Impact of a Yoga and Meditation Intervention on Students’ Stress and Anxiety Levels
Methods. College students participated in a six-week pilot program that consisted of a 60-minute vinyasa flow yoga class once weekly, followed by guided meditation delivered by trained faculty members at the University of Rhode Island College of Pharmacy. Students completed pre- and post-intervention questionnaires to evaluate changes in the following outcomes: stress levels, anxiety levels, and mindfulness skills. The questionnaire consisted of three self-reporting tools: the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facet Mindfulness Questionnaire (FFMQ). Students’ scores on each were assessed to detect any changes from baseline using the numerical and categorical scales (low, medium, and high) for each instrument.
Results. Seventeen participants, aged 19 to 23 years, completed the study. Thirteen participants were female and four were male. Nine of the students were enrolled in the Doctor of Pharmacy program and eight were enrolled in other academic programs. Students’ anxiety and stress scores decreased significantly while their total mindfulness increased significantly. Changes in categorical data from pre- to post-intervention on the BAI and PSS were significant, with no students scoring in the “high” category for stress or anxiety on the post-intervention questionnaire.
Conclusion. Students experienced a reduction in stress and anxiety levels after completing a six-week yoga and meditation program preceding final examinations. Results suggest that adopting a mindfulness practice for as little as once per week may reduce stress and anxiety in college students. Administrators should consider including instruction in nonpharmacologic stress and anxiety reduction methods, within curricula in order to support student self-care.
Stress is defined as “a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.” 1 Students enrolled in health professions programs have high levels of stress. 2 Pharmacy students, specifically, have demonstrated an increased level of stress and decreased quality of life throughout their curricular programs. 3-8 Nationally, stress among Americans is increasing. Stress may negatively affect health and wellness, leading to detrimental physical and emotional symptoms such as headaches, anxiety, and depression. In 2017, college-aged Americans reported higher levels of stress than older generations and often did not adequately address their stress through positive coping mechanisms. 9 One positive modality that has demonstrated a reduction in pharmacy student stress is physical exercise. 2
Yoga and meditative practices may provide a skillset to assist college students in their coping mechanisms, both in and out of the classroom. The objective of this pilot project was to evaluate the efficacy of a six-week yoga and meditation intervention on college students’ stress perception, anxiety levels, and mindfulness skills. The information gathered from our research assisted in designing curricular opportunities within a PharmD program to support students with coping mechanisms to navigate their academic and life stressors. We hypothesized that the dual intervention of yoga and meditation would demonstrate more benefit to students in a shorter timeframe than either practice separately.
Drug abuse continues to be a major problem in Malaysia (1), with almost half of the Malaysian prison population of 30,000 having been indicted for various drug-related offenses (2). Acknowledging the importance of drug abuse and relapse as a public health issue, the Malaysian government has implemented a number of programs aimed at curtailing drug distribution as well as improving drug-treatment programs. Starting from 2010, the National Anti-Drug Agency (NADA) undertook efforts to transform their existing rehabilitation programs to a so-called open-concept approach. Rather than focusing solely on compulsory rehabilitative treatment for convicted drug offenders (3), the open-concept approach provides drug users with the opportunity to receive treatment voluntarily at local community service centers without facing legal judgment or prosecution (4). This new approach was aimed at allowing relapsed users to seek treatment while continuing with their life and career (5), while also encouraging drug users with the motivation to change, to seek treatment voluntarily with no legal consequences.
The possibility that people from many different, non-criminal backgrounds are engaging in drug use is also illustrated by recent research showing individual differences in the ability to use drugs without developing dependence (15). Ersche et al. (16), for example, examined the personality traits and neural correlates associated with stimulant dependence. They compared 27 individuals who used cocaine recreationally for a minimum period of 2 years without exhibiting substance-dependent behavior patterns to 50 individuals with stimulant dependence. Non-dependent, recreational users were able to engage in drug use in social situations without affecting their daily functioning (i.e., relationships with family and friends, school and work responsibilities) possibly because they showed lower overall levels of compulsivity and impulsivity than those who were dependent, even while demonstrating similar levels of sensation-seeking (16). Understanding drug use and abuse, thus, is probably more complicated than previous Malaysian statistics suggested, with a much greater number of casual or recreational users among the educated and higher social strata than was previously assumed.
This study thus aimed to broaden our understanding of the issues by taking a different approach. Rather than just looking at users or those who have been admitted to drug treatment programs, we chose to look at the views and opinions of the general public and non-users about the availability and use of illicit substances in Malaysia. Although previous research involving non-user populations has looked at reasons for non-use of illicit drugs (17) as well as perceptions of risk in Latin American countries (18), this kind of research has not been conducted in Malaysia. Understanding the mind-set of the non-user population, their conceptions and misconceptions about drug use, as well as related attitudes is, we feel, important for evaluating the effectiveness of existing drug education programs as well as for designing government health programs (19).
A second goal of this study was to understand the impression among university students, who are generally understood to be at high risk for drug use (20), of existing educational programs. The Malaysian government has initiated two programs, “SHIELDS” and “Tomorrow’s Leader,” which are aimed at providing drug education and prevention in public and private universities (7). However, there is little information available on the effectiveness of these and other programs conducted at various universities. Thus, this study also obtained qualitative feedback from students on their past experiences with drug education and prevention programs.
Tips for starting a relaxation practice
Learning the basics of these relaxation techniques isn’t difficult, but it takes regular practice to truly harness their stress-relieving power. Try setting aside at least 10 to 20 minutes a day for your relaxation practice.
Set aside time in your daily schedule. If possible, schedule a set time once or twice a day for your practice. If your schedule is already packed, try meditating while commuting on the bus or train, taking a yoga or tai chi break at lunchtime, or practicing mindful walking while exercising your dog.
Make use of smartphone apps and other aids. Many people find that smartphone apps or audio downloads can be useful in guiding them through different relaxation practices, establishing a regular routine, and keeping track of progress.
Expect ups and downs. Sometimes it can take time and practice to start reaping the full rewards of relaxation techniques such as meditation. The more you stick with it, the sooner the results will come. If you skip a few days or even a few weeks, don’t get discouraged. Just get started again and slowly build up to your old momentum.
Can, Yekta Said, Heather Iles-Smith, Niaz Chalabianloo, Deniz Ekiz, Javier Fernández-Álvarez, Claudia Repetto, Giuseppe Riva, and Cem Ersoy. “How to Relax in Stressful Situations: A Smart Stress Reduction System.” Healthcare 8, no. 2 (April 16, 2020): 100. https://doi.org/10.3390/healthcare8020100
Toussaint, Loren, Quang Anh Nguyen, Claire Roettger, Kiara Dixon, Martin Offenbächer, Niko Kohls, Jameson Hirsch, and Fuschia Sirois. “Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation.” Evidence-Based Complementary and Alternative Medicine 2021 (July 3, 2021): e5924040. https://doi.org/10.1155/2021/5924040
Unger, Cynthia A, David Busse, and Ilona S Yim. “The Effect of Guided Relaxation on Cortisol and Affect: Stress Reactivity as a Moderator.” Journal of Health Psychology 22, no. 1 (January 1, 2017): 29–38. https://doi.org/10.1177/1359105315595118
Sahni, Pooja Swami, Kamlesh Singh, Nitesh Sharma, and Rahul Garg. “Yoga an Effective Strategy for Self-Management of Stress-Related Problems and Wellbeing during COVID19 Lockdown: A Cross-Sectional Study.” PLOS ONE 16, no. 2 (February 10, 2021): e0245214. https://doi.org/10.1371/journal.pone.0245214
Keng, Shian-Ling, Moria J. Smoski, and Clive J. Robins. “Effects of Mindfulness on Psychological Health: A Review of Empirical Studies.” Clinical Psychology Review 31, no. 6 (August 2011): 1041–56. https://doi.org/10.1016/j.cpr.2011.04.006
Loprinzi, Paul D., and Emily Frith. “Protective and Therapeutic Effects of Exercise on Stress-Induced Memory Impairment.” The Journal of Physiological Sciences: JPS 69, no. 1 (January 2019): 1–12. https://doi.org/10.1007/s12576-018-0638-0
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Body Scan Meditation by Jon Kabat Zinn (VIDEO) – Follow along with a full body scan meditation led by Jon Kabat Zinn, Professor of Medicine Emeritus and creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.