Integrated yoga therapy for improving mental health in managers.

BACKGROUND: Managers' lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to "Excessive Tension" and consequent deterioration in "Executive Efficiency."
OBJECTIVE: To assess mental health in managers undergoing yoga-based Self-Management of Excessive Tension (SMET) program.
MATERIALS AND METHODS: 72 managers with 48.75±3.86 years of mean age were participated in this study of single group pre-post design. The General Health Questionnaire data were taken on the first and sixth day of 5 days SMET program.
RESULTS: The data analysis showed 68.25% decrease (P<0.001) in somatic symptoms, 66.29% decrease (P<0.001) in anxiety and insomnia, 65.00% decrease (P<0.001) in social dysfunction, 87.08% decrease (P<0.001) in severe depression, and 71.47% decrease (P<0.001) in all medical complaints.
CONCLUSION: These results suggest that participation in a SMET program was associated with improvement in mental health and may have implications for "Executive Efficiency."

The present age of speed and competition has increased the stresses and strains resulting in an increasing prevalence of lifestyle-related health problems[1] and specifically managers’ lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to “Excessive Tension” and consequent deterioration in “Executive Efficiency.”[2] One of the increasingly popular tools to overcome this new challenge is physical activity. There is growing evidence that has established the benefits of physical exercises in preventing lifestyle-related diseases[3] such as primary prevention of diabetes,[4] prevention of cardiac diseases through control over major risk factors such as smoking, lipids, obesity, and stress,[5] better quality of life of cancer patients,[6] positive health in normal persons through better physical fitness,[7] and stress reduction.[8] Yoga, which is considered to be a tool for both physical and mental development of an individual, is being recognized around the globe only in the last century although it has been practiced in India over several centuries to promote positive health and well-being. It gives solace for the restless mind and can give great relief to the sick.[910] It has become quite fashionable even for the common man to keep fit.[11] With growing scientific evidence, yoga is emerging as an important health behavior-modifying practice to achieve states of health, both at physical and mental levels. Several studies have demonstrated the beneficial effects of yoga on health behavior in many lifestyle-related somatic problems such as hypertension,[12] bronchial asthma,[13] diabetes[14] including some psychiatric conditions such as anxiety neurosis[15] and depressive illness.[16]

Yoga at Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore, offers a holistic and integrated stress management program called Self-Management of Excessive Tension (SMET) to combat this modern lifestyle problem and thereby one can lead a holistic way of living in health, harmony, and happiness.[2] Previous work on stress management educational program reported significant improvement in the subjective well-being inventory scores of the 77 subjects within a period of 10 days when compared with controls. These observations suggest that a short lifestyle modification and stress management educational program can make an appreciable contribution to primary prevention and management of lifestyle diseases.[17] Previous study on SMET reported decrease in occupational stress levels and baseline autonomic arousal in managers, suggesting significant reduction in sympathetic activity[18] and better emotional well-being in them.[19] Although yoga is getting popular, no previous investigation has systematically evaluated effects of yoga-based SMET program (in a residential setup) on mental health in managers. Hence, we have designed present study to assess the efficacy of 5 days SMET program on managers using general health questionnaire (GHQ).

OBJECTIVES

The objective of the study is to assess general health status (total health), which includes four domains namely somatic symptoms (SS), anxiety and insomnia (AI), social dysfunction (SF), and severe depression (SP), using a GHQ.

MATERIALS AND METHODS

Subjects

The subjects for the study were 72 corporate executives (63 males and 9 females), with a mean age of 48.75±3.86 years. Routine clinical examinations showed all of them in normal health, and none was using any other wellness strategy. All of them had high-fiber low-fat vegetarian diet and no caffeinated drinks, alcohol, or tobacco in any form during the 5 days residential SMET program. We got the participants’ signed consent to participate in the study after explaining the variables we would record and the study design. The institutional review board also had approved the project. We selected participants of the following inclusion and exclusion criteria to meet the study requirements fully.

Inclusion criteria: Age between 45 and 60 years (males and females), physically, and mentally fit.

Exclusion criteria: Taking medication, using any other wellness strategy.

Design: A single group pre–post study.

Assessments

The GHQ: 28-item tests using a binary method of scoring (0, 0, 1, 1) yields an assessment on four robust subscales: SS, AI, SF, and SP. A sum of the scores for these four subscales gives the score for total health. Lower scores in the GHQ indicate better state of the health. The cutoff scores for the GHQ used for this study were 4 or 5 (4/5).[20] It provides information about the recent mental status, thus identifying the presence of possible psychiatric disturbance. This questionnaire has acceptable psychometric properties and has good internal consistency and reliability with Cronbach's alpha of 0.85 and validity of 0.76.[21]

Intervention

All the subjects participated in SMET program[2] for 5 days [Tables 1 and 2].

Table 1

The schedule of the SMET program

Table 2

Lecture session during SMET program

Practical session during SMET program: Cyclic Meditation,[122] a combination of stimulating and calming practices based on yoga was given to the participants.

Data collection

The GHQ data were collected before (Pre) and after (Post) the 5 days SMET program.

Analysis

Statistical analysis was done with the help of statistical package for social sciences-16. The Kolmogorov–Smirnov test showed that the data were not normally distributed. We used the Wilcoxon signed-rank test to compare means of the data collected before (Pre) and after (Post) the SMET program.

RESULTS AND DISCUSSION

The data analysis [Table 3] showed 68.25% significant decrease (P<0.001) in somatic symptoms (GHQ_SS), 66.29% significant decrease (P<0.001) in anxiety and insomnia (GHQ_AI), 65.00% significant decrease (P<0.001) in social dysfunction (GHQ_SF), 87.08% significant decrease (P<0.001) in severe depression (GHQ_SP), and 71.47% significant decrease (P<0.001) in all medical complaints [Figures 1 and 2] (GHQ_Total).

Table 3

Data analysis

Figure 1

GHQ before and after the SMET program

Figure 2

Percentage decrease in GHQ after the SMET program

The idea of mental health is closely related with the concept of emotional intelligence. A manager with less medical complaints will be mentally healthy and emotionally balanced and can perform better in his workplace which will reflect in the organizational effectiveness. Moreover, managers with low medical complaints are happier, healthier, and more successful in their relationships which are signs of high emotional intelligence. Persons with high emotional intelligence may strike a balance between emotion and reason, are aware of their own feelings, show empathy and compassion for others, and have high self-esteem which may be instrumental in many situations in the workplace and can help achieve organizational effectiveness.[23] Recent research has shown a positive relationship between emotional intelligence and workplace success.[24]

Previous studies on yoga reported enhanced mental health as a result of the practice of yoga way of life. The results indicate the importance of yoga as an integral element in improving managerial performance in organizations.[25-27] Our study is consistent with these findings, indicating that a systematic adoption of the SMET program can result in better health among managers for their “Executive Efficiency,” thus paving the way for their better performance as managers.

CONCLUSION

The results from the present study suggest that participation in a SMET program may be associated with improvement in mental health and may have implications for “Executive Efficiency.” Because before and after designs limit inferences about intervention effects, further research is warranted to explore the effects of SMET program for stress management using a larger, randomized controlled trial.