Tuesday, August 24, 2010

Yoga (ba) GABA

One of my standard recommendations for people who have anxiety is to practice yoga. There are controlled clinical trials demonstrating its efficacy (1)(2), and who hasn't felt that amazing sense of serenity and well-being after a particularly good yoga class? Part of treating anxiety is to bring people down from the state of constant alertness, to help someone be comfortable in his or her own skin for once. Yoga, through the process of holding (sometimes) uncomfortable positions and breathing through the stress, is a direct physical practice for allowing yourself to get through a psychological stress. Eastern ways of viewing stress, as a wave to allow to crash over you rather than as something you can fight, can be helpful in teaching people how to cope.

All well and good. Binge drinking can help you relax (short term) and teaches you how to deal with discomfort in a very physical way too. But I don't recommend it for anxiety. Binge drinking and heavy alcohol use will often make anxiety much worse.

Why does yoga help and a flood of alcohol hurt? Well, the money is on GABA. Gamma-aminobutryic acid is a neurotransmitter I've made brief mention of before. GABA is the chief inhibitory neurotransmitter in the mammalian nervous system. It cools things off and chills things out. People with depression and anxiety have been shown to have low amounts of GABA in their cerebrospinal fluid. MRI spectroscopy has been used to estimate the amount of GABA in people who are depressed, and the levels are low compared to controls (3).

Activate the GABA receptors in the brain with ambien, Xanax, a glass of wine, and you get relaxed and sleepy. When these substances are constantly in the brain and then rapidly withdrawn, you suddenly have overexcited GABA receptors and you can get unfortunate side effects such as insomnia, anxiety, and seizures.

Medicines often used for anxiety or seizures (or both) increase GABA itself. These treatments include depakote, lithium, SSRIs, tricyclic antidepressants, and a treatment for very resistant psychosis and depression, electroconvulsive therapy (shock treatments). And researchers at Boston University Medical School have found increases in the brain (measured via MRI) with yoga (3).

The study I have full access to is a pilot study of 8 experienced yoga practitioners and 11 comparison subjects. None had any history of psychiatric illness or seizures. The yoga people were asked to do 60 minutes of yoga postures and breathing. The control group was asked to read quietly for an hour. Then everyone got an MRI spectroscopic examination. Fun! The people who did yoga ended up with 27% increase in GABA in their noggins compared to controls. Since GABA is relaxing and anti-anxiety, that's good! Turns out, though, that the yoga peeps had lower baseline GABA, but since the study was so small, it just so happened that all the women in the yoga group were in the luteal phase of the menstrual cycle (the second "premenstrual" half, after ovulation), and the women in the controls happened to be in the follicular stage. Turns out that our GABA levels are lower in the "premenstrual" half of the cycle (so give me that glass of wine, honey....).

Recently, the same group at BU did a second, somewhat larger study (4) comparing walkers and yoga practitioners. (I won't have access to the full text of this study for 3 months unless I go to the actual medical library.  Uncool, Journal of Alternative and Complementary Medicine!) Again, healthy people were studied, not anyone with psychiatric illness. This time, 19 yoga practitioners and 15 walkers did yoga or walked for an hour three times a week for twelve weeks. The yoga practitioners reported improved mood and anxiety compared to the controls, and MRIs showed increased GABA in the thalamus of the yoga practitioners compared to the walkers.

Yoga isn't Paleolithic. I don't see our distant ancestors practicing downward facing dog. But yoga combines physical activity with forced acute attention on the present. Lose your focus in tree stand, and you lose your balance. In my mind, yoga and other mindful meditation practices emulate, to some respect, the focus and attention we had to have while hunting and gathering. We couldn't be thinking about the mortgage or Uncle Phil getting drunk at last year's Christmas party. We had to be focused on the trail and the prey.

There are many ways to add mindfulness and a present focus to our everyday lives, and growing evidence that it is good for our brains to do so.

15 comments:

  1. interesting, I wonder if this is working the same way?
    http://www.nejm.org/doi/pdf/10.1056/NEJMoa0912611

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  2. Good post to read while listening to my daughter's tv show, Yo Gabba Gabba, in the background.

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  3. i prefer L-Theanine for lowering my glutamate sensitivity and slightly increasing GABA throughout the day (without inducing drowsiness). at night, i directly take GABA. L-Theanine produces the same calm, yet focused state you described above,and also can help when having ADD, or keeping calm in challenging or stressful situations. way underrated in my opinion.

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  4. GABA does not cross the blood brain barrier (except in a few little places, where the brain is in direct contact with the blood). L-theanine is an interesting compound, though as always my interest is why would we be low in GABA anyway? Is it stress + genetic vulnerability? Is it deficiency? Is it lack of hunting/gathering (or otherwise doing focused tasks with our bodies and hands, for example)? All fun speculation.

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  5. GABA does not cross the barrier ONLY if it's healthy and tight. if i take the usual 750mg GABA tablet, i almost fall from the chair after like 15 minutes because of the relaxation and sleepiness it induces. if i take 2-3 tablets, it almost shuts down my autonomous breathing, and creates some tingling in the lips etc. the suppressive effects are very similar to GHB btw (with which i have experimented extensively a few years ago ;) it's a *brilliant* instant anti-depressant btw. probably comparable to ketamine, which i haven't tried yet tho). GABA would not be a successful supplement since years if it didn't cross the barrier in a significant amount of people. there are so many reasons why the B/B barrier can get damaged that this doesn't surprise me at all. my suspicion is: leaky gut/dysbiosis OR gluten sensitivity OR food allergies OR chronic infection OR chronic inflammation OR environmental toxins can lead to a leaky barrier. and now that i'm saying this i realize that since i stopped eating gluten (and other foods i'm allergic to like milk and eggs) several weeks ago GABA seems to work less and less for me - even to the degree that i have stopped taking it a few days ago. isn't that interesting..

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  6. (i was referring to GHB as an instant anti-depressant btw. usually in a dosage of 1-3g. see http://www.biopsychiatry.com/ghb/authentic.html for example. GABA does nothing like this unfortunately. it only makes you relaxed, sleepy and dizzy lol)

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  7. Walking does not seem that difficult compared to many of the yoga classes I have been to. Perhaps it's the intensity of the exercise that dictates the magnitude of the GABA response.

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  8. Qualia - agree with you on the healthy BBB, and there is evidence that gluten or other what proteins cross it in humans.

    Chris - I believe they were trying to use exercise burning similar amounts of calories, to see if it was the exercise or the yoga that caused the GABA increase. That's what I could glean from news coverage of the paper and the abstract - I won't have access to the actual paper for 3 months.

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  9. Per your post and this article (http://news.yahoo.com/s/livescience/20100825/sc_livescience/yogashowspotentialtowardoffcertaindiseases) — do anti-depressants reduce systemic inflammation? Best, Kevin

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  10. I have sent Emily a paper off-list regarding GABA & growth hormone release. Here is the link to the abstract: http://www.ncbi.nlm.nih.gov/pubmed/18091016

    I have experimented with & used GABA whilst under very high training loads. At doses of 3g, I am sure there is enough 'spill-over' via the areas of the brain that can be crossed readily, to have an effect (either that, or many of the noticeable effects are mediated peripherally rather than centrally). As I mentioned to Emily, in one of the athletes I used GABA on, I have never seen anyone soak up so much training day after day as this athlete. Though I have to say (and I didn't include this in my email to Emily), in hindsight, I suspect this athlete had major gluten issues, so might have been a hyper-responder as as result.

    I too responded well to GABA pre- removal of gluten and other neolithic agents from my diet. I was able to get some GABA recently (it is a class B drug here in New Zealand due to its proximity to the date rape drug GHB so you run the gauntlet getting it in) and I don't think it was as effective as what I have experienced previously. But that is trying it whilst being 'fully primal'.

    I do use L-theanine to help shut my brain off at night so I can get to sleep at maximise that all important first 3 hours and the growth hormone release that goes with it. At high doses of L-theanine, I find it puts me out fairly readily and I have never noticed being groggy in the morning nor any other side effects.

    I am going to go crash-test dummy on stacking theanine with L-glutamine prior to sleep... just cos I can!

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  11. Kevin - yes, antidepressants are systemically anti-inflammatory, along with yoga and psychotherapy. I mention the specifics in my first post in August, "Depression crashed your party"

    Jamie - thanks for the paper! Fortunately I have no issues falling asleep. It's staying asleep with two kids 3 and under that becomes a problem....

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  12. Hi Emily, then it stands to reason that mildly depressed people on long-term antidepressants should have a lower rate of incidence of inflammatory diseases, from IBDs to lupus, and beyond. Do any studies bear out that prediction? Regards, Kevin

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  13. Kevin, I would say that the only fair comparison would be with never treated depressed people (no antidepressants, yoga, or psychotherapy). It is doubtful that any such long term study has been done.

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  14. It seems that the question is “why does yoga work to reduce anxiety?”. Here is a yoga teacher’s perspective!

    The increase in the presence of GABA is a measurable physical change that happens as a result of a much deeper energetic process.

    Yoga is the methodology that was given to us to re-unite with the energy that created us. The true practice of yoga brings us back to the feeling of our eternal self, the feeling of wholeness. The practice of yoga helps to expand the feeling and presence of our soul into our body and mind. When we feel anxiety it is a sign that some part feels separate from the feeling of wholeness. The part that evolved separately from the feeling of oneness is the mind (also known as the ego). When the mind feels separate, it feels afraid. When we turn to alcohol, cigarettes, sugar, TV, business, excessive exercise, shopping, eating to numb anxiety, we actually move further from the feeling of wholeness, and towards the feeling separateness, loneliness, fear, anger etc. That is one of the reasons why numbing practices are not good permanent solutions to anxiety. They all, when done for the purpose of numbing, (different from when you feel guided by your sou) indeed bring one farther from that feeling of wholeness and deeper into separateness. Numbness is just what we are doing to hide the pain of being separate from the feeling of oneness. The path of yoga is the process of waking up from the deep forgetting of who we are inside the heart energy center (different from the physical heart). The heart energy center holds the feeling of the “true me”, the eternal you. It is the holder of the feeling of your soul, a quiet feeling of infinite wisdom, love and a quiet joy,

    When we do yoga, this heart center energy begins to circulate through the body. Each yoga pose is like a circuit that helps to connect the body and mind with a particular aspect of your soul. However, not all practices of yoga will guide the body back to alignment with the soul. When the practice grows the feeling of self love, rather than self aggrandizement...chances are good that you are growing your connection with your soul, rather than growing your separateness.

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  15. Taking GABA supplements made me dizzy and very short of breath,which brought on a really panicky feeling ,15 mins after swallowing...it wasnt nice.

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