that yoga therapy is a powerful tool for helping teens combat not only the current stress of quarantine, but the long-term mental health effects as well. Yoga practices and movements help youth retrain the life rhythms that have been disrupted by the pandemic. They become empowered to listen to their bodies and emotions in healthy, positive ways.
Therapists can learn how to teach patients yoga-based techniques through Embodied Youth Training. We train therapists how to utilize an effective yoga therapy option for kids. We help therapists and clinics make a bigger difference in kids’ lives by offering them yoga tools that have long lasting benefits that are especially effective at helping teens overcome the negative impacts of COVID-19.