Review Article

Yoga and stress management during and post COVID-19 urban lifestylein Japan
Akiko Kato and Rajib Shaw
Graduate School of Media and Governance, Keio University, Japan

Abstract
When COVID-19 started spreading in Japan, the government announced national emergency in April-May, and requested people
to stay inside home for a prolonged period of time. This has caused significant stress in different groups of urban residents inJapan, where close contacts were the key issue. An online survey conducted with urban residents have pointed out that 78% were
under stress, and 18% were using yoga to relieve from the stress. Although the percentage of people conducing yoga was less, butthey wanted to continue it even after the COVID-19 is over. With some literature review, the paper argues yoga as an effectivemeans of stress and health management during as well post Corona time. This is especially relevant to urban lifestyle, since yoga
can be done by any age group, including physically challenged people. It is argued that yoga can also release stresses in different
disaster situation, especially in the evacuation centers.
Key words: COVID-19, yoga, stress management, urban lifestyle, healthcare
Asian Journal of Complementary and Alternative Medicine. Volume 08 Issue 3
Published on: 30/12/2020*Author for Correspondence: Graduate School of Media and Governance, Keio University, Japan
Cite this article as: Akiko Kato and Rajib Shaw. Yoga and stress management during and post COVID-19 urban lifestyle in Japan
Asian Journal of Complementary and Alternative Medicine, Vol 8 (3), 48-54:2020.

Introduction
In December 2019, an outbreak of coronavirus infection(COVID-19) was reported in Wuhan City, North Province,
People’s Republic of China, and has infected significant
number of people causing death, severe health problems,
impacts of economies, livelihood and lifestyles. Japan, with its
close proximity to China, high volume travel between the twocountries, high urban density and relatively higher percentage
of aged population is considered vulnerable to this global
pandemic from the initial stage [1, 2]. On April 7, 2020, theGovernment of Japan revised the state of emergency, judging
that “a situation has occurred that could have a tremendous
impact on the people’s lives and the national economy due tothe nationwide and rapid spread of the disease. Based on theprovisions of Article 32, Paragraph 1 of the Act on Special
Measures Concerning Influenza, etc.” Unlike other countries,
the state of emergency in Japan is not a forced lockdown, rathera request to its citizen to refrain from going out, maintaining
basic social norms and protection measures, reductionof economic and social. Before calling for nation wide
emergency, several prefectures including Tokyo Metropolitan
Government, Hokkaido (the northern island) has declared its
prefectural emergency and made the same request to its people
to observe certain levels of restrictions. This was one of thefirst attempt in recent years that the Japanese Government

has called for national emergency due to pandemic, which isconsidered as a biological hazard.
In addition to the economic stagnation, more than 100 million
people stayed in the home for more than a month including
all ages like infants, school children, working people and theelderly. In other words, the fight against this unprecedented
virus has resulted in the burden of lack of exercise and stresson healthy people, who did not have any symptoms of thevirus. The stress caused by refraining from going out causessocial and family problems such as domestic violence, andthe increase in suicides due to financial instability is alreadyanxious [3]. The stress and lack of exercise associated withthese self-restraint from going out, often termed as “corona
blue”, have become a problem not only for adults who workfrom home, but also for children who cannot go to school, andto elderly people who cannot go to day care services.
On April 22, 2020, two weeks after the state of emergency wasannounced, a government expert meeting discussed measuresagainst the new coronavirus and proposed to reduce contact
with people by 80% as “situational analysis” and “proposal”)[4]. The expert panel recommended 10 points for online
activities for muscle training and yoga. As a result, it becamea proposal to relieve the mental and physical stress using
yoga that can be done online at home and maintain wellness.
Different academic institutes, including Keio University has© Asian Journal of Complementary and Alternative Medicine, 2020

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also decided to introduce video yoga lessons as a mean tomaintain the wellness of the mind and body at homes when
students refrain from going out. In this way, yoga found its
new niche in urban lifestyle to combat the unprecedented largescale and long-lasting impacts of COVID-19. In addition, as
we are seeing multiple waves in COVID-19 in different partsof the world, including Japan (which is under third wave from
October 2020), the world may continue to be intermittently
and partially refrained from going out or banned from goingout for which will also cause prolonged stress.
In this context, the paper examines the importance andusefulness of yoga for effective stress management, withspecific focus on urban residents. With an online survey
conducted in Japan, the paper argues that in the urban lifestyleduring as post COVID-19, yoga can play an important role instress management, as well as overall health management.

Yoga and its effects on health andstress management
Yoga is defined as “stopping all activities of the mind and mind
(chitta)” (MOA 2017, p 4-5) [5]. This section describes the
medical science related argument for effectiveness of Yoga.
Our minds are influenced by the physical world and are in astate of confusion and suffering every day. Minds and thoughts
are constantly changing, and yoga is the task of completely
stopping change while controlling the changing mind. Withyoga, one can free oneself from the state of mind that istrapped in that suffering and binding (MOA 2017, p 4-5) [5].
By stopping the movement of one’s mind, one can reach astate of enlightenment and control it in a calm state. Yoga is tocalm one’s mind and free oneself from the painful conditionsof confusion. In other words, yoga is a mental activity aimed at
calming the mind and body. In addition to using various asanas(poses), pranayama (breathing), meditation (meditation), yoga
is a healthy and lively lifestyle with a balanced approach tolife [5]. It makes the most of the ability of yoga breathing(pranayama) and meditation to balance the sympathetic andparasympathetic nerves. The stress hormone cortisol has
emerged as the true nature of stress. It has been found that highlevels of cortisol secreted by long-lasting stress reduce theprocesses of nerve cells in the hippocampus of the brain. The
hippocampus is the part that controls memory and is involvedin emotions. It has become apparent that damage can lead todementia and depression. Yoga breathing is an effective way tosolve this [6]. Numerous researches have pointed out scientificvalue of yoga on health management.
In addition, the program “Mindfulness”, which was born basedon yoga meditation, is attracting attention as a method of
preventing mental illness caused by breathing [7]. Mindfulness
meditation and reduced breathing can help calm the amygdala
and manage stress [8]. Because the respiratory center is close

to the pituitary gland, yoga control of the pituitary gland calms
the pituitary gland and suppresses cortisol secretion from theadrenal cortex to reduce stress. Pranayama can reduce bloodflow in the pituitary gland and reduce stress.
It is said that serotonin levels are low in stress and depression.
Serotonin is a transmitter that suppresses the runaway of
noradrenaline and dopamine and balances the mind. The
serotonin nervous system exists as tens of thousands of cellbodies in the raphe nuclei in the midline of the brainstem, and its
axons project to a wide range of brain regions from the cerebral
cortex to the spinal cord, affecting various brain functions[9]. Therefore, mental stability can be obtained by increasing
serotonin. In particular, the spontaneous firing mode of serotonin
nerves has the following characteristics. Regular impulse firingcontinues at a few hertz during awakening, with slow-wave sleep
firing sparsely and irregularly, and REM [rapid eye movement
sleep] sleep with complete firing arrest. In other words, it works
on the cerebral cortex and has various functions such as making
one feel refreshed when wake up, making one’s body active
when wake up in the morning, suppressing the sensation ofpain, and working on anti-gravity muscles. When serotonin is
low, these functions do not work well, making it harder to getup and making it easier to feel pain in trivial matters. Serotonin
is said to increase through a regular life, exposure to light, andrhythmic exercises such as dancing and jogging [10].
[11] a professor of integrated physiology at Toho University
School of Medicine, conducted Zen yoga breathing exercisesfor people who had no experience in zazen and observed
the appearance of alpha waves [11]. Among the α waves (813Hz), the high-frequency α2 component (10-13Hz) increased
significantly, theta waves decreased, and β waves did not show
significant fluctuations. The point to note about the appearanceof alpha waves during awakening is that anyone who closes
their eyes immediately becomes an alpha wave-dominant brain
wave [12]. Therefore, we tried Zen yoga breathing even whenthe eyes were closed (note that the above data is in the openstate). Since the eyes are closed, a high peak of the α wave
is observed from the beginning. The α wave (corresponding
to the low frequency α1 component) disappears at about 7
minutes of the breathing method, and instead, at 4-5 minutesof the breathing method, a new α2 component appears and isgradually enhanced. That is, it was considered that the Zen
yoga breathing method changed the arousal state of the brain
waves and the cerebral cortex through a pathway in the brain
different from that by closing the eyes. [13]. It is rhythmic
exercise that further enhances serotonin neural activity inthe awake state. Yoga, the rhythmic movement of breathing,enhances the impulse firing of serotonin nerves.
Yoga seems to be used by wider variety of people andprofessionals from different section of the society. Tom Brady’s© Asian Journal of Complementary and Alternative Medicine, 2020

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health regimen would not be complete without a healthy doseof ancient Eastern wisdom. He is a hardcore lover of yoga,
which he gives credit for miraculous mental and physicalbenefits: “It’s great for flexibility, it’s therapeutic, and greatfor your attitude.” Sports personnel, including Major League
baseball players, soccer players, sumo wrestlers are foundto be using yoga increasingly for both their stress and healthmanagement [14]. In Japan, yoga is gradually introduced toelementary, junior and middle high schools as a part of extracurricular activities. Self Defense Forces in Japan, including
Maritime Self Defense team are also using yoga when theyneed to spend longer time in the

COVIDS-19 Stress Management
In the world, several countries like China, Italy, France, otherEU countries, UK, USA, Russia, Canada, Indian have taken
policies such as lockdown and refraining from going out atperiodic and spatial ways over last several months. This put
billions of people under house arrest for weeks and months at
home. This first-ever global experience of lockdown in March
2020 was repeated in the form of second and third waves
over the next few months. In other words, this research ischaracterized by studying the fight against stress caused by thehistoric number of people under house arrest for the first timein history, also to enhance a better preparedness for similardisasters in the future. This is related to stress management
method from the standpoint of disaster prevention and earlyrecovery. People, including celebrities in different countries
have been engaged in indoor family or self-activities likecooking, indoor exercise or workout, web concerts etc. torelease their stresses, and this can be viewed through numerous
social media posts over last several months.
There are several researches on COVID-19 related stresses.
The level of stresses varies from people to people, sometimes
based on the age, occupation etc. The importance of
psychosocial assessment and monitoring is highlighted by[15], and argues that the assessment should include queries
about Covid-19–related stressors (such as exposures to infectedsources, infected family members, loss of loved ones, andphysical distancing), secondary adversities (economic loss, forexample), psychosocial effects (such as depression, anxiety,psychosomatic preoccupations, insomnia, increased substanceuse, and domestic violence), and indicators of vulnerability(such as preexisting physical or psychological conditions).
Different tips are provided through different research forstress management during COVID-19. A few can be listed
as follow: healthy eating habit, creative physical exercises,social connectivity, practicing kindness, enough time forrest and relaxing, focusing on mindfulness etc. Integrative
consideration of COVID-19 also emphasizes on stressmanagement, and urged the importance of mindfulness

techniques such as meditation, breathing exercises, guided
imagery, etc. [16]. In a survey of around 1000 Chinese college
students, [17] have pointed out different types of stresses
during isolation in COVID-19 period. The study argued thatlong isolation can have negative consequence on the mental
stress among young generation, and have suggested six step
intervention strategy, including delivery of appropriate risk
information and enhancing knowledge on stress management
among others.
Role of yoga in stress management has also been emphasized
by several authors. [18] emphasized on the importance ofshortage of yoga trainer and argued that yoga practice isactively sought to achieve reduced anxiety and stress so that
improved sleep may positively impact immunity. They also
argued the importance of social media in spreading online
yoga and its usefulness in stress management and highlighted
the effectiveness of yoga in working from home stressmanagement. [19] also argued the importance of yoga and
Ayurveda as alterative public health approach for COVID-19
health management. Arguing that poor mental health condition
including stress and depression, are known to increase the riskof acute respiratory infections, the paper argued that several
measures for mental health are described in yoga therapy,
including pranayama (breathing exercise) which enhances lungfunction. Meditation is found to reduce inflammation markers
and influence markers of virus-specific immune responses.

Survey in JapanTo understand the stress issues among wider urban residents
in Japan, a questionnaire survey on stress management andyoga practice during COVID-19 period was organized by
Keio University and Yoga organization of Japan during 15thof May to 15th of June 2020. The survey was conducted online
using promotion through different social media and website.
A total of 336 people responded to the survey with different
age groups and nationalities (mostly Japanese, but also India,
USA and others, who are residing in Japan). Female % of the
respondents were higher with 63%. 51% of the respondents areof the age group between 20s and 30s, followed by 23% of 40s
and 50s, and 20% under 20s.
Figure 1 shows the results of the survey. It seems that 78%of the respondents are feeling some kind of stresses during
COVID-19. The stress is exemplified in the form of different
health impact like clod limbs, dizziness, less appetite,irritation, out of breath etc. Financial issue, fear of infection,
isolation from society, are some of the causses of stress.
People use different ways to release stresses like sports,
stretching, yoga, as well as reading etc. Around one third of
respondents used to conduct yoga before the pandemic, witha small percentage (18%) were conducting yoga for stressmanagement (Figure 2).

© Asian Journal of Complementary and Alternative Medicine, 2020

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Figure 1: Feeling stress and ways to release stress.

Figure 2: Performing yoga before and during COVID-19
Those who conducted yoga, usually does it once a week or
2-3 times a week (Figure 3). From the survey, it is found that
54% of people who practice yoga, do yoga by themselves,and 36% of people who practice yoga using online platform,
including you tube (Figure 3). Usual time is 5-10 minutes
and 10-30 minutes (Figure 4). The survey also showedthat 37% are doing yoga aiming at improving immunity,and 21% are doing it for stress management (Figure 4).
To a question whether they want to continue yoga after
COVID-19, 17% responded positively, especially for the
purpose of stress management. A minor percentage (2%)
intend to use yoga to improve cardiopulmonary function,
while 10% wanted to continue yoga to maintain being slim
and good physique.

© Asian Journal of Complementary and Alternative Medicine, 2020

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Akiko Kato and Rajib Shaw

Figure 3: Performing yoga and meditation during COVID-19

Figure 4: Timing of performing yoga and meditation© Asian Journal of Complementary and Alternative Medicine, 2020

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Akiko Kato and Rajib Shaw

Discussion
Currently, not only Japan but the world is facing the onslaughtof new coronavirus infections. Each country has focused on
stopping the spread of the infection, even if it suspends its
economy, industry and education, and as a result, working fromhome by refraining from going out has become a norm, and ourlifestyle has changed significantly. Under the circumstanceswhere it is difficult to accept patients in hospitals because ofover-crowded healthcare systems, different virtual ways ofcommunication methods such as telework, take-out, online
shopping, mail order, etc. are getting popular. Social changeis accelerating due to the psychological effects of anxiety
and fear of being unable to meet people. In the future, even
if the epidemic of the new coronavirus infection is settled, itis thought that the lifestyle with physical distance as a new
countermeasure against infectious diseases will remain thesame. Therefore, it is required to propose changes in urban
lifestyles, focusing on people’s health and happiness, and how
to have a sustainable lifestyle in the future.
As a characteristic of urban lifestyle, there is a tendency tolike queues and crowds. Events such as parties, dining out,
museums, concerts, etc. are great pleasures of the urban
lifestyle, and while stimulating the exchange of different
cultures with exciting knowledge and technology, we seek
nature and relaxation in rural areas. However, during pandemic,
these events themselves were restricted, depriving people ofthe pleasure of going out. Physical distance has become a newmanner, and online gatherings, shopping, and browsing haveprogressed, depriving the characteristic enjoyment of urban
lifestyles. The drastic reduction in opportunities to express
oneself in relation to others has made it difficult to satisfy thedesire for self-approval from status appeals and group appeals,
and the altruistic value of branded products and luxury products
among consumers has also declined.
In addition, social infrastructure such as transportation,cityscapes, and lifelines support urban lifestyles. Even if
the houses are small in size in urban areas in Japan, many
people commute to work comfortably in an office building
equipped with air conditioning control. However, due to therequest to refrain from going out, the population of commutersconcentrated in the city decreased, and they were forced to stayin a small house. It doesn’t require long commute times anddoesn’t move. Under these circumstances, the value of urbansocial infrastructure has declined rapidly, and many companies
have lost the meaning of renting offices in buildings at highrent.
The concept of care and cure got its new position in urban
lifestyle due to pandemic. While people go to hospitals andhealth centers for getting cured, it is increasingly becoming
important to make proper health care measures which prohibits

disease, and also enhance immunity and reduces stresses ina busy urban lifestyle. From the above survey results, it isobserved that while there is a significant urban resident inJapan who were felling stress during the CVOID-19 pandemic,
not that many people were practicing yoga. The history ofyoga in Japan date back to the year 806 during Tang Dynasty,
however, the recent days yoga started when Tempu Nakamura
practiced yoga in 1919 and started teaching it. Yoga has been
popular among the female urban residents over years, which
has been mainly used as a mean to stay slim and fit. The yoga
movement in Japan got the boost with the start of International
Yoga Day in 2015 by Government of India, which promoted
yoga globally as a soft power tool. Yoga Organization of Japan
has been strongly promoting yoga among different age groups
and professionals, including national diet members.
It is interesting to note from the survey that those who were
doing yoga could find it to be effective means for stressmanagement. Similarly, yoga can also be effective against theharmful effects of lockdown and refraining from going out.
The benefits of performing yoga can be summarized as: 1)
one can practice yoga indoor and by alone, 2) All generations(elderly, middle-aged, elementary, junior high and high school,
infants) can practice yoga, 3) prevents the risk of illness due
to lack of exercise, 4) avoiding personal and family crises due
to stress, and 5) yoga is possible for people with disabilities.
The following points should be kept in mind when creating afuture COVID-19 yoga program: 1) regularly train your lungs
with breathing exercises (prevention), 2) eliminating lack of
exercise by asana (pose), 3) immunity boosting and stressrelease by asana, 4) relieve stress by meditation, 5) immunity
boosted by Ayurvedic diet, and 6) reducing economy classsyndrome due to asana. In addition, from the perspective ofdisaster prevention yoga, it is necessary to carry out yoga
programs from pre-disaster prevention. Performing yoga ona regular basis is a measure against COVID-19. In addition,
regarding disasters other than corona, it is necessary to makepolicy recommendations to create and disseminate a yoga
program to maintain physical and mental health and wellness
in the event of a disaster, especially in the evacuation centers.

Conclusion
The study focused on the urban residents during COVID-19
pandemic and looked at the stress people were facing. The
online survey pointed out that while significant percentage of
people are undergoing stress, only one fifth practiced yoga as a
stress management reliever. However, those who have practiced
yoga wanted to continue it even after the pandemic is over. The
paper also argues that in Japanese urban lifestyle, stress is asignificant part, with or without Corona. Therefore, practicing
yoga as a part of urban lifestyle helps in reducing the stress,enhances immunity against diseases and enhances physical© Asian Journal of Complementary and Alternative Medicine, 2020

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Akiko Kato and Rajib Shaw

fitness. Since yoga and meditation can be practiced anywhereby any age groups, including people having disabilities, thiscan be a part of healthy lifestyle. Yoga can be considered asa part of “care” system, which will reduce the pressure on the“cure” systems in the hospital and health centers.

Author Contribution
A.K. contributed to survey, analysis and initial writing of thedraft. R.S. contributed to conceptualization, initial writing.
Both the authors have read and agreed to the current versionof the manuscript.

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