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{{#seo:
{{#seo:
|title=Psychiatric diseases
|title=Psychiatric diseases
|titlemode=append
|titlemode=append
|keywords=carakasamhitaonline, charak samhita, caraka samhita, Ayurveda, Psychiatric diseases in Ayurveda, management of Psychiatric diseases, research on management of Psychiatric diseases, Indian system of medicine, alternative medicine, health, psychiatry
|keywords=carakasamhitaonline, charak samhita, caraka samhita, Ayurveda, Psychiatric diseases in Ayurveda, management of Psychiatric diseases, research on management of Psychiatric diseases, Indian system of medicine, alternative medicine, health, psychiatry, mental diseases, schizophrenia, insanity, depression, insomnia,
|description= Diagnosis and Management of Psychiatric diseases in Ayurveda
|description= Diagnosis and Management of Psychiatric diseases in Ayurveda
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|label3 = Reviewer
|label3 = Reviewer
|data3 = Basisht G.<sup>2</sup>
|data3 = [[Gopal Basisht|Basisht G.]]<sup>2</sup>
|label4 = Editors
|label4 = Editors
|data4 = Deole Y.S.<sup>3</sup>, Aneesh E. G.<sup>2</sup>
|data4 = [[Yogesh Deole|Deole Y.S.]]<sup>3</sup>, Aneesh E. G.<sup>4</sup>
|label5 = Affiliations
|label5 = Affiliations
|data5 = <sup>1</sup> Chief Consultant, Hitayurveda healthcare center, KR Puram, Hasaan, Karnataka, India
|data5 = <sup>1</sup> Chief Consultant, Hitayurveda healthcare center, KR Puram, Hasaan, Karnataka, India
<sup>2</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar, Gujarat, India
<sup>2</sup>Rheumatologist, Orlando, Florida, U.S.A.
<sup>3</sup> Executive Editor and Professor in Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
<sup>3</sup> Executive Editor and Professor in Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
<sup>4</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, Gujarat, India
|label6 = Correspondence emails
|label6 = Correspondence emails
|data6 = carakasamhita@gmail.com
|data6 = drnpmanas@gmail.com,
carakasamhita@gmail.com
|label7 = Publisher
|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
|label7 = Date of first publication:
|label8 = Date of first publication:
|data7 = January 21, 2022
|data8 = January 21, 2022
|label8 = DOI
|label9 = DOI
|data8 = Under process
|data9 = 10.47468/CSNE.2022.e01.s09.082
}}
}}
<div style='text-align:justify;'>
<p style="text-align:justify;">This article is based on a lecture delivered by Dr. Narayana Prakash B, Chief consultant, Hitayurveda Health care, KRPuram, Hassan, Karnataka, India., in Prof. M. S. Baghel Memorial Lecture Series on Sep 09, 2021.
This article is based on a lecture delivered by Dr. Narayana Prakash B, Chief consultant, Hitayurveda Health care, KRPuram, Hassan, Karnataka, India., in Prof. M. S. Baghel Memorial Lecture Series on Sep 09, 2021.
<br/>
[[Ayurveda]] considers body and mind as interconnected entities. It does not separate one from the other in the holistic concept of [[Purusha]]. The treatment for body and mind is mentioned by ancient scholars for almost all diseases. Health is the foundation of virtue, wealth, enjoyment, and salvation; diseases are the destroyers of it.</p>
[[Ayurveda]] considers body and mind as interconnected entities. It does not separate one from the other in the holistic concept of [[Purusha]]. The treatment for body and mind is mentioned by ancient scholars for almost all diseases. Health is the foundation of virtue, wealth, enjoyment, and salvation; diseases are the destroyers of it.
==General causes for the diseases of the mind==
==General causes for the diseases of the mind==
===Role of intellect ([[buddhi]])===
===Role of intellect ([[buddhi]])===
Thoughts are objects of the mind. The mind is continuously involved in process of thinking. The intellect ([[buddhi]])controls the mind and regulates its thinking. It differentiates good and bad thoughts. Continuous indulgence of the mind in harmful thinking and the inability of intellect to control it results in diseases.
Thoughts are objects of the mind. The mind is continuously involved in process of thinking. The intellect ([[buddhi]]) controls the mind and regulates its thinking. It differentiates good and bad thoughts. Continuous indulgence of the mind in harmful thinking and the inability of intellect to control it results in diseases.
===Role of sense organs ([[indriya]])===
===Role of sense organs ([[indriya]])===
The use of incompatible dietetics (viruddhaaahara), can cause psychic disorders. If food is proper, the mind will be healthy. Dietary regulations (aharavidhi) shall be followed while taking food. Then only does it nourish the body and mind. Food plays important role in the manifestation of many psychological diseases.
The use of incompatible dietetics (viruddhaaahara), can cause psychic disorders. If food is proper, the mind will be healthy. Dietary regulations (aharavidhi) shall be followed while taking food. Then only does it nourish the body and mind. Food plays important role in the manifestation of many psychological diseases.
==Mental disorders in children==
===Mental disorders in children===
In the pediatric age group, the mind is seldom afflicted. The psychic abnormalities start by the influence of surroundings as the child grows. The positive or negative inputs from the surroundings lead to nourishment or deprivation of the mind.
In the pediatric age group, the mind is seldom afflicted. The psychic abnormalities start by the influence of surroundings as the child grows. The positive or negative inputs from the surroundings lead to nourishment or deprivation of the mind.
Impairment in body activity (cheshta vibhrama): Controlled and relevant motor activity gets impaired. There might be hyperactivity or hypoactivity.
Impairment in body activity (cheshta vibhrama): Controlled and relevant motor activity gets impaired. There might be hyperactivity or hypoactivity.
Impaired social activity (achara vibhrama): The behavior and social attitude of the patient would be unfair, improper, and irrelevant. He may violate all ethics and manners. For eg. the Patient may remain undressed, unhygienic, or have odd dressing.
Impaired social activity (achara vibhrama): The behavior and social attitude of the patient would be unfair, improper, and irrelevant. He may violate all ethics and manners. For eg. the patient may remain undressed, unhygienic, or have odd dressing.
====Types and Clinical features====
'''[[Vata]] dominant unmada:'''
Constant wandering; sudden spasm of eyes, eyebrows, lips, shoulder, jaws, forearms, and legs; constant and incoherent speech; patient continuously smiles or laughs or dance; play musical instruments in inappropriate situations; froth comes out of mouth, etc.
'''[[Pitta]] dominant unmada:'''
Anger and irritation; inflicting injury to themselves and others; ferocious look, desire for shade, cold water, and foods.
'''[[Kapha]] dominant unmada:'''
Observance of silence; desire for solitude; discharge of saliva and nasal secretions; aversion towards cleanliness; aversion towards food etc.
'''Sannipatika unmada:'''
All clinical features are observed in this type.
'''Agantuja unmada (exogenous type):'''
Intellectual errors ([[prajnaparadha]]) are the root cause of this disease. Sinful activities in a past life are also one of the causes. Various behavior patterns are observed in this type. The person may start behaving like deva (god), rakshasa (demons), etc. The association of a specific [[dosha]] cannot be seen in this condition. The person may exhibit superhuman powers like excessive physical strength and energy; unnatural power of retention and memory etc. Certain conditions like devonmada, gandharvonmada, and yakshonmada do not require treatments as they do not cause any harm.
Different disorders in conventional psychiatry like acute mania, bipolar disorders, manic disorders, depression, schizophrenia can be understood under the broad umbrella of unmada.
===Atattvabhinivesha===
Abnormal thinking pattern is observed in this condition. The impaired intelligence, and abnormal psychic pattern, as in obsessive-compulsive disorders (OCD) is seen.
==General principles of treatment==
===Preventive measures===
Proper diet is needed for proper mental health. A wholesome food should be taken as per dietary guidelines (aharavidhi). Re-vitalization through a code of conduct (achara rasayana) is also a preventive measure. This can be considered behavior therapy in [[Ayurveda]]. Rejuvenation ([[rasayana]]) and aphrodisiac therapy ([[vajikarana]]) are very important for the prevention as well as treatment of all sorts of psychic disorders. Brain tonics, memory boosters, nootropics, and vitalizers (medhya rasayana) should be taken daily for the improvement of intellect and prevention of psychic disorders.
===Three types of treatments===
The three major types of treatment for mental disorders are
#Divine/ spiritual therapy (daivavyapashraya)
#Rational therapy based on reasoning (yuktivyapashraya)
#Psychotherapy (sattvavajaya)
'''Divine/ spiritual therapy (daivavyapashraya):''' This includes incantations (mantra), medicine, wearing gems, auspicious offerings, oblations, offerings to the sacred fire, following spiritual rules, fasting, obeisance to gods, etc. The worship of Lord Rudra is specially mentioned and is in practice also.
'''Rational therapy based on reasoning (yuktivyapashraya):''' This consists of a proper dietetic regimen and medication.
'''Psychotherapy (sattvavajaya):''' It includes the restraint of the mind from harmful/unwholesome objects. It is specifically implemented in anxiety and depression.
All these therapies are used in the comprehensive management of psychic disorders.
===General treatments for unmada===
[[Panchakarma]] treatments like oleation ([[snehana]]), fomentation ([[swedana]]), emesis ([[vamana]]), purgation ([[virechana]]), enema ([[basti]]), venesection (siravyadha) are indicated according to the condition. Some other specific treatment modalities like tying (bandhana), confinement (avarodhana), frightening (vitrasana), forgetfulness (vismapana), etc. are also mentioned to control the violent tendencies of patients.
====Treatment of [[vata]] dominant unmada====
*Intake of ghee (snehapana) with purana ghrita, lashunadya ghrita, kalyanaka ghrita, mahakalyanaka ghrita, mahapaishachika ghrita, ashwagandha ghrita etc.
*Mild purification
*Unctuous enema (sneha basti) preferably with a combination of two unctuous preparations
*Oil application on the head: This helps to induce sleep and calms down the patient.
*Nasal application with Anu taila or ghee preparations.
*Collyrium with Brahmyadi varti
*Mineral (rasa) preparations: Manasamitra vati, Unmadagajakesari, Brahmi vati, Bruhatvatachintamani, Vatagajankusha rasa, Mahavatavidwansa rasa, Sameerapannaga rasa.
*Fermented preparation (Asava/arishta): Saraswatarishta, ashwagandharishta, balarishta
*Decoctions (kashaya): Kalyanaka/ Varavishaladi kashaya, Brahmidrakshadi kashaya, Mamsyadi kashaya
*Electuaries (lehya): Ashwagandhadi, Ajashwagandhadi, Ajamamsa rasayana, Brahma rasayana
*Powders (churna): Saraswata, Brahmyadi, Sarpagandadi churna, combination of Convolvulus prostrates (shankhapushpi), Bacopa monnieri (brahmi), Tribulus terrestris (gokshura) and Rauvolfia serpentine (sarpagandha).
====Treatment of [[pitta]] dominant unmada====
*Purgation ([[virechana]]) is the first principle of treatment. For internal oleation Tiktaka ghrita, Brahmi ghrita, Shatavari ghrita, Phalasarpi etc. are used.
*Pouring of medicated buttermilk (takradhara) or medicated milk (ksheeradhara)
*Anointing head (shirolepa) with Amalakyadi yoga
*Expressed nasal medication (avapeedana nasya)
*Mineral (rasa) preparations: Kamadugha rasa, pravalapanchamrita rasa, manasamitra vati, brahmi vati, pravalapishti, rajata bhasma.
*Fermented preparation (asava/arishta): Chittachandirasava, shrikhandasava.
*Decoctions(kashaya): Tiktaka, Brahmidrakshadi, Guduchyadi
*Powders (churna): Brahmyadi, chandanadi, avippattikara, shatavaryadi
*Electuaries (Lehya): Drakshamalaki, Amalaki rasayana, Drakshadi, Kushmanda rasayana
====Treatment of [[kapha]] dominant unmada====
*Emesis ([[vamana]]) and purgation ([[virechana]]) with purana ghrita, hingwadi ghrita, panchagavya ghrita, mahapanchagavya ghrita, lashunadi ghrita
*Powder nasal medication (pradhamana) with shwasakuthara rasa, smritisagara rasa, vachadi churna etc.
*Pouring of medicated buttermilk (takradhara) or medicated decoctions (kashayadhara)
*Mineral (rasa) preparations: Manasamitra vati, smritisagara rasa, brahmi vati, sameerapannaga rasa.
*Fermented preparation (Asava/arishta): Mritasanjeevani sura
*Powders (churna): Vachadi churna, kushthadi yoga
===Treatment of atattvabhinivesha===
Purification through [[panchakarma]] procedures is the principal treatment. Nourishment therapy is indicated with brain stimulants. Panchagavya ghrita with juice (swarasa) of Bacopa monnieri (Brahmi) or other rejuvenating preparations are advised. Psychological counseling is also advised.
==Some other related conditions and its treatments==
===Sleep disorders===
'''Insomnia:''' Oil massage; bath; meat juices of domestic, marshy, and aquatic animals; milk, wine, cheerfulness of mind, perfumes, mild massage, application of medicated paste in head and face, use of comfortable beds are advised in insomnia.
'''Hypersomnia:''' Purgation ([[virechana]]), emesis ([[vamana]]), nasal medication ([[nasya]]), venesection ([[raktamoksha]]), worries, medicated smoke inhalation, fasting, uncomfortable beds are advised for those who have excessive sleep.
'''Other psychic disorders mentioned in [[Ayurveda]]'''
*Anxiety disorders (chittodvega)
*Phobic disorders (bhaya)
*Attention disorders (anavasthitachitta)
*Hypochondriasis (gadodvega)
*Dissociative disorders (smararoga)
*Personality disorders (rajasika and tamasika kaya)
*Chorea (tandavaroga)
*Substance abuse disorders (Madatyaya)
*Seizure disorders ([[Apasmara]])
*Stress-related disorders (manodukhajonmada)
*Perverted sexual disorders (asyeka, kumbika etc.)
==Conclusion==
In [[Ayurveda]], elaborate descriptions of mental disorders with their management is available. In day to day practice mental disorders are well managed by Ayurvedic interventions. It requires a holistic approach including management with medicines, counseling, and spiritual therapies.
==Related Chapters==
[[Indriyopakramaniya Adhyaya]], [[Unmada Nidana Adhyaya]], [[ Apasmara Nidana Adhyaya]],
[[ Katidhapurusha Sharira Adhyaya]], [[Unmada Chikitsa Adhyaya]], [[Apasmara Chikitsa Adhyaya]], [[Tistraishaniya Adhyaya]]
==Further reading==
*Vagbhata, Ashtanga hridayam, Sarvangasundara commentary by Arunadutta, Chaukambha Orientalia, Varanasi-2007, Uttara Tantra, Chapter 6, Unmada Pratishedhadhyaya.
*Sushruta, Sushruta Samhita, English translation and edited by Kaviraj Kunjalal Bhishagranta; published by Chowkhambha Sanskrit series, Vol.ll, Uttara tantra, Chapters 60, 61 and 62
*Yoga ratnakara, Vidyotini hindi commentary, edited by Sri Brahmashankara Shastri, Choukhambha Sanskrit Samsthana , Varanasi, Purvaardha, page 488-496
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