Yoga for Depression and Anxiety: A Narrative Review of Mechanisms and Clinical Efficacy
DOI:
https://doi.org/10.12775/QS.2026.59.72774Keywords
yoga, depression, anxiety, complementary therapy, neurobiology, psychotherapyAbstract
Introduction: Depressive and anxiety disorders are highly prevalent and frequently co-occurring mental health conditions, contributing significantly to global disease burden. Limitations of standard treatments highlight the need for complementary therapeutic approaches.
Aim: To evaluate the efficacy of yoga as an adjunctive intervention for depressive and anxiety disorders and related symptoms, and to summarize its underlying neurobiological and psychological mechanisms.
Methods: A narrative review of the literature published between 2006 and 2026 was conducted using databases such as PubMed, Scopus, and Google Scholar. Studies assessing yoga interventions in adult populations with depression and/or anxiety were included.
Results: Yoga demonstrated small-to-moderate reductions in depressive and anxiety symptoms, particularly when compared with passive controls. It appears effective as an adjunct to psychotherapy, with additional benefits linked to neurobiological mechanisms (e.g., HPA axis regulation, increased GABA and BDNF) and improved emotional regulation. However, its efficacy is less consistent when compared as a standalone intervention against active controls such as CBT.
Conclusions: Yoga is a safe and beneficial complementary intervention for depression and anxiety, especially when combined with standard treatments. It should not replace first-line therapies but may enhance overall outcomes and well-being.
References
1. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9(2):137-150. https://doi.org/10.1016/S2215-0366(21)00395-3
2. Lamers F, Van Oppen P, Comijs HC, et al. Comorbidity Patterns of Anxiety and Depressive Disorders in a Large Cohort Study: the Netherlands Study of Depression and Anxiety (NESDA). J Clin Psychiatry. 2011;72(03):341-348. https://doi.org/10.4088/JCP.10m06176blu
3. Stein DJ, Scott KM, De Jonge P, Kessler RC. Epidemiology of anxiety disorders: from surveys to nosology and back. Dialogues Clin Neurosci. 2017;19(2):127-136. https://doi.org/10.31887/DCNS.2017.19.2/dstein
4. Janiri D, Moser DA, Doucet GE, et al. Shared Neural Phenotypes for Mood and Anxiety Disorders: A Meta-analysis of 226 Task-Related Functional Imaging Studies. JAMA Psychiatry. 2020;77(2):172. https://doi.org/10.1001/jamapsychiatry.2019.3351
5. Schoevers RA, Van HL, Koppelmans V, Kool S, Dekker JJ. Managing the Patient with Co-Morbid Depression and an Anxiety Disorder: Drugs. 2008;68(12):1621-1634. https://doi.org/10.2165/00003495-200868120-00002
6. Wen S, Yan Y, Shao J, et al. Comparative gastrointestinal effects of antidepressants for the acute treatment of adults with major depressive disorder: a network and dose‒response meta-analysis. Transl Psychiatry. 2025;16(1):34. https://doi.org/10.1038/s41398-025-03751-3
7. Park LT, Zarate CA. Depression in the Primary Care Setting. Solomon CG, ed. N Engl J Med. 2019;380(6):559-568. https://doi.org/10.1056/NEJMcp1712493
8. McIntyre RS, Alsuwaidan M, Baune BT, et al. Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions. World Psychiatry. 2023;22(3):394-412. https://doi.org/10.1002/wps.21120
9. Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry. 2014;13(1):56-67. https://doi.org/10.1002/wps.20089
10. Singh B, Olds T, Curtis R, et al. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. Br J Sports Med. 2023;57(18):1203-1209. https://doi.org/10.1136/bjsports-2022-106195
11. Munro NR, Teague S, Somoray K, et al. Effect of exercise on depression and anxiety symptoms: systematic umbrella review with meta-meta-analysis. Br J Sports Med. 2026;60(8):590-599. https://doi.org/10.1136/bjsports-2025-110301
12. Chen Y, Wen J, Liu A, Wen SW, Zhou J. Revisiting the effects of physical activity on anxiety and mediation from plasma proteins: triangulation of evidence from observational study, Mendelian randomization, mediation and meta-analysis. J Affect Disord. 2026;393:120422. https://doi.org/10.1016/j.jad.2025.120422
13. Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev. 2019;107:525-539. https://doi.org/10.1016/j.neubiorev.2019.09.040
14. Xu L, Goldberg SB, Zhang L, Hu C. The effectiveness of second-generation mindfulness interventions on anxiety and depression: A systematic review and meta-analysis. Clin Psychol Rev. 2026;123:102693. https://doi.org/10.1016/j.cpr.2026.102693
15. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: A review of empirical studies. Clin Psychol Rev. 2011;31(6):1041-1056. https://doi.org/10.1016/j.cpr.2011.04.006
16. Edenfield TM, Saeed SA. An update on mindfulness meditation as a self-help treatment for anxiety and depression. Psychol Res Behav Manag. Published online October 2012:131. https://doi.org/10.2147/PRBM.S34937
17. Yoga | Definition, History, & Facts. Encyclopaedia Britannica. Accessed April 7, 2026. https://www.britannica.com/topic/Yoga-philosophy
18. Ivtzan I, Jegatheeswaran S. The Yoga Boom in Western Society: Practitioners’ Spiritual vs. Physical Intentions and Their Impact on Psychological Wellbeing. J Yoga Phys Ther. 2015;05(03). https://doi.org/10.4172/2157-7595.1000204
19. Mandlik GV, Nguyen B, Ding D, Edwards KM. Not All Yoga Styles Are the Same: An International Survey on Characteristics of Yoga Classes. J Integr Complement Med. 2023;29(5):321-326. https://doi.org/10.1089/jicm.2022.0712
20. Dysart A, Harden S. Effects of Temperature and Tempo: Evaluating How Much Time in a Typical Community-Based Yoga Class Is Moderate-Intensity Aerobic Activity. Int J Environ Res Public Health. 2023;20(3):2349. https://doi.org/10.3390/ijerph20032349
21. Pascoe MC, Bauer IE. A systematic review of randomised control trials on the effects of yoga on stress measures and mood. J Psychiatr Res. 2015;68:270-282. https://doi.org/10.1016/j.jpsychires.2015.07.013
22. Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017;86:152-168. https://doi.org/10.1016/j.psyneuen.2017.08.008
23. Marshall M, McClanahan M, McArthur Warren S, Rogers R, Ballmann C. A Comparison of the Acute Effects of Different Forms of Yoga on Physiological and Psychological Stress: A Pilot Study. Int J Environ Res Public Health. 2020;17(17):6090. https://doi.org/10.3390/ijerph17176090
24. Eda N, Ito H, Akama T. Beneficial Effects of Yoga Stretching on Salivary Stress Hormones and Parasympathetic Nerve Activity. J Sports Sci Med. 2020;19(4):695-702.
25. Malhi GS, Mann JJ. Depression. The Lancet. 2018;392(10161):2299-2312. https://doi.org/10.1016/S0140-6736(18)31948-2
26. Xie Z, Deng Y, Xie C, Yao Y. Changes of adrenocorticotropic hormone rhythm and cortisol circadian rhythm in patients with depression complicated with anxiety and their effects on the psychological state of patients. Front Psychiatry. 2023;13:1030811. https://doi.org/10.3389/fpsyt.2022.1030811
27. Wardenaar KJ, Vreeburg SA, Van Veen T, et al. Dimensions of Depression and Anxiety and the Hypothalamo-Pituitary-Adrenal Axis. Biol Psychiatry. 2011;69(4):366-373. https://doi.org/10.1016/j.biopsych.2010.09.005
28. Koh W, Kwak H, Cheong E, Lee CJ. GABA tone regulation and its cognitive functions in the brain. Nat Rev Neurosci. 2023;24(9):523-539. https://doi.org/10.1038/s41583-023-00724-7
29. Taylor CP, Angelotti T, Fauman E. Pharmacology and mechanism of action of pregabalin: The calcium channel α2–δ (alpha2–delta) subunit as a target for antiepileptic drug discovery. Epilepsy Res. 2007;73(2):137-150. https://doi.org/10.1016/j.eplepsyres.2006.09.008
30. Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012;78(5):571-579. https://doi.org/10.1016/j.mehy.2012.01.021
31. Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Breast Cancer Group, ed. Cochrane Database Syst Rev. 2017;2017(1). https://doi.org/10.1002/14651858.CD010802.pub2
32. Capiau A, Huys L, Van Poelgeest E, et al. Therapeutic dilemmas with benzodiazepines and Z-drugs: insomnia and anxiety disorders versus increased fall risk: a clinical review. Eur Geriatr Med. 2022;14(4):697-708. https://doi.org/10.1007/s41999-022-00731-4
33. Andrews PW, Bharwani A, Lee KR, Fox M, Thomson JA. Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response. Neurosci Biobehav Rev. 2015;51:164-188. https://doi.org/10.1016/j.neubiorev.2015.01.018
34. Liu B, Liu J, Wang M, Zhang Y, Li L. From Serotonin to Neuroplasticity: Evolvement of Theories for Major Depressive Disorder. Front Cell Neurosci. 2017;11:305. https://doi.org/10.3389/fncel.2017.00305
35. Mousten IV, Sørensen NV, Christensen RHB, Benros ME. Cerebrospinal Fluid Biomarkers in Patients With Unipolar Depression Compared With Healthy Control Individuals: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022;79(6):571. https://doi.org/10.1001/jamapsychiatry.2022.0645
36. Pizzagalli DA, Berretta S, Wooten D, et al. Assessment of Striatal Dopamine Transporter Binding in Individuals With Major Depressive Disorder: In Vivo Positron Emission Tomography and Postmortem Evidence. JAMA Psychiatry. 2019;76(8):854. https://doi.org/10.1001/jamapsychiatry.2019.0801
37. Kjaer TW, Bertelsen C, Piccini P, Brooks D, Alving J, Lou HC. Increased dopamine tone during meditation-induced change of consciousness. Cogn Brain Res. 2002;13(2):255-259. https://doi.org/10.1016/S0926-6410(01)00106-9
38. Calabro FJ, Montez DF, Larsen B, et al. Striatal dopamine supports reward expectation and learning: A simultaneous PET/fMRI study. NeuroImage. 2023;267:119831. https://doi.org/10.1016/j.neuroimage.2022.119831
39. Castrén E, Monteggia LM. Brain-Derived Neurotrophic Factor Signaling in Depression and Antidepressant Action. Biol Psychiatry. 2021;90(2):128-136. https://doi.org/10.1016/j.biopsych.2021.05.008
40. Björkholm C, Monteggia LM. BDNF – a key transducer of antidepressant effects. Neuropharmacology. 2016;102:72-79. https://doi.org/10.1016/j.neuropharm.2015.10.034
41. Polyakova M, Stuke K, Schuemberg K, Mueller K, Schoenknecht P, Schroeter ML. BDNF as a biomarker for successful treatment of mood disorders: A systematic & quantitative meta-analysis. J Affect Disord. 2015;174:432-440. https://doi.org/10.1016/j.jad.2014.11.044
42. Gibbons TD, Cotter JD, Ainslie PN, et al. Fasting for 20 h does not affect exercise‐induced increases in circulating BDNF in humans. J Physiol. 2023;601(11):2121-2137. https://doi.org/10.1113/JP283582
43. Yuping Z, Tianbi L, Wentao S, Yun L, Guodong Z. The Optimal Type and Dose of Exercise for Elevating Brain‐Derived Neurotrophic Factor Levels in Patients With Depression: A Systematic Review With Pairwise, Network, and Dose–Response Meta‐Analyses. Barlati S, ed. Depress Anxiety. 2024;2024(1):5716755. https://doi.org/10.1155/da/5716755
44. Cahn BR, Goodman MS, Peterson CT, Maturi R, Mills PJ. Yoga, Meditation and Mind-Body Health: Increased BDNF, Cortisol Awakening Response, and Altered Inflammatory Marker Expression after a 3-Month Yoga and Meditation Retreat. Front Hum Neurosci. 2017;11:315. https://doi.org/10.3389/fnhum.2017.00315
45. Tolahunase MR, Sagar R, Faiq M, Dada R. Yoga- and meditation-based lifestyle intervention increases neuroplasticity and reduces severity of major depressive disorder: A randomized controlled trial. Restor Neurol Neurosci. 2018;36(3):423-442. https://doi.org/10.3233/RNN-170810
46. Koncz A, Nagy E, Csala B, et al. The effects of a complex yoga-based intervention on healthy psychological functioning. Front Psychol. 2023;14:1120992. https://doi.org/10.3389/fpsyg.2023.1120992
47. Treves IN, Chen YY, Wilson CL, et al. A meta-analysis of the effects of mindfulness meditation training on self-reported interoception. Sci Rep. 2025;15(1):38889. https://doi.org/10.1038/s41598-025-22661-4
48. Price CJ, Hooven C. Interoceptive Awareness Skills for Emotion Regulation: Theory and Approach of Mindful Awareness in Body-Oriented Therapy (MABT). Front Psychol. 2018;9:798. https://doi.org/10.3389/fpsyg.2018.00798
49. Kwok JYY, Kwan JCY, Auyeung M, et al. Effects of Mindfulness Yoga vs Stretching and Resistance Training Exercises on Anxiety and Depression for People With Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol. 2019;76(7):755. https://doi.org/10.1001/jamaneurol.2019.0534
50. Hammond J, Brown WJ. Building an Operational Definition of Grounding. Trauma Violence Abuse. Published online June 27, 2025:15248380251343189. https://doi.org/10.1177/15248380251343189
51. Noetel M, Sanders T, Gallardo-Gómez D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2024;384:e075847. https://doi.org/10.1136/bmj-2023-075847
52. Brinsley J, Schuch F, Lederman O, et al. Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Br J Sports Med. 2021;55(17):992-1000. https://doi.org/10.1136/bjsports-2019-101242
53. Moosburner A, Cramer H, Bilc M, Triana J, Anheyer D. Yoga for Depressive Disorder: A Systematic Review and Meta‐Analysis. Xiong J, ed. Depress Anxiety. 2024;2024(1):6071055. https://doi.org/10.1155/da/6071055
54. Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. J Affect Disord. 2017;213:70-77. https://doi.org/10.1016/j.jad.2017.02.006
55. O’Shea M, Capon H, Skvarc D, et al. A pragmatic preference trial of therapeutic yoga as an adjunct to group cognitive behaviour therapy versus group CBT alone for depression and anxiety. J Affect Disord. 2022;307:1-10. https://doi.org/10.1016/j.jad.2022.03.028
56. Mu X, Xu K, Wang X, Sun Y, Wen D, Dong D. The effects of yoga exercise on stress relief capacity and emotional changes: a systematic review and meta-analysis. Front Psychol. 2026;17:1707131. https://doi.org/10.3389/fpsyg.2026.1707131
57. Cramer H, Lauche R, Anheyer D, et al. Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2018;35(9):830-843. https://doi.org/10.1002/da.22762
58. Schleinzer A, Moosburner A, Anheyer D, Burgahn L, Cramer H. Effects of yoga on stress in stressed adults: a systematic review and meta-analysis. Front Psychiatry. 2024;15:1437902. https://doi.org/10.3389/fpsyt.2024.1437902
59. Barry TJ, Murray L, Fearon P, Moutsiana C, Johnstone T, Halligan SL. Amygdala volume and hypothalamic-pituitary-adrenal axis reactivity to social stress. Psychoneuroendocrinology. 2017;85:96-99. https://doi.org/10.1016/j.psyneuen.2017.07.487
60. Roberts AG, Peckins MK, Gard AM, et al. Amygdala reactivity during socioemotional processing and cortisol reactivity to a psychosocial stressor. Psychoneuroendocrinology. 2022;144:105855. https://doi.org/10.1016/j.psyneuen.2022.105855
61. Bystritsky A, Kronemyer D. Stress and Anxiety. Psychiatr Clin North Am. 2014;37(4):489-518. https://doi.org/10.1016/j.psc.2014.08.002
62. Simon NM, Hofmann SG, Rosenfield D, et al. Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2021;78(1):13. https://doi.org/10.1001/jamapsychiatry.2020.2496
63. Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2023;80(1):13-21. https://doi.org/10.1001/jamapsychiatry.2022.3679
64. Cramer H, Ostermann T, Dobos G. Injuries and other adverse events associated with yoga practice: A systematic review of epidemiological studies. J Sci Med Sport. 2018;21(2):147-154. https://doi.org/10.1016/j.jsams.2017.08.026
65. Wu Y, Yan D, Yang J. Effectiveness of yoga for major depressive disorder: A systematic review and meta-analysis. Front Psychiatry. 2023;14:1138205. https://doi.org/10.3389/fpsyt.2023.1138205
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