Exploring young women's experiences of a mindful yoga intervention for depression in the Netherlands: Qualitative analysis of positive and negative effects

Objectives: Evidence of the benefits of yoga for patients with major depressive disorder (MDD) is mixed and results mainly from randomized controlled trials (RCTs). Adding qualitative measures to RCTs may give additional insight into the range of outcomes experienced by participants. We therefore used qualitative measures to assess the positive and negative experiences of young women (18-34 years) with depression who received a 9-week mindful yoga intervention added to treatment as usual.

Methods: We conducted qualitative interviews after a 12-month follow-up alongside an RCT in the Netherlands. Questions were open-ended and assessed experiences with mindful yoga reflecting positive or negative experiences. In addition, we explicitly asked about negative effects. Interviews were systematically analysed, and statements were placed in five domains (Affective, Cognitive, Conative, Somatic and Yoga Skills) and diverse subcategories.

Results: We collected qualitative interviews of 58 of the 88 participants randomized to mindful yoga (66%). The majority of participants had no previous experience with yoga (76.8%). Mean age was 24.68 (SD = 4.70). A little over half of the participants were employed (53.6%). All participants were diagnosed with current depression. Level of self-reported symptoms of depression was considered 'severe' and level of clinician-rated symptoms of depression was considered 'moderate'. For most participants, the current episode started 1-2 years ago (35.8%) or more than 2 years ago (34%). Of these 58 participants, 81.0% reported positive effects and 65.5% reported negative effects. Positive experiences consisted mostly of positive affect (56.9%), meta-cognition (44.8%) and general physical relaxation (41.4%). Negative experiences consisted mostly of meta-cognition (37.9%), agitation or irritability (20.7%) and physical inflexibility (12.0%).

Conclusions: Most young women in the mindful yoga intervention experienced both positive and negative effects. In future research, broader measurements of positive effects and structural assessments of negative effects are warranted.