Changes

{{#seo:

{{#seo:

|title=Unmada Nidana

|title=Unmada Nidana

|titlemode=append

|titlemode=append

|keywords=Unmada, Sanjna Jnana, Amarsha, himsa, Prajnaparadha, Psychosis, insanity, mental factors examination, perversion, impairment of decision making, intellectual functions, charak samhita, ayurveda, psychiatric, psycho somatic disorders.  

|keywords=Unmada, Sanjna Jnana, Amarsha, himsa, Prajnaparadha, Psychosis, insanity, mental factors examination, perversion, impairment of decision making, intellectual functions, psychiatric, psycho somatic disorders, Ayurveda, Indian system of medicine, charak samhita.  

|description=Nidana Sthana Chapter 7. Diagnosis and etiopathogenesis of psychosis disorders

|description=Nidana Sthana Chapter 7. Diagnosis and etiopathogenesis of psychosis disorders

}}

}}

<big>'''Nidana Sthana Chapter 7. Diagnosis and etiopathogenesis of psychosis disorders '''</big>

<big>'''Nidana Sthana Chapter 7. Diagnosis and etiopathogenesis of psychosis disorders '''</big>

{{Infobox

{{Infobox

|title = Unmada Nidana

|title = Unmada Nidana

|label4 = Other Sections

|label4 = Other Sections

|data4 = [[Sutra Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|data4 = [[Sutra Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

 

== Introduction ==

== Introduction ==

unmada, a major mental disorder, has been known to Ayurvedic practitioners since ancient times in India. In the Vedic period, the disease was thought to be caused due to ''grahas'' or demons, but in [[Ayurveda]], it is considered a major mental illness. unmada as such does not describe a lone clinical entity comparable to a modern diagnostic category, rather it is a group of psychotic disorders. As the psychotic disorders cover almost all the major mental illnesses, the different types and subtypes of unmada can be separately correlated with different psychotic disorders. The clinical features of the different types of unmada resemble various types of schizophrenia, manic psychosis, psychotic depression, and depressive disorders.

unmada, a major mental disorder, has been known to Ayurvedic practitioners since ancient times in India. In the Vedic period, the disease was thought to be caused due to ''grahas'' or demons, but in [[Ayurveda]], it is considered a major mental illness. unmada as such does not describe a lone clinical entity comparable to a modern diagnostic category, rather it is a group of psychotic disorders. As the psychotic disorders cover almost all the major mental illnesses, the different types and subtypes of unmada can be separately correlated with different psychotic disorders. The clinical features of the different types of unmada resemble various types of schizophrenia, manic psychosis, psychotic depression, and depressive disorders.

Thus, unmada covers a wide range of major mental disorders and is considered synonymous with madness and mental derangement, in which a person loses contact with reality and loses the ability to regulate his actions & conduct according to the norms of the society. When ''doshas'' move upwards in the body into the head, they could cause aberrations in the functioning of ''manas''(mind) while producing ''mada'' (delusional/ intoxicated state) in an individual. The mental status of psychotic patients is vividly described while explaining the clinical aspect of the disease. The description suggests that a patient of unmada develops derangement of all the activities of ''manas''(mind), ''buddhi''(intellect), ''ahamkara''(ego) and ''indriyas'' (sense organs). The patient develops thought disturbances in the form of abnormalities of ''chintana''(thinking), ''vichara''(discriminating) and ''uha''(analyzing), derangement of memory in the form of ''smriti nasa'' (memory loss.) and ''smriti bhramsha'' (memory impairment), behavioral, social and emotional disturbances in the form of abnormalities of ''achara, dharma'' and ''bhavas'' along with functional derangement of ''indriyas'' which is manifested clinically as disturbed speech and other variants such as incoherence (''abaddha vakyam''), thought blocking (''hridaya shunyata''), loosening of associations, neologism, echolalia etc. and various psychomotor disturbances.

Thus, unmada covers a wide range of major mental disorders and is considered synonymous with madness and mental derangement, in which a person loses contact with reality and loses the ability to regulate his actions & conduct according to the norms of the society. When ''[[dosha]]s'' move upwards in the body into the head, they could cause aberrations in the functioning of ''[[manas]]''(mind) while producing ''mada'' (delusional/ intoxicated state) in an individual. The mental status of psychotic patients is vividly described while explaining the clinical aspect of the disease. The description suggests that a patient of unmada develops derangement of all the activities of ''[[manas]]''(mind), ''[[buddhi]]''(intellect), ''ahamkara''(ego) and ''[[indriya]]s'' (sense organs). The patient develops thought disturbances in the form of abnormalities of ''chintana''(thinking), ''vichara''(discriminating) and ''uha''(analyzing), derangement of memory in the form of ''[[smriti]]  nasa'' (memory loss.) and ''[[smriti]] bhramsha'' (memory impairment), behavioral, social and emotional disturbances in the form of abnormalities of ''achara, dharma'' and ''bhavas'' along with functional derangement of ''[[indriya]]s'' which is manifested clinically as disturbed speech and other variants such as incoherence (''abaddha vakyam''), thought blocking (''hridaya shunyata''), loosening of associations, neologism, echolalia etc. and various psychomotor disturbances.

unmada is classified into two broad categories: ''nija''(endogenous), or those caused by internal imbalance of ''dosha'' i.e. ''vata'', ''pitta, kapha'' and ''sannipataja'', and ''agantu nimitta'', i.e., those caused by exogenous factors. Sushruta (S. ut.62/4-5) and Vagbhatta - both are of the opinion that unmada is of six types, of which four are due to ''doshas'', the fifth is ''madyaja'' (like intoxications) and sixth is ''vishaja'' (poison-based or poison-like). Both have described the ''agantuja unmada'' separately as the condition of ''amanushopasarga'' (due to affliction of supra-human power) and ''bhuta badha'' (due to affliction of demons), under the heading ''amanusopasarga pratishedha'' (treatment of affliction of supra-human power) and ''bhuta badha pratisedha'' (treatment of affliction of demons) respectively. The body of knowledge within [[Ayurveda]] dedicated to psychiatry underscores the advancement in scientific knowledge on this subject that existed thousands of years ago.

Unmada is classified into two broad categories: ''nija''(endogenous), or those caused by internal imbalance of ''[[dosha]]'' i.e. ''[[vata]]'', ''[[pitta]], [[kapha]]'' and ''sannipataja'', and ''agantu nimitta'', i.e., those caused by exogenous factors. Sushruta <ref>Sushruta. Uttara Tantra, Cha.62 Unmadapratishedam Adhyaya verse 4-5. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> and Vagbhatta - both are of the opinion that unmada is of six types, of which four are due to ''[[dosha]]s'', the fifth is ''madyaja'' (like intoxications) and sixth is ''vishaja'' (poison-based or poison-like). Both have described the ''agantuja unmada'' separately as the condition of ''amanushopasarga'' (due to affliction of supra-human power) and ''bhuta badha'' (due to affliction of demons), under the heading ''amanusopasarga pratishedha'' (treatment of affliction of supra-human power) and ''bhuta badha pratisedha'' (treatment of affliction of demons) respectively. The body of knowledge within [[Ayurveda]] dedicated to psychiatry underscores the advancement in scientific knowledge on this subject that existed thousands of years ago.

</div>

</div>

==Sanskrit Text, Transliteration and English Translation==

==Sanskrit Text, Transliteration and English Translation==

<div class="mw-collapsible mw-collapsed">

<div class="mw-collapsible mw-collapsed">

</div></div>

</div></div>

There are five types of unmada such as those caused due to the three ''doshas, sannipata'' (simultaneous vitiation of the three ''doshas''), and exogenous causes. [3]

There are five types of unmada such as those caused due to the three ''[[dosha]]s, sannipata'' (simultaneous vitiation of the three ''[[dosha]]s''), and exogenous causes. [3]

=== Individuals prone to unmada ===

=== Individuals prone to unmada ===

This verse describes the qualities of a person prone to getting afflicted with unmada, as well as the conditions that are conducive to the affliction of the disease:

This verse describes the qualities of a person prone to getting afflicted with unmada, as well as the conditions that are conducive to the affliction of the disease:

*Four types of ''doshika unmada'' quickly manifest in individuals who are fearful, confused and complicated, who do not know societal rules and norms, and who lead erratic lifestyles and dietary habits (unclean, unwholesome, untimely eating habits, as well as neglecting any prescribed dietetic rules). ''Doshas'' in such individuals are in a volatile state and are prone to getting vitiated.   

*Four types of ''doshika unmada'' quickly manifest in individuals who are fearful, confused and complicated, who do not know societal rules and norms, and who lead erratic lifestyles and dietary habits (unclean, unwholesome, untimely eating habits, as well as neglecting any prescribed dietetic rules). ''[[Dosha]]s'' in such individuals are in a volatile state and are prone to getting vitiated.   

*Resorting to specific lifestyle activities that are not conducive to good health, especially when

*Resorting to specific lifestyle activities that are not conducive to good health, especially when

**the body is exceedingly weak & cachexic;

**the body is exceedingly weak & cachexic;

**the person is subjected to excessive mental trauma / physical assault.

**the person is subjected to excessive mental trauma / physical assault.

Such individuals often get afflicted with subclinical mental disorders, leading to unstable intellect because of volatile ''doshas''. When the seat of consciousness, wisdom, and the system that regulates mental activities are badly affected, then all these factors lead to the manifestation of unmada. [4]

Such individuals often get afflicted with subclinical mental disorders, leading to unstable intellect because of volatile ''[[dosha]]s''. When the seat of consciousness, wisdom, and the system that regulates mental activities are badly affected, then all these factors lead to the manifestation of unmada. [4]

</div>

</div>

**Distortion of eyes.

**Distortion of eyes.

These are the pre-monitory symptoms of unmada caused by the vitiation of ''doshas''. [6]

These are the pre-monitory symptoms of unmada caused by the vitiation of ''[[dosha]]s''. [6]

=== Specific features of ''vatika'' type unmada ===

=== Specific features of ''vatika'' type unmada ===

*Emaciation and roughness;

*Emaciation and roughness;

*Protruding dusky red eyes;  

*Protruding dusky red eyes;  

*Aggravation by ''vata''-provoking factors; and  

*Aggravation by ''[[vata]]''-provoking factors; and  

*Pacification by factors which are opposite to ''vata''

*Pacification by factors which are opposite to ''[[vata]]''

</div>

</div>

These are the features of ''vatika'' type of unmada. [7-1]

These are the features of ''vatika'' type of unmada. [7-1]

*Prolonged anguish;

*Prolonged anguish;

*Ferocious eyes with coppery, green or yellow color;  

*Ferocious eyes with coppery, green or yellow color;  

*Aggravation of the signs and symptoms by ''pitta'' provoking factors

*Aggravation of the signs and symptoms by ''[[pitta]]'' provoking factors

*Pacification by factors which are opposite to ''pitta''

*Pacification by factors which are opposite to ''[[pitta]]''

are the features of ''paittika'' type of ''unmada.''[7-2]

are the features of ''paittika'' type of ''unmada.''[7-2]

*Edematous face;

*Edematous face;

*White and timid eyes full of dirt;

*White and timid eyes full of dirt;

*Aggravation of the signs & symptoms by ''kapha'' provoking factors

*Aggravation of the signs & symptoms by ''[[kapha]]'' provoking factors

*Pacification by factors which are opposite to ''kapha''

*Pacification by factors which are opposite to ''[[kapha]]''

These are the features of ''kaphaja'' type of unmada.

These are the features of ''kaphaja'' type of unmada.

Features of ''sannipatika'' type unmada:

Features of ''sannipatika'' type unmada:

In the unmada caused by the combined vitiation of all the three ''doshas'', all the symptoms mentioned above are simultaneously manifested. This type of unmada is considered to be incurable. [7-3]

In the unmada caused by the combined vitiation of all the three ''[[dosha]]s'', all the symptoms mentioned above are simultaneously manifested. This type of unmada is considered to be incurable. [7-3]

=== Management of unmada ===

=== Management of unmada ===

Thus it is said :

Thus it is said :

A competent physician should selectively employ the above-mentioned therapies to treat the curable types of unmada caused by the vitiation of ''doshas'' as per the fundamental principles of the prescribed therapy. [9]

A competent physician should selectively employ the above-mentioned therapies to treat the curable types of unmada caused by the vitiation of ''[[dosha]]s'' as per the fundamental principles of the prescribed therapy. [9]

=== Exogenous unmada ===

=== Exogenous unmada ===

<div style="text-align:justify;">

<div style="text-align:justify;">

The type of unmada having etiology, premonitory symptoms, signs and symptoms, pain and favorable therapeutics (''upashaya'') different from those of the types of unmada caused by the vitiation of ''doshas'' are known to be of exogenous type. Some scholars hold the view that this type of unmada is caused by the effect of the activities of the past life. Lord Atreya considers intellectual errors as the causative factor of this condition. Due to intellectual errors, the patient disregards the Gods, ascetics, ancestors, ''gandharvas, yakshas,'' ''rakshasas, pishachas,'' preceptors, elders, teachers and the other respectable ones. He also resorts to undesirable and inauspicious (or blasphemous) activities. The gods etc. cause unmada in him because of his own inauspicious activities. [10]

The type of unmada having etiology, premonitory symptoms, signs and symptoms, pain and favorable therapeutics (''upashaya'') different from those of the types of unmada caused by the vitiation of ''[[dosha]]s'' are known to be of exogenous type. Some scholars hold the view that this type of unmada is caused by the effect of the activities of the past life. Lord Atreya considers intellectual errors as the causative factor of this condition. Due to intellectual errors, the patient disregards the Gods, ascetics, ancestors, ''gandharvas, yakshas,'' ''rakshasas, pishachas,'' preceptors, elders, teachers and the other respectable ones. He also resorts to undesirable and inauspicious (or blasphemous) activities. The gods etc. cause unmada in him because of his own inauspicious activities. [10]

</div>

</div>

*Desire for inflicting cruel acts, torture, etc. on living beings

*Desire for inflicting cruel acts, torture, etc. on living beings

*Restlessness

*Restlessness

*Impairment of ''ojas'', colour, complexion and physical strength  

*Impairment of ''[[ojas]]'', colour, complexion and physical strength  

*Abuse and incitement of the gods etc. in dreams.

*Abuse and incitement of the gods etc. in dreams.

== Tattva Vimarsha(Fundamental Principles)==

== Tattva Vimarsha(Fundamental Principles)==

*The unmada pathology involves psychic ''dosha'' (''rajas'' and ''tamas'') and body ''doshas'' ( ''vata, pitta'' and ''kapha'').  

*The unmada pathology involves psychic ''[[dosha]]'' (''rajas'' and ''tamas'') and body ''[[dosha]]s'' ( ''[[vata]], [[pitta]]'' and ''[[kapha]]'').  

*The individuals with low mental strength and emotionally unstable with the mind afflicted repeatedly by desires, anger, greed, excitement, fear, attachment, exertion, anxiety and grief are more prone for unmada.  

*The individuals with low mental strength and emotionally unstable with the mind afflicted repeatedly by desires, anger, greed, excitement, fear, attachment, exertion, anxiety and grief are more prone for unmada.  

*Improper diet and lifestyle play important role in causing unmada. Therefore these shall be checked in management.  

*Improper diet and lifestyle play important role in causing unmada. Therefore these shall be checked in management.  

*unmada involves cognitive distortion pertaining to mind, intellect, consciousness, knowledge, memory, desire, attitude, activities and behavior. These factors shall be assessed to determine severity of disease, management protocol and prognosis.  

*unmada involves cognitive distortion pertaining to mind, intellect, consciousness, knowledge, memory, desire, attitude, activities and behavior. These factors shall be assessed to determine severity of disease, management protocol and prognosis.  

*The ''dosha'' dominance shall be assessed for deciding the protocol for management of ''nija''(endogenous) unmada.  

*The ''[[dosha]]'' dominance shall be assessed for deciding the protocol for management of ''nija''(endogenous) unmada.  

*Intellectual error is the basic cause of exogenous unmada.

*Intellectual error is the basic cause of exogenous unmada.

*Exogenous unmada is characterized by untimely, uncertain and uncalled for manifestations, superhuman strength, valor, manliness, enthusiasm, power of understanding and retention, memory, spirituality, logical and scientific knowledge and power of speech.  

*Exogenous unmada is characterized by untimely, uncertain and uncalled for manifestations, superhuman strength, valor, manliness, enthusiasm, power of understanding and retention, memory, spirituality, logical and scientific knowledge and power of speech.  

== Vidhi Vimarsha (Applied Inferences) ==

== Vidhi Vimarsha (Applied Inferences) ==

As the present chapter deals with the psychopathogenesis and diagnosis of unmada, the fundamental approach of [[Ayurveda]] in the etiopathogenesis of psychiatric diseases needs to be discussed. Charak considers violation of dietetic rules as an important causative factor for unmada. Both body and mind are affected by diet. unmada occurs in individuals taking diet in manners forbidden by the dietetic rules, consuming improper dietary articles, food articles that are unclean and ill prepared, incompatible and vitiated. According to Chandogya Upanishad, quality of mind depends upon the food taken by the individual. Once digested, the food is divided into three components – gross (''sthula''), medium (''madhyam'') and (''sukshma''). The subtle portion of the food nourishes the mind. Bhagavad Gita also opines that the ''sattvika, rajasika'' and ''tamasika'' types of ''buddhi'' (intellect) is derived from the characteristics associated with the type of diet. Thus, [[Ayurveda]] considers that incompatible, vitiated food articles affect the physical as well as mental state of an individual, predisposing him to psychiatric illnesses in general, if he is already harboring other causative factors.

As the present chapter deals with the psychopathogenesis and diagnosis of unmada, the fundamental approach of [[Ayurveda]] in the etiopathogenesis of psychiatric diseases needs to be discussed. Charak considers violation of dietetic rules as an important causative factor for unmada. Both body and mind are affected by diet. unmada occurs in individuals taking diet in manners forbidden by the dietetic rules, consuming improper dietary articles, food articles that are unclean and ill prepared, incompatible and vitiated. According to Chandogya Upanishad, quality of mind depends upon the food taken by the individual. Once digested, the food is divided into three components – gross (''sthula''), medium (''madhyam'') and (''sukshma''). The subtle portion of the food nourishes the mind. Bhagavad Gita also opines that the ''sattvika, rajasika'' and ''tamasika'' types of ''[[buddhi]]'' (intellect) is derived from the characteristics associated with the type of diet. Thus, [[Ayurveda]] considers that incompatible, vitiated food articles affect the physical as well as mental state of an individual, predisposing him to psychiatric illnesses in general, if he is already harboring other causative factors.

Secondly, psychiatric illnesses with special reference to unmada are not only associated with the vitiation of ''manas doshas'' but there is vitiation and provocation of ''sharira doshas'' as well. It points to the fact that though psychiatric illnesses are associated with subtle pathological changes at the bio-energetic level, they are also simultaneously accompanied by qualitative as well as quantitative changes/imbalances in the neurotransmitters and other bio-chemicals at the physical level. Thus, the normal psychological processes as well as the psychopathologies, operate simultaneously at multiple levels (biological, bio-energetic) and also at subtler levels where the intangible thought processes start appearing in the relatively tangible field of bio-energy. All this needs extensive exploration using the available scientific tools.

Secondly, psychiatric illnesses with special reference to unmada are not only associated with the vitiation of ''[[manas]] [[dosha]]s'' but there is vitiation and provocation of ''sharira [[dosha]]s'' as well. It points to the fact that though psychiatric illnesses are associated with subtle pathological changes at the bio-energetic level, they are also simultaneously accompanied by qualitative as well as quantitative changes/imbalances in the neurotransmitters and other bio-chemicals at the physical level. Thus, the normal psychological processes as well as the psychopathologies, operate simultaneously at multiple levels (biological, bio-energetic) and also at subtler levels where the intangible thought processes start appearing in the relatively tangible field of bio-energy. All this needs extensive exploration using the available scientific tools.

Thirdly, entire thought processes, attitudes, emotional experiences, desires and behaviors of an individual, which are relatively intangible, have the capacity to bring about qualitative as well as quantitative changes in the ''manas'' and ''sharira doshas, agni,'' and ''ojas''. These psychological factors are also capable of bringing about structural as well as functional changes in the ''dhatus'' (body tissues), ''malas'' (biological byproducts and wastes) and ''srotasas'' (macro and micro-channels). These are some of the most fundamental considerations. which needs special attention.

Thirdly, entire thought processes, attitudes, emotional experiences, desires and behaviors of an individual, which are relatively intangible, have the capacity to bring about qualitative as well as quantitative changes in the ''[[manas]]'' and ''sharira [[dosha]]s, agni,'' and ''[[ojas]]''. These psychological factors are also capable of bringing about structural as well as functional changes in the ''[[dhatu]]s'' (body tissues), ''[[mala]]s'' (biological byproducts and wastes) and ''srotasas'' (macro and micro-channels). These are some of the most fundamental considerations. which needs special attention.

The eight psychological and behavioral factors are described here that get imbalanced when the individual is afflicted with mental diseases. These factors are- ''manas, buddhi, sanjna jnana, smriti, bhakti, sheela, chesta'' and ''aachara''. This provides a basis for objectively and empirically assessing the mental functions of a patient afflicted with unmada. Using this understanding, Ayurvedic institutions have been able to create a rubric to analyze patients and conduct various mental health studies. A three-stepped approach to creating such a scale is as follows:-

The eight psychological and behavioral factors are described here that get imbalanced when the individual is afflicted with mental diseases. These factors are- ''[[manas]], [[buddhi]], sanjna jnana, [[smriti]], bhakti, sheela, chesta'' and ''aachara''. This provides a basis for objectively and empirically assessing the mental functions of a patient afflicted with unmada. Using this understanding, Ayurvedic institutions have been able to create a rubric to analyze patients and conduct various mental health studies. A three-stepped approach to creating such a scale is as follows:-

#In depth study of various definitions, synonyms, commentaries available on the eight factors.

#In depth study of various definitions, synonyms, commentaries available on the eight factors.

Now described in some detail would be each of the eight psychological and behavioral factors used in Ayurvedic studies on mental health:

Now described in some detail would be each of the eight psychological and behavioral factors used in Ayurvedic studies on mental health:

#The term ''manas'' in this context refers to the thought, affect and emotional aspect of mind. Therefore, the various kinds of thought abnormalities like delusions and delusional ideations, and states of mood e.g. depressed, elated, anxious etc are assessed under this factor.  

#The term ''[[manas]]'' in this context refers to the thought, affect and emotional aspect of mind. Therefore, the various kinds of thought abnormalities like delusions and delusional ideations, and states of mood e.g. depressed, elated, anxious etc are assessed under this factor.  

#The term ''buddhi'' (''ya buddhi niscayatmika'' Ca. Sa 1/33) refers to intellect, decision making, and problem solving aspects of mental functioning. Standardized tools for assessing intelligence e.g. Weschler Intelligence scale, Bhatia Battery for Performance Test of Intelligence etc. and clinical methods of test judgement are useful in this regard.

#The term ''[[buddhi]]'' (''ya buddhi niscayatmika'') [Cha.Sa.[[Sharira Sthana]] 1/23] refers to intellect, decision making, and problem solving aspects of mental functioning. Standardized tools for assessing intelligence e.g. Weschler Intelligence scale, Bhatia Battery for Performance Test of Intelligence etc. and clinical methods of test judgement are useful in this regard.

#The term ''sanjna jnana'' refers to the awareness of surroundings and response to external stimuli and measures, phenomena such as orientation and responsiveness, and attention and consciousness. Clinical methods available for measuring these aspects should be used.

#The term ''sanjna jnana'' refers to the awareness of surroundings and response to external stimuli and measures, phenomena such as orientation and responsiveness, and attention and consciousness. Clinical methods available for measuring these aspects should be used.

#The term ''smriti'' refers to all components of memory, such as immediate retention and recall, recent memory and remote memory including learning acquisition. The available tools of memory measurement viz. digit span, object recall, Weschler Memory scale, PGI Memory scale etc. are useful for assessing this factor.

#The term ''[[smriti]]'' refers to all components of memory, such as immediate retention and recall, recent memory and remote memory including learning acquisition. The available tools of memory measurement viz. digit span, object recall, Weschler Memory scale, PGI Memory scale etc. are useful for assessing this factor.

#The term ''bhakti'' refers to the normal, intact, altered and unusual desires related to food, dress, entertainment, study, work, hobby, sex etc. which are measured under this aspect.

#The term ''bhakti'' refers to the normal, intact, altered and unusual desires related to food, dress, entertainment, study, work, hobby, sex etc. which are measured under this aspect.

#The term ''sheela'' refers to habits, temperament and general behavior, which are measured under this aspect.

#The term ''sheela'' refers to habits, temperament and general behavior, which are measured under this aspect.

! rowspan="1"| Disease

! rowspan="1"| Disease

! rowspan="1"| Clinical features

! rowspan="1"| Clinical features

! rowspan="1"| Predominant ''dosha''

! rowspan="1"| Predominant ''[[dosha]]''

|-

|-

| rowspan="12" style="vertical-align: top;" | 1. Panic attack

| rowspan="12" style="vertical-align: top;" | 1. Panic attack

|-

|-

| Palpitation, sweating || ''raja, pitta''

| Palpitation, sweating || ''raja, [[pitta]]''

|-

|-

| Trembling or shaking || ''vata''

| Trembling or shaking || ''[[vata]]''

|-

|-

| Sensation of shortness of breath Feeling of choking|| ''vata''

| Sensation of shortness of breath Feeling of choking|| ''[[vata]]''

|-

|-

| Chest pain or discomfort || ''vata''

| Chest pain or discomfort || ''[[vata]]''

|-

|-

| Nausea or abdomen distress || ''vata''

| Nausea or abdomen distress || ''[[vata]]''

|-

|-

| Feeling dizzy, unsteady lightheaded or Faint || ''pitta''

| Feeling dizzy, unsteady lightheaded or Faint || ''[[pitta]]''

|-

|-

| De-realization or depersonalization || ''raja, vata and pitta''

| De-realization or depersonalization || ''raja, [[vata]] and [[pitta]]''

|-

|-

| Feeling of losing control or going crazy || ''raja''

| Feeling of losing control or going crazy || ''[[raja]]''

|-

|-

| Fear of dying || ''raja, vata''

| Fear of dying || ''[[raja]], [[vata]]''

|-

|-

| Paraesthesia || ''raja, vata''

| Paraesthesia || ''[[raja]], [[vata]]''

|-

|-

| Chills or hot flushes|| ''vata'' <hr>''vata-pitta''

| Chills or hot flushes|| ''[[vata]]'' <hr>''[[vata]]-[[pitta]]''

|-

|-

|}

|}

=== Table 3:Predominance of ''raja'' and ''vata'' ===

=== Table 3:Predominance of ''raja'' and ''[[vata]]'' ===

{| class="wikitable"

{| class="wikitable"

! rowspan="1"| Disorder

! rowspan="1"| Disorder

! rowspan="1"| Clinical features  

! rowspan="1"| Clinical features  

! rowspan="1"| Predominant ''dosha''

! rowspan="1"| Predominant ''[[dosha]]''

|-

|-

| rowspan="8" style="vertical-align: top;"| Generalized Anxiety

| rowspan="8" style="vertical-align: top;"| Generalized Anxiety

|-

|-

| Excessive anxiety & worry (apprehensive expectation) || ''raja, vata''

| Excessive anxiety & worry (apprehensive expectation) || ''[[raja]], [[vata]]''

|-

|-

| The person finds it difficult to control the worry || ''raja, vata''  

| The person finds it difficult to control the worry || ''[[raja]], [[vata]]''  

|-

|-

| Restlessness || ''raja, pitta''

| Restlessness || ''[[raja]], [[pitta]]''

|-

|-

| Being easily fatigued || ''raja, vata''

| Being easily fatigued || ''raja, [[vata]]''

|-

|-

| Difficulty concentrating or mind going blank || ''raja, vata''

| Difficulty concentrating or mind going blank || ''raja, [[vata]]''

|-

|-

| Irritability || ''raja, pitta vata''

| Irritability || ''raja, [[pitta]] [[[vata]]''

|-

|-

| Sleep disturbance || ''vata''

| Sleep disturbance || ''[[vata]]''

|-

|-

|}

|}

=== Table 4:Predominance of ''tamas'' and ''kapha dosha'' ===

=== Table 4:Predominance of ''tamas'' and ''[[kapha]] [[dosha]]'' ===

{| class="wikitable"

{| class="wikitable"

| rowspan="14" style="vertical-align: top;"| Major Depressive Illness

| rowspan="14" style="vertical-align: top;"| Major Depressive Illness

|-

|-

| Depressed mood most of day || ''tama, kapha''

| Depressed mood most of day || ''tama, [[kapha]]''

|-

|-

| nearly every day as indicated by either subjective report (eg. feels sad or empty) || ''tama, kapha''

| nearly every day as indicated by either subjective report (eg. feels sad or empty) || ''tama, [[kapha]]''

|-

|-

| or observation made by others (eg. appears fearful) || ''Vata''

| or observation made by others (eg. appears fearful) || ''[[Vata]]''

|-

|-

| Markedly diminished interest or || ''vata, kapha tama, kapha''

| Markedly diminished interest or || ''[[vata]], [[kapha]] tama, [[kapha]]''

|-

|-

| pleasure in all or almost all activities most of the day ||  

| pleasure in all or almost all activities most of the day ||  

| Significant weight loss when not dieting or || ''tama''

| Significant weight loss when not dieting or || ''tama''

|-

|-

| weight gain or decrease or increase in appetite nearly every day. || ''kapha tama''

| weight gain or decrease or increase in appetite nearly every day. || ''[[kapha]] tama''

|-

|-

| insomnia or hypersomnia nearly everyday || ''vata kapha tama''

| insomnia or hypersomnia nearly everyday || ''[[vata]] [[kapha]] tama''

|-

|-

| Psychomotor retardation or agitation || ''tama''

| Psychomotor retardation or agitation || ''tama''

| fatigue or loss of energy nearly everyday || ''tama''

| fatigue or loss of energy nearly everyday || ''tama''

|-

|-

| Feeling of worthlessness or excessive or inappropriate guilt || ''tama kapha''

| Feeling of worthlessness or excessive or inappropriate guilt || ''tama [[kapha]]''

|-

|-

| Diminished ability to think or concentrate or indecisiveness || ''tama kapha''

| Diminished ability to think or concentrate or indecisiveness || ''tama [[kapha]]''

|-

|-

| Recurrent thoughts of death,recurrent suicidal ideas || ''tama, kapha''

| Recurrent thoughts of death,recurrent suicidal ideas || ''tama, [[kapha]]''

|-

|-

|}

|}

=== Table 5:Predominance of ''Raja'' and ''Pitta dosha'' ===

=== Table 5:Predominance of ''Raja'' and ''[[Pitta dosha]]'' ===

{| class="wikitable"

{| class="wikitable"

| rowspan ="11" style="vertical-align: top;" | Mania

| rowspan ="11" style="vertical-align: top;" | Mania

|-

|-

| A distinct period of abnormality and || ''raja, pitta''

| A distinct period of abnormality and || ''raja, [[pitta]]''

|-

|-

| persistently elevated, expansive or irritable mood.|| ''raja, pitta''

| persistently elevated, expansive or irritable mood.|| ''raja, [[pitta]]''

|-

|-

| Inflated self esteem or grandiosity || ''raja pitta''

| Inflated self esteem or grandiosity || ''raja [[pitta]]''

|-

|-

| Decreased need for sleep || ''vata, raja''

| Decreased need for sleep || ''[[vata]], raja''

|-

|-

| More talkative than usual || ''vata''

| More talkative than usual || ''[[vata]]''

|-

|-

| Flight of ideas || ''raja vata''

| Flight of ideas || ''raja [[vata]]''

|-

|-

| increase in goal directed activity || ''raja pitta''

| increase in goal directed activity || ''raja [[pitta]]''

|-

|-

| or psychomotor agitation || ''raja pitta''

| or psychomotor agitation || ''raja [[pitta]]''

|-

|-

| Excessive involvement in pleasurable activities that have a high potential for painful consequences || ''raja, pitta, vata''

| Excessive involvement in pleasurable activities that have a high potential for painful consequences || ''raja, [[pitta]], [[vata]]''

|-

|-

| During the period of mood disturbance any three or more of above Symptoms have persisted ||  

| During the period of mood disturbance any three or more of above Symptoms have persisted ||  

|}

|}

=== Table 6: Predominance of ''Raja'' and ''Vata'' ===

=== Table 6: Predominance of ''Raja'' and ''[[Vata]]'' ===

{| class="wikitable"

{| class="wikitable"

| rowspan="12" style="vertical-align: top;"| Schizophrenia

| rowspan="12" style="vertical-align: top;"| Schizophrenia

|-

|-

| Social withdrawal, often with deterioration in personal care, || ''tama, kapha''

| Social withdrawal, often with deterioration in personal care, || ''tama, [[kapha]]''

|-

|-

| Loss of ego boundaries with inability to perceive onself as Separate || ''Alpasatva'' with excessive ''raja'' and ''tama''

| Loss of ego boundaries with inability to perceive onself as Separate || ''Alpasatva'' with excessive ''raja'' and ''tama''

|-

|-

| Loose thought association, often with slowed thinking or over inclusive || ''raja vata''

| Loose thought association, often with slowed thinking or over inclusive || ''raja [[vata]]''

|-

|-

| and rapid shifting from topic to topic || ''raja, vata''

| and rapid shifting from topic to topic || ''raja, [[vata]]''

|-

|-

| Autistic absorption of inner thoughts || ''raja''

| Autistic absorption of inner thoughts || ''raja''

|-

|-

| frequent sexual or religious preoccupation || ''raja tama, kapha''

| frequent sexual or religious preoccupation || ''raja tama, [[kapha]]''

|-

|-

| Auditory hallucinations || ''raja, vata''

| Auditory hallucinations || ''raja, [[vata]]''

|-

|-

| Delusions || ''raja''

| Delusions || ''raja''

| Flat Affect || ''raja''

| Flat Affect || ''raja''

|-

|-

| Hypersensitive to environmental stimuli || ''raja, vata''

| Hypersensitive to environmental stimuli || ''raja, [[vata]]''

|-

|-

| Impaired concentration Depersonalization wherein one behaves like a detached observer of one's own actions. || ''raja'' and ''vata''

| Impaired concentration Depersonalization wherein one behaves like a detached observer of one's own actions. || ''raja'' and ''[[vata]]''

|-

|-

|}

|}

* [[Unmada Chikitsa]]  

* [[Unmada Chikitsa]]  

<div id="BackToTop"  class="noprint" style="background-color:#DDEFDD; position:fixed;

<div id="BackToTop"  class="noprint" style="background-color:#DDEFDD; position:fixed;

  padding:0.1em; font-weight:bolder; -moz-border-radius:8px; ">

  padding:0.1em; font-weight:bolder; -moz-border-radius:8px; ">

[[#top| Back to the Top ]]</span></div>

[[#top| Back to the Top ]]</span></div>