ABSTRACT

As a global burden, depression, one of the most common among all the psychiatric disorders, affects about 121 million people worldwide. Today, depression is the second cause of disability adjusted life-years (DALYs) in the age category 15-44 years.1 Apart from the huge public health burden, the cost of depression is enormous: workplace costs of over $34 billion per year in direct and indirect costs. People with depression have higher rates of mortality, and over 15% of depressed people take their own lives. This suicide rate is six times higher among men 85 years old and over than it is for the general population. Depression worsens the prognosis for patients with comorbid chronic medical illnesses. In addition, the caregiver burden associated with depression signicantly affects workplace performance, and children of mothers who suffer from chronic depression display more behavioral problems at school. Rates of undetected depression among drug and alcohol users are estimated to be as high as 30%.2 One important clinical issue in treatment of depression is that treatment resistance is relatively common. In cases of depression treated by a primary care physician, 32% of patients partially responded to treatment, and 45% did not respond at all. Rates of total remission following antidepressant treatment are only 50.4%.3 Nonpharmacological behavioral interventions are attractive because they are potentially more enduring than pharmacological

Introduction .................................................................................................................................... 369 Yoga, Meditation, and Mindfulness: Three Overarching Circles .................................................. 370 Yoga and (Mental) Health .............................................................................................................. 370 Use of Yoga and Mindfulness in Depression ................................................................................. 371 Yoga and Mindfulness-Based Cognitive Therapy: Use of Yoga in Its Entirety ............................. 372

The Y-MBCT Model for Depression and Its Psychosomatic Adaptations ................................ 374 Preliminary Data on Efcacy of DepS Y-MBCT in Depression .................................................... 375 Some Differences of Y-MBCT Models from Contemporary Models ............................................ 375 Conclusions, Limitations, and Future Directions .......................................................................... 376 Acknowledgments .......................................................................................................................... 376 References ...................................................................................................................................... 376

treatments. The lack of side effects and drug-drug interactions, often a concern with pharmacological approaches, may also be more appealing to patients in choosing these interventions.