In the West, our definitions of mental health tend to relate to absence of maladaptive behaviours (violence, phobias, compulsions) and freedom from symptoms (anxiety, depression, seeing things and hearing voices). We tend to view a healthy person as one who conforms to normal social expectations of behaviour - can maintain relationships, keep a job, is friendly, etc. These definitions are limited because they relate to the norms of the culture or society in which they are formed and, more importantly, they take no account of any ideal state of mental health.
Blacks Medical Dictionary states that: "Problems of feeling, thinking and behaving may be regarded as a mental illness if they become excessive for the particular individual in relation to the difficulties experienced."
In today's Western society, we can see the outcome of such a limited definition, as explained so concisely in the Bhagavad Gita (2:62-63):
"When a man dwells upon the pleasures of sense objects, attraction for them arises in him. From attraction arises desire, the lust of possession, and this leads to passion, to anger."
"From passion comes confusion of mind, then loss of remembrance, the forgetting of duty. From this loss comes the ruin of reason, and the ruin of reason leads man to destruction."
A different view, which is perhaps higher and more difficult to attain, is one that gives meaning to our lives in a way that 'mere social success' cannot. Mental health, then, could be defined as 'a whole balanced person, living a life which is in harmony with themselves and the universe around them'. If we choose to view it in this way, then social success has little meaning - and most people have limited mental health.
Balance is the essence of this yogic ideal - and here we are considering the notion of energetic balance. When energy is blocked and not flowing freely, this manifests as the state we call depression. When energy is deranged and scattered, it manifests as the condition we call anxiety. When energy is out of balance and the person is out of touch with reality - as it is commonly experienced - and in touch with a different reality, when it becomes difficult to function on day-to-day levels, it is labelled psychosis.
What, then, do we mean by balance? We may be considered balanced if we can move from one situation to another, adapting ourselves where necessary. To be quiet and introspective at times and, at other times, allowing the energy to flow outwards and to make contact with the world. When there is a mental imbalance, we often find that the energy is 'stuck', with too much or too little energy going into the world or into ourselves. When we work with yogic practices, we try to bring the whole of our being, our mind, body, energy (prana) and spirit into a more harmonious and balanced state.
According to Swami Niranjanananda, "Pranic imbalance is a relatively new concept. We have been geared up to look at ourselves from the physical and mental viewpoint. However, yogis have attributed the cause of most of the mental, emotional or physical imbalances as originating in the pranic body, the pranic structure."'
In yoga, we understand the pranic structure as broadly relating to these polarities:
So how might we describe the energetic imbalance in the case of a depressed person? Excessive thinking, introversion and parasympathetic activity with insufficient access to energy.
In the case of a person with anxiety/panic attacks, how might we describe the imbalance? Here the energy is scattered, there is often hyperactivity, the sympathetic nervous system is continually overactive and consequently the person becomes unable to respond to real threat or crisis. The efficacious practices of yoga are different for the two groups, but there are common practices suitable for both groups. Thereafter, yoga practices are many and varied; a program can therefore be tailored to meet the needs of the individual with particular mental health difficulties. For those who experience depression, the more dynamic yoga postures (asanas) and breathing techniques (pranayamas) are indicated, as well as balancing practices such as alternate nostril breathing (nadi shodhana). For those who are experiencing anxiety and maybe manifesting panic attacks, the more introverting and calming practices are best, together with practices to balance the energy.
For people with psychotic illness, it is important to use practices which are grounding and balancing. Of these, work done for its own sake, rather than for any reward (karma yoga), preferably in an ashram (where the work may be hard, grounding, physical work) is undoubtedly the best. The aim is to keep the awareness in contact with the body and its connection to the earth. For this group, all yoga techniques should be practised with open eyes.
Of course, the teacher must be familiar with those practices which are contra-indicated for each group of people.
Often people with mental health difficulties come to yoga with the belief that they need to practise meditation and that this is the panacea which will resolve all their difficulties. In the short term, this is not true. Only when some balance has been restored by the practices of hatha yoga and maybe relaxation, does it become possible to practise meditation. Then it is possible to gain insight into, and resolve, the underlying causes of the condition.