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 Table of Contents  
Year : 2022  |  Volume : 3  |  Issue : 3  |  Page : 292-293

Spirituality as an Effective Aid in Reducing the Mental Stress of Medical Students in India

Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Date of Submission19-Oct-2022
Date of Decision31-Oct-2022
Date of Acceptance12-Nov-2022
Date of Web Publication28-Dec-2022

Correspondence Address:
Dr. Pulkit Johar
All India Institute of Medical Sciences, Rishikesh - 249 203, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JME.JME_130_22

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How to cite this article:
Johar P, Kodamana H, Miglani S. Spirituality as an Effective Aid in Reducing the Mental Stress of Medical Students in India. J Med Evid 2022;3:292-3

How to cite this URL:
Johar P, Kodamana H, Miglani S. Spirituality as an Effective Aid in Reducing the Mental Stress of Medical Students in India. J Med Evid [serial online] 2022 [cited 2023 Feb 1];3:292-3. Available from: http://www.journaljme.org/text.asp?2022/3/3/292/365849


Medical education in India has always been competitive. Right from getting admission to a medical school to applying for residencies, medical students have to face numerous examinations, vivas, etc., that test not just their academic prowess but their mental resilience as well. There is little change in the stress levels, that the students are exposed to after joining a medical school. The persistent presence of the need to perform well academically takes a toll on the mental health of medical students. This is evident from the fact that the global prevalence of anxiety among medical students was 33.8%.[1] Meanwhile, the global prevalence of depression among medical students was 28%.[2]

A study carried out by Arora et al. found that the most common reason reported for substance abuse among medical students was due to psychological stress. Further, stress is directly linked with the development of psychiatric disorders such as depression and anxiety amongst medical students.[3] Hence, it is imperative that effective coping mechanisms must be implemented by students to retain an effective and healthy state of mental well-being.

Sattar et al. found out that various coping mechanisms used by medical students to cope with mental health disorders included social and emotional support seeking, active coping, acceptance, avoidance, substance abuse, sports and so on. The study also revealed that out of the total individuals, 25% resorted to using spirituality as a coping mechanism.[4] Our opinion is to consider spirituality as an important coping mechanism for mentally stressed students. Numerous studies regarding the effects of spirituality on mental health have been carried out. Spirituality is a human development process that involves experiences of meaning-making, connectedness and transcendence.[5] This may be with god, nature, art, music, community, etc., which gives a sense of meaning and purpose in life.

A study carried out by Balboni et al. found that among cancer patients, 88% of respondents identified religion and spirituality as factors that were paramount in helping them adjust to their illnesses.[6] In addition, prayer, meditation and religious study were highlighted as factors important in coping with mental illness. Despite the fact that spirituality and religion are terms used interchangeably, there are slight differences between the two. Religion limits one to a particular set of practices, which have been followed traditionally. Spirituality involves the incorporation of multiple practices that are not specific to one particular religion. Further, focusing on just religion may lead to negative health outcomes such as discrimination and social isolation.[7] This substantiates the benefits of spirituality in reducing emotional distress. Hence, we aim to introduce spirituality as an effective coping mechanism to deal with mental stress.[3]

Spirituality can be incorporated by following certain practices. In an Indian setting, Satsangs, Raj Yoga and Naam simran (mantra-based meditation), singing, chanting, listening to religious discourses, hatha yoga, mindfulness meditation, going on pilgrimages and visiting temples are all different forms of spiritual practices.[8] Among this mantra-based meditation, hatha yoga and mindfulness meditation have been studied extensively and have proven effects on reducing stress in students.

Mindful meditation is a form of meditation, which involves a combination of deep breathing, and mindfulness, which is defined as a mental state that involves being fully focused on the present moment. This form of meditation has been developed into a mindfulness-based stress reduction programme, which has been shown to reduce stress anxiety in healthy controls. It is also known to lower the workload on the heart by reducing the heart rate and aids in better sleep.[9]

Hatha yoga is a school of yoga which focuses on the body as a means to attain perfect well-being.[10] It places great emphasis on diet, breathing patterns and bodily positions called 'asanas'. A meta-analysis revealed that hatha yoga plays an important role in reducing stress anxiety and depression. This is further substantiated by Dalgas et al.[11] who states that hatha yoga controls hormonal emissions, physiological factors and regulation of nerve impulses helping improve depression and mental disorder. Yogic breathing exercises, called pranayama, play a major role in decreasing mental stress amongst people. This has been proven by Bhimani et al. who discovered that pranayama has the ability to increase the parasympathetic output to the heart.[12]

Mantra-based meditation is another popular spiritual practice that aids in stress reduction. It involves the repetition of a phrase or a word. Transcendental meditation is one of the most popular forms of Mantra based meditation (MBM).[13] A systematic review carried out regarding its effectiveness reveals that MBM is associated with systolic and diastolic blood pressure and helps in reducing trait anxiety. It also shows significant benefits for burnouts, sleep disorders, substance abuse and so on.[9]

Thus, through the incorporation of these three practices, medical students can incorporate spirituality into their day-to-day lives to cope with the ever-increasing amount of stress that they endure.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al. The global prevalence of anxiety among medical students: A meta-analysis. Int J Environ Res Public Health 2019;16:2735.  Back to cited text no. 1
Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: A meta-analysis. Med Educ 2016;50:456-68.  Back to cited text no. 2
Arora A, Kannan S, Gowri S, Choudhary S, Sudarasanan S, Khosla PP. Substance abuse amongst the medical graduate students in a developing country. Indian J Med Res 2016;143:101-3.  Back to cited text no. 3
[PUBMED]  [Full text]  
Sattar K, Yusoff MS, Arifin WN, Yasin MA, Nor MZ. Effective coping strategies utilised by medical students for mental health disorders during undergraduate medical education – A scoping review. BMC Med Educ 2022;22:121.  Back to cited text no. 4
Lalani N. Meanings and interpretations of spirituality in nursing and health. Religions 2020;11:428.  Back to cited text no. 5
Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, et al. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol 2007;25:555-60.  Back to cited text no. 6
Estrada CA, Lomboy MF, Gregorio ER Jr., Amalia E, Leynes CR, Quizon RR, et al. Religious education can contribute to adolescent mental health in school settings. Int J Ment Health Syst 2019;13:28.  Back to cited text no. 7
Singh K, Junnarkar M, Singh D, Suchday S, Mitra S, Dayal P. Associations between religious/spiritual practices and well-being in Indian elderly rural women. J Relig Health 2020;59:2753-74.  Back to cited text no. 8
Álvarez-Pérez Y, Rivero-Santana A, Perestelo-Pérez L, Duarte-Díaz A, Ramos-García V, Toledo-Chávarri A, et al. Effectiveness of mantra-based meditation on mental health: A systematic review and meta-analysis. Int J Environ Res Public Health 2022;19:3380.  Back to cited text no. 9
Hofmann SG, Andreoli G, Carpenter JK, Curtiss J. Effect of hatha Yoga on anxiety: A meta-analysis. J Evid Based Med 2016;9:116-24.  Back to cited text no. 10
Dalgas U, Stenager E, Ingemann-Hansen T. Multiple sclerosis and physical exercise: Recommendations for the application of resistance-, endurance- and combined training. https://pdfs.semanticscholar.org/403d/2e5190061b607cdd1d3d13a62283d6f603ad.pdf  Back to cited text no. 11
Bhimani NT, Kulkarni NB, Kowale A, Salvi S. Effect of pranayama on stress and cardiovascular autonomic function. Indian J Physiol Pharmacol 2011;55:370-7.  Back to cited text no. 12
Yunesian M, Aslani A, Vash JH, Yazdi AB. Effects of transcendental meditation on mental health: A before-after study. Clin Pract Epidemiol Ment Health 2008;4:25.  Back to cited text no. 13


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