Depression is a common mental illness, suffered by an estimated 3.8% of the world’s population. Depression is now considered one of the most prevalent mental health conditions in America.Since the COVID-19 pandemic in 2020, psychological illnesses, including depressive and anxiety disorders, have spiked. Worse, current treatments, unfortunately, have a high non-response and relapse rate. And, to make matters worse, most pharmacologic treatments have undesirable side effects.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), depressive symptoms are usually defined as “depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration”. Depression often comes with chronic or recurrent symptoms of anxiety, as well. Sadly, these illnesses usually lead to a decreased quality of life and insufficient self care. Beyond that, the risk of chronic disease and/or death (often by suicide), exists.
There have been numerous well-designed studies and meta-analyses done on depression and/or anxiety regarding the benefits of Tai Chi. Evidence exists that Tai Chi is an effective, non-pharmacologic, treatment option for improving depression and/or anxiety in older adults. Tai Chi and/or Qigong, can significantly regulate emotions and relieve the symptoms of mood disorders in adults of any age. These benefits are not exclusive to “older” adults!
Tai Chi uses slow, deep breathing along with flowing movements, attention, and imagery to relax, strengthen, and integrate/harmonize the body and the mind. Practitioners focus on their body postures and movements, while regulating their breathing. This takes the focus away from their “stressor”.
A 2019 study looked at Clinical Trials to determine why Tai Chi alleviates depressive symptoms. They believe that it may “modulate the activity and connectivity of key brain regions”. These regions may regulate mood, modulate the autonomic nervous system, reduce “neuro-inflammatory sensitization”, modulate gray matter volume of the hippocampus, and regulate “hippocampal neurogenesis”. Tai Chi is a mild to moderate intensity exercise which, in turn reduces stress and modulates the inflammation process. Rarely recognized, Tai Chi can also increase vagal modulation in elderly individuals.
One meta-analysis published in the Int J Environ Res Public Health. 2023 Feb, concluded that non-pharmacological interventions are more effective for those with mild forms of depression. Tai Chi and Qigong have been found to decrease depressive symptoms, they are cost effective, they have lower to no side effects, and they have low relapse rates.
Recently, a group of Chinese scientists undertook a meta-analysis to determine which mind/body exercises were the most effective for older adults with depression and/or anxiety. Research determined that Tai Chi’s slow, fluid movements, plus deep breathing, contributed to lower stress levels, reduced tension, and improved mental well-being. Tai Chi and Qigong showed better improvement in anxiety reduction than other exercises. Participants benefited by improved body awareness and mind/body connection.
Interestingly, Dr. Albert Yeung, a Tai Chi practitioner and researcher, developed Tai Chi for Mood (Tai ChiM). He developed this Form specifically for individuals with mood disorders. Tai ChiM excludes Tai Chi’s complex transitions between movements, which makes it easier to learn, which, in turn, would likely encourage students to continue practicing the Form. Tai ChiM consists of 12 separate Tai Chi meditative movements, and uses deep, paced (mental focused)breathing. Tai ChiM focuses more on relaxation and less on physical strength. However, most Tai Chi forms do not focus on physical strength! For readers interested in checking out this form, it is available on YouTube with English, Chinese, and Spanish subtitles: (https://youtu.be/08IFKiXb3bA).
Let’s talk about Qigong:
Qigong emphasizes breath regulation and balancing internal energy. It is effective in improving depression and anxiety. Because it focuses on self-regulation of emotions, emotional stability is enhanced. Practitioners (participants) learn to cope with any anxious emotions before “they get out of control”. One especially effective Qigong exercise is Baduanjin (aka the Brocades). Baduanjin consists of eight postures which makes it a simpler mind/body exercise to learn. It is easily practiced by older adults (even those with cognitive decline), most of those with disabilities, and can be done at home in very little space. Researchers found that Baduanjin produces “greater and more extensive improvements in Wechsler Memory Scale (WMS) subscores and gray matter brain volume changes” than even Tai Chi when practiced by older (healthy) adults.
Both Tai Chi and Qigong are appropriate and beneficial for people of all ages, and most physical conditions (depending on the particular form). Most movements can be done standing or sitting and, in some Forms, can even be done lying down. It requires very little physical space. An important advantage Tai Chi and/or Qigong as a treatment or to augment other treatments, is the lack of adverse side effects.
Some thoughts on the current and future “wish lists”.
Tai Chi and/or Qigong can be used as adjuncts to antidepressant therapy, health education, and/or cognitive behavioral therapy.
Currently, instructional videos and less structured Tai Chi Forms have been developed. Some researchers suggest developing a simple, tailored Tai Chi protocol for patients with depression. Combining Tai Chi, Qigong and other mind-body exercises may create a new intervention which incorporates the advantages of each, in order to enhance modulation effects.
According to researchers, it also may be beneficial to create a Tai Chi and/or Qigong “regimen/protocol” tailored for specific individuals/populations with different disorders in the future.
Just like no one size fits all, one might take into account the patient’s personal situation, including their likes and dislikes. Some older adults may prefer the deep breathing and slow movements of Tai Chi, while others may gravitate to the breath regulation of Qigong. There are also others who may prefer other mind/body exercises. Intervention plans could be personalized for each individual.
Bottom line: I anticipate that there are questions and comments that will come up after reading this blog. Researchers are not necessarily Tai Chi (or Qigong) practitioners. I am not suggesting nor judging any of the questions below. There are no right or wrong answers. These are just “thinking” points!
I know that there are many “traditional”practitioners who feel that Tai Chi is becoming “watered down” and “for the masses”. Or are we taking a “different”Tai Chi into the future? By making all these changes and simplifying Tai Chi Forms, are we removing the “essence” of Tai Chi? Have we drifted further away from the teachings of the “founding” Masters and Grand Masters? By changing Forms and making Tai Chi accessible for all, will we lose something in the long run? Or is it a win-win?
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