In a 69-year-old man with chronic multi-therapy resistant bipolar depression, combining intravenous ketamine three times per week with sequential theta burst stimulation led to complete remission that persisted at a two-year follow-up. The patient had previously failed numerous antidepressants, mood stabilizers, electroconvulsive therapy, and standalone brain stimulation. Clinical improvement was measured by a drop in the Hamilton Depression Rating Scale from 15 to 8 and eventually to remission. Electroencephalography showed corrected dysregulated brain activity patterns, suggesting changes in short-term adaptive plasticity. This combination may offer a treatment path for patients who do not respond to standard therapies.
Pranayama, the ancient yogic practice of breath control, acts as a natural method of neuromodulation by influencing autonomic functions, brainwave patterns, and neuroendocrine responses. Evidence from clinical, neuroimaging, and psychophysiological studies shows that techniques such as slow breathing, rapid breathing, and unilateral nostril breathing stimulate the vagus nerve, regulate the autonomic nervous system, and shift hemispheric brain dominance—mechanisms similar to contemporary approaches like transcranial magnetic stimulation and vagus nerve stimulation. Pranayama offers an accessible, self-directed alternative for managing stress, enhancing cognition, and promoting emotion regulation. Significant knowledge gaps remain, including the need for well-powered, randomized-controlled studies to understand durability of effects, optimal protocols, and mechanisms of action.
Schizophrenia involves disconnection at neural, mental, and social levels, leading to poor quality of life due to cognitive deficits and negative symptoms that resist standard antipsychotics. Yoga may improve quality of life by targeting these symptoms. This paper proposes a model integrating neuroscience evidence: meditation styles may strengthen prefrontal brain networks, improving neurocognition and mentalizing; coordinated physical postures with a teacher may enhance social cognition and empathy via the mirror neuron system. Oxytocin is suggested as a mediator for social connectedness. The model offers clinical and heuristic implications.