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Ayurvedic treatment modalities for depresssion and mental disorders

Allopathy treats mental disorders with anti-depressants. Ayurveda views Manas
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Table of Contents

How This Helps

Ayurveda defines health (Swasthya) as “Samadosha samagni samdhatu malakriya……prasannatmendriya manaha swasthaittyabhidiyate”  which roughly translates to  “balanced doshas, or harmony in mind, body and spirit”. Ayurveda focuses on the promotion of health, and prevention and cure of diseases through the concepts of positive physical and mental health. Definition of ‘Ayu’ clarifies promptly that ‘life is the combined state of body, senses, mind and soul.’

The World Health Organization defines depression as a common mental disorder, with clinical features as depressed mood, loss of interest or pleasure, feeling 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 other disease by 2030 (except for HIV/AIDS).

According to Acharya Charaka, ‘the entity which is responsible for thinking is manas’ (the mind) which is connected to both jnanendriya (sensory centers) and karmendriya (motor centers), hence called as Ubhayatmaka (combined psychomotor entity).

Manas (the mind) has following actions:

• Indriyabhigraha (sensory and motor perceptions and control)

• Svasyanigraha (self-control)

• Uha (speculation)

• Vicarya (thinking)

Manas has two basic qualities: anutva (atomic nature) and ekatva (unitary nature).

Manas influences the prakriti (constitution) even at the embryonic stage; Ayurveda states that ‘the feutus grows steadily with the help of the reproductive element and the panchmahabhutas (five basic elements) namely, Prithvi (earth), Aap (water), Teja (fire), Vayu (air), and Akash (space) .

See: Importance of diet & nutrition on mental health

Instructions

CLASSIFICATION OF MANASVIKARA (mental disorders):

Three Doshas: Vata, Pitta and Kapha are the three functions which regulate all of the physiological, emotional and spiritual aspects of a person’s life. They all have five subdivisions, delicately intertwined. Ayurveda describes in excellent detail about how they work and how to keep them in balance as well as how to bring them into balance when they’re out of balance.

a) Digestive fire: This is named Agni. Agni can be equated to the word metabolism. Including the digestion, absorption, assimilation. Conversion of the assimilated food to different Dhatus, such as Plasma, blood, bone, muscle, fat, seminal fluid in males and Artava in girls  and ultimately Ojas or the critical force of the body. In medical term this really is the last responsible tissue to the secretion of Serotonin and Dopamine.

b) Excretory functions: Ayurveda puts great emphasis for the excretory functions to be in excellent order to be in excellent health. This would prevent ailments. Keeps one in good health, soul and provides long life. Ayurveda elaborately explains how one ought to keep one’s lifestyle.

c) Pleasantly disposed contented spirit, mind and perceptions: Ayurveda’s definition of health is all encompassing. Social wellbeing may only be possible when all these standards are met.

Ayurveda has the following classifications of Manasvikara and provides mapping guidelines of the cause and resultant disease.

1. Nija : Diseases caused by external trauma, due to involvement of vitiated Doshas.

• Due to the Dushti / vitiation of Raja and Tama.

• Due to the Dushti / vitiation of the Raja, Tama and the Sharir Dosha i.e. vata/pitta/kapha.

• Manodehik roga: Which originate on mental level but they mostly show their symptoms on the physical level.

• Akshma vyaktitya janya manas roga/ Personality disorder

2. Aagantuja: As pathogenesis of Nija Vyadhi progresses then they mimic as Agantuja Vyadhi.

• Bhutabadhajanya (Bhutonmada)

• Grahabadhajanya (Grahonmada)

Manasa Vikara (Mental disorders) is mentioned in Ayuveda classics

Nanatmaja
manasa vikara

(due to
vitiation of manas quality viz raja and tamas)

 

1.Asabda
sravana (auditory hallucinations)

2.  Tama (withdrawal)

3.  Ati-pralepa (prating)

4.
Aswapna (insomnia)

5. Tandra
(stupor)

6.
Atinidra (excessive sleep)

7. Bhrama
(confusion)

Ubhayatmaka
manasa vikara

(due to
vitiation of raja, tama and shareer dosha)

1.Unmade
(psychosis)

 2. Apasmara (epilepsy)

 3. Apatanaka, apatantraka (hysteria)

 4. Atatwabhinivesa (obsessive syndrome)

 5. Madatyaya (alcoholic psychosis)

 6. Sanyasa (coma)

Mano-dehik
roga

(disorder
having mental level origin but manifest symptoms on physical level also)

1.Krodhaja
jwara (fever caused by anger)

2.
Bhayaja atisara(diarohoea caused by fear)

3.  Shokaja atisara (diarohoea caused by grief)

4. Amavata (rheumatoid arthritis)

5. Tamak shwas (bronchial asthma)

Manasa
vikara due to vitiation of rajas & tamas (Neurosis)   

1.Abhyashuya
(jealousy)

2.  Bhaya (fear)

3.  Chittodvega (anxiety)

4.  Dainya (meanness of the inferiority
complex)

5.  Harsha (hyper-excitement)

6.  Kama(desire)

7.  Krodha
(anger)

8.  Lobha (greed)

9.  Mada (arrogance)

10.  Maana (pride)

11.  Moha (confusion)

12.  Shoka (grief)

 13. Visada (anguish)

14.
Irshya (envy).

Akshama Vyaktitva
Janya Manas Roga (Personality disorders)

 

1. Swa hinata (inadequate personality)

2. Amedhata (mental deficiency)

3. Vikrut Satva (psychopathic personality)

AETIOLOGY (Manner of causation of mental disorders):


According to Ayurveda, the following factors contribute to the causation of depression and mental disorders:

• Emotional disturbances, unwholesome diet & lifestyle.

• Pragyaparadha is the most important cause for the manifestation of Manas vyadhi (mental disorder). 

• Vibhramsha(di of Dhi (learning), Dhriti (retention), Smriti (long term memory).

 • Atiyoga, Ayoga and Mitya yoga of Kala.

• Chitta vruttis (thoughts that clutter the mind ) like Mada (mental instability), Kshipta, Vikshipta (abnormal projection), Ekagra (concentration) all these because of tama guna bahulya(vitiation of tama guna) leads to Manasaroga.

• Shiromarma-bhighata (trauma to energy ponts / marma points present over urdhvajatrugata – head and neck region) may lead to different Manasavyadhi.


SYMPTOMS:

• For Ubhayatmaka vikara (due to vitiation of raja, tama and shareer dosha) like unmada (psychosis), apasmara (epilepsy), mada (alcoholic psychosis), sanyasa (coma) etc. 

• But for Nanatmaja manas vikara, no descriptive details are available regarding their symptoms. Their names only specify the mental level condition promptly as anger, grief etc.

See: Bacopa benefits, memory boosting herb for anxiety


MANAH PARIKSA (Mental examination)

According to Ayurveda, the mental aspects of the examination are done by inspecting and evaluating the following factors:

• Shela (habit, temperament, etc.)

• Chesta (psychomotor activity and achara conduct)

• Anumana (inference) 

• Vijnana (understanding) 

• Vyavasaya (purposeful nature of action)

• Dhairya (courage) 


PATHOGENESIS: (manner of development of a disease)

From an Ayurvedic perspective, the following three factors are responsible for the all physical and mental diseases:

1. Pragyaparadha : Dhi-vibramsha ( learning disturbance), Dhritivibhramsha (conscious mind indulges in performing harmful things knowingly) and Smriti-vibramsha (memory disturbance) are the main causative factors of the mental disorders, which lead to disease producing karmas (actions/sins of past)

2. Parinama :  Result of all improper deeds (Kukarma) will mature in time and when matures, the person will be afflicted with particular disorder is termed as parinama.

3. Asatmendriyartha sanyoga : Unwholesome contacts with senses in the form of Atiyoga (excessive utilization), Ayoga (non-utilization) and Mithyayoga (wrong utilization) of sense faculties.Due to nidana sevena / adopting all causative factors – vitiates vatadi shareerika dosha and Raja – tama . Manasa dosha take ashraya (reside) in Hrudaya  heart region) and Mastishka (brain part )- and vitiates Manovahasrotas (channels conveying manas/conveyers of manas) – thus produce Manovyadhi (mental disorder).Generally, for all types of mental disorders, alpasatwa (weak mind), manovahasrota (channels conveying manas/conveyers of manas), manasadosha ( Rajas and Tamas) and tridosha ( Vata, Pitta and Kapha) are said to be responsible.  Some memorable quotes drive home the basic point.  “The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.” In the words of Plato, “mind the science gap” beyond the “pill therapy” prompt us to rethink on the foundations of how positive mental health and interdisciplinary approaches are required in health sector. Ayurvedic medicine highlights the importance of self-care in order to prevent diseases from manifesting. The etiology or causation of many illnesses according to Ayurveda, originate from the improper functioning of the digestive system which alludes to a therapeutic understanding that differs significantly from conventional Western medicine.

See: Brahmi – Bacopa Monnieri – Ayurveda remedy for mental health


Early Diagnosis of Depression

This process is comprised of six key steps i.e. SHAT KRIYA KAAL, for early diagnosis, prognosis and for adopting timely preventive and curative measures.1. Sanchaya  (Natural accumulation of Doshas) – The doshas in these stages increase quantitatively,  their quality remaining normal.2. Prakopa (More aggravation) – stage of excitation of doshas in which the accumulated doshas start getting Prakopa (More accumulation)  3. Prasara (Overflow level) – The imbalanced dosha spreads throughout the body, involving one, two, or all the three doshas together with rakta. 4. Sthanasamsraya (Stage of disease augmentation) – The dosha begins to move into organs and bodily tissues which are susceptible to disturbance and precipipitates dosha-dusyasammurchana (interaction of vitiated doshas with dosyas or local tissues). This is the stage of start of real disease and is associated with appearances of prodromal or early symptoms i.e.purva rupa. 5. Vyakti (Stage of symptom manifestation) – characterizes by full manifestations of signs and symptoms of the dully developed spacific disease. It is acute stage of disease.6. Bheda (Stage of complications) – If the disease is not properly treated at the stage of vyakti, it may become sub-acute, chronic or incurable on account of extensive damage sustained or irreversible structural change having taken place due to neglect of early diagnosis and prompt treatment.

See: Does exercise positively impact patients experiencing depression


TREATMENT FOR DEPRESSION & MENTAL DISORDERS

 “Trividha aushadhamiti Daivyavyapashraya yuktivuapashraya satvavajyascha”

Ayurveda recommends three types of chikitsa (treatments)  listed below:

• DAIVAVYAPASRAYA CHIKITSA  / SPIRITUAL THERAPY : This refers to measures like mantra (incantation), Ausadhi (wearing scared herbs), mani (wearing precious gems), mangala (propitiatory rites), homa (sacrifice), upahara (offerings), niyama (vows), praschitta (ceremonial   penitence), upavasa (fasts), swastyayana (prostrations), pranipata (surrender), gamana (pilgrimage), etc,. Chanting Mantras Boosting Positive waves and energy and removing negative thoughts from the mind. Enhancing Satvaguna and balancing Raja and Tama guna which are causative factors.

• YUKTIVYAPASRAYA CHIKITSA / LOGICAL THERAPY: This refers to the use of ahara (diet) and oushadha (drugs).

• SATVAVAJAYA CHIKITSA / MENTAL or PSYCHOTHERPAY: The aim of this therapy is to restrain mind from desire for unwholesome objects with occupational, behavioral  and like therapies to restrain mind from unwholesome objects.


Role of Achara Rasayana / NITYA RASAYANA (social and mental code of conduct):

Ayurveda stresses on the holistic concept of health and disease. It does not call health merely as absence of disease but something more positive and integrated. Achara Rasayana described in this respect is very essential for the treatment of Manas Roga having direct effect on the potentiating of Sattva Guna of mind.

DIET & LIFESTYLE:

 

 AVOID / APATHYA

WHOLESOME
TO ADOPT/ PATHYA

Chinta(anxiety)

 Shoka(grief)

 Bhaya(fear)

 Krodha(anger)

Apavitra
padartha( unwholesome acts)

 Madya (alcohol intake)

 Viruddha(unwholesome food)

Atyanta
teekshna (very spicy)

 Ushna (too hot)

 Guru (too heavy food)

Adhikavyavaya
(over-eating)

Ati-vyayama
(excessive exercise)

 Ati-nidra (excessive sleeping)

Kshudha
(suppression of hunger)

Trishna
vegadhrana (suppression of thirst)

Godhuma
(wheat)

Mudga
(green gram0

Shali
(rice variety)

Dharoshnadugdha

 Shatadoutaghrita

Navaneeta

 Puranaghrita

Dharaniya
vega(urges to be controlled)

Aachar
rasayan (code of conduct/ethics)

EVIDENCE BASED THERAPIES FOR TREATING MANAS VIKARA:

Traditional Ayurvedic text emphasized the importance of purification (shodhana)  in  Chittavasada which involves utilization of PanchaKarma therapy by various means:• Antarparimarjana: It includes the process of internal purification • Samshodhana: Elimination of vitiated Doshas by Panchacarma therapy  • Bahiraparimarjana: It is a process of external purification; purvakarma  of  panchakarma  i.e.  Snehan (oileation) & Swedana (sudation). Medicated oil is used for external application with heat application.

GENERAL
PANCHKARMA PROCEDURES TO TREAT MANOVIKARA:

·
Abhyang & swedan (oelation & sudation)

·
Vaman (emesis therapy)

·
Virechan (purgation therapy)

·
Shirodhara

·
Shiro-pichu

·
Shiro-lepa