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The World Health Organization defines depression as a common mental disorder, with clinical features as depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and power of concentration . According to WHO, depression is expected to account for more lost years of healthy life than any other disease by 2030, except for HIV/AIDS . The ‘Diagnostic and Statistical Manual of Mental Disorders – V’ describes symptoms of Major Depressive Disorder (MDD) as: a depressed mood, suicidal ideation, fatigue or loss of energy, psychomotor agitation, and insomnia, persisting for most of the day, nearly every day for a period of two weeks. In Ayurveda, “Prasannatmendriya manah” is quoted as definition of health. Different factors which affect mental health are wrong behavior related to Kaya, Vaak and Manas.Depression has become an unwanted companion casting a shadow on every aspect of our lives. It remains as a social stigma in terms of prevalence and suffering, dysfunction, morbidity and economic burden.Clinically as per symptoms, depression is correlated with vishada, avasada, manodhukhaja unmada and kaphaja unmada. A 28 years female client presented with following complaints: Generalized Diet issues Constipated hard stoolsLethargy & generalized weakness in the bodyDepressed moodDiminished ability to concentrateHyposomniaTearfulness without any reason and over-eating.HOW CAN AYURVEDA BE A BOON FOR SUCH CASES IN TREATING DEPRESSION WITH THE USE OF HERBS & PANCHAKARMA PROCEDURES. See this case of depression as to how I treated my patient with optimum use of herbs, diet, yoga and Ayurvedic therapies. AETIOLOGY:Family history Trauma or stress in personal or professional life Pessimistic personality with low esteem Certain medical ailments have depression as add on feature such as Parkinson’s disease, cancer, schizophrenia etc.Side effect of certain medications such as steroids, anti-hypertensive drugs, etc.Psychological disorders such as anxiety disorder, eating disorders etc.PATHOGENESIS:Ayurveda mentions the following causes for depression:Lack of coordination between Dhi (learning), Dhriti (retention) and Smriti (long term memory)Imbalance of prana shakti Pragyapradha (violation of natural ethics)As per our classical references, the causative factor in mental disease (mano-vikara) is mainly an increase and imbalance in the mansika doshas i.e. ‘Rajas’ and ‘Tamas’. These two states are described to ‘Icchha ‘(Desire) and ‘Dwesh’ (Repulsion) which are mainly triggered by stress. Imbalance of rajas and aggravation of tamas at the psychic level are important pathological factors. Imbalances of the three doshas are representative of different cognitive and somatic symptoms:VATAPITTAKAPHA Vitiation: destroys mental sense and gives rise to griefManifestation: anxiety and hyperactivityVitiation: mental states of excessive fear, lust and griefManifestation: passivity and lethargyVitiation: lethargy, anxiety and in-discriminationManifestation: strong emotions, anger. CLINICAL FEATURES: Mood variations Disturbed sleep, eating patterns Weight gain/loss issuesFeeling of low esteem Somatic complaints Short temper, a feeling of anxiety Tearfulness for no reason, an unrealistic sense of failure DIFFERENTIAL DIAGNOSIS:Anxiety disorder Personality disorderHypothyroidism Vitamin B deficiency Nutritional deficiencyMetabolic disease as diabetes
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AYURVEDIC MANAGEMENT APPROACH:
PREVENTION |
LINE OF TREATMENT |
SHASTRIYA FORMULATIONS |
SATWAVAJAYA CHIKITSA |
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NIDANA PARIVARJANA
SHODHAN CHIKITSA
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SHODHAN CHIKITSA:
Snehapana(internal oelation) : Kalyanak ghrita 10ml with saindhav for 5 days , for early oelation process , empty stomach.
Sarvang abhyang : Full body massage with ksheerbala oil followed by sarvang swedana (full body steaming)
Nasya : Brihana nasya with puarana ghrita ( old cow ghee) in a dose of 4 drops in each nostril for 5 days.
Shirodhara : With medicated oil ( Chandanadi tail+ Ksheer Bala tailam ) for first 3 days , then ksheerdhara/jaladhara for 40 min daily for 8 days .
Shiro-abhyang : Head massage with Brahmi oil mixed in almond oil daily .
Shirolepa
YOGIC PRACTICE SEQUENCE FOLLOWED:
Sookshma vyayama (warming up exercise)
Asana
Pranayama
Deep relaxation technique
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