Integrating Ayurveda in Mental Health Care

 

Basis of Ayurveda Psychiatry - Modern psychiatry is based on different theories based on Neuro transmitter mechanisms, biochemical agents and endocrinological manifestations. Ayurvedic psychology on the other hand is based on concept of Triguna, Tridosha and related theories. In the current perspective, western modern science accepts the influence of heredity and transfer of certain traits from the parents to their offspring. “Mata Pitru sattve” used by Charaka if viewed in this perspective appears rather rational. The current day physicians is in full agreement with the importance given by Ayurveda Acharyas to the bicardiac state (Dauhrida) – Emotional state of the mother during pregnancy bears a heavy influence on the prospects of the offspring. Ayurveda is replete with innumerable reference to mind, its nature, origin, function, mental faculties, physiological and pathological states of mind, vivid and appropriate definitions for mental disorders, their symptomatology and measures to treat them.  

 

Ayurvedic perspective of mind - In the evolution of the universe, mind is made up of Triguna ie. Sattva, Rajas and Tamas.  Predominance of Sattva Guna, which is the state of equilibrium, is responsible for mental health and predominance of Rajas and Tamas gunas are pathological states of mind. Rajas guna in association with Tama creates Panchamahabhuta, which is responsible for the creation of visible world. 

 

Cause of Psychiatric problems - Intellectual blasphemy and misbalance of Trigunas has been viewed as the cause of almost all the disorders in Ayurveda. The approach of treatment of Manas Roga is holistic and is oriented to the removal of route cause of Manas Roga. 

 

Three – fold therapy - Four-dimensional approach of life ie. Sharira, Indriya, Sattva, Atman is basically a psychosomatic theory emphasizing holistic concept. The unique approach of Charak in this context is the operation of immune complex in a psychosomatic fashion. Immune system is directly enriched by Ojas and the approach of Ojas is definitely psychosomatic which is very much relevant in the present advancements of science. The therapeutics is altogether psychosomatic in nature where Daivavyapasraya, Yukti vyapasraya and Sattvavajaya chikitsa are the basic principles of medicine. These three-fold therapy represents three categories of approaches adopted by Ayurveda Acharyas for the care and cure of pathological conditions of the body and mind. Daivavyapasraya is more or less empirical in as much it revolves around faith and unseen (Adrishtam) influences. Yuktivyapasraya on the other hand is more of rational nature as it involves reasoning and use of rational faculties. Sattvavajaya however is a mixed bag of rational and empirical procedures though it tends to be more rational than empirical. Though all these 3 approaches are applied in psychological illnesses, Sattvavajaya in view of its relevance remains the mainstay of Ayurvedic psychotherapy. 

 

Sattvavajaya is an Ayurvedic form of Psychotherapy developed as a non-pharmacological method to improve the mental health and to manage the psychological counterparts of disorders. It is a method of restraining the mind from unwholesome objects and it has been prescribed for persons suffering from mental disorders. 

 

Medhya Rasayana - The concept of promoting cognitive functions like Reception (Grahana), Retention (Dharana) and Recollection (Smriti) is something unique. Ayurvedic literature reveals a comprehensive description of a class of drugs called Medhya Rasayana for this purpose, which are also used in the management of psychological and psychosomatic disorders. Basically they promote intellectual faculty and have a pronounced potency in treating a variety of psychological disorders. The action of Ayurvedic herbs is based on the pharmacodynamics properties – Rasa, Guna, Virya, Vipaka and Prabhava. Also the herbs work on the basis of food dynamics or nutritional dynamics resulting in the wanted effect. This mechanism may be much similar to Nootropic agents of western medicine. These herbs not only promote cognitive function and intellectual activities but also are useful in a wide variety of psychological and psychosomatic disorders. Extensive studies conducted so far reveal that Medhya Rasayana herbs of Ayurveda (Ashwagandha, Brahmi, Shankhapushpi, Vacha, Mandukaparni, Jatamansi) possess varying degrees of Anxiolytic and adaptogenic effect and as such they can be used as Antistress agents and as remedies for treating mental diseases with anxiety and aggression. They have shown significant effect in reducing anxiety and depression, promoting adjustment, improve memory and induce healthy sleep.

 

Achara Rasayana – Achara Rasayana is the unique concept of Ayurveda, which is mainly advocated for psychosomatic disorders in preventive and therapeutic aspects.

 

Ayurvedic Therapies – Therapies like Murdha Taila (Shirodhara, Shirobasti, Shiropichu, Shiro Abhyanga), Abhyanga, Nasya, Basti are beneficial in psychosomatic disorders and improves the QOL.

 

Role of Sattvic Diet - Ahara (Diet) is also one of the creations. Ahara, composition of Panchamahabhuta is utilized for Sharira and Mana. Therefore quality of mind depends upon the quality of Ahara taken by the individual.

 

Research studies - 

 

• In a clinical study to assess learning and memory activity of Brahmi Ghrita, Yadav KD et al. concluded that BrahmiGhrita enhances learning and memory as analogous to standard drug (piracetam) in normal rats. 
• In a study, Joshi R et al. examined the effect of Panchagavya Ghrita on convulsions, oxidative stress and cognitive impairment in pentylenetetrazole (PTZ) induced seizures in rats. It was concluded that the administration of Panchagavya Ghrita attenuates seizures, cognitive impairment and oxidative stress in pentylenetetrazole induced seizures in rats.
• The data emerging out of the clinical trial conducted by Koushik AK et al. indicated significant clinical relief and favourable shift of grades of the clinical components of anxiety namely nervousness, palpitation, insomnia, irritability, lack of concentration etc. following Medhya Rasayana therapy. 
• In a research study conducted on 89 school going children by Koshi et al. at Balamandir Research Foundation, Chennai, it was concluded that the administration of Shankhapushpi for 1 year in school going children showed that it enhanced the mental agility of children. 
• In a randomized clinical study, Atul Shankar Sarokte et al. concluded that Medhya Rasayanas are quick in action and bring about improvement in memory faster when compared with Yogic practices.
• In a study to evaluate efficacy of Satvavajaya Chikitsa and Aushadhiya Medhya Chikitsa for improving Smriti in young healthy volunteers, Amin et al. concluded that Satvavajaya Chikitsa shows better results in immediate recollection in terms of short-term memory while Shankhapushpi found much better in long-term memory enhancement on various tests of Wechsler Memory Scale. 
• Babu G et al. in a study concluded that Achara Rasayana a code of right socio-behavioral conducts effectively prevents the chittodvega by maintaining the adequacy of defense mechanism. It can successfully treat Chittodvega by means of Dharana (Japa) and Dhyana (Tapas). Dharana and Dhyana normalize the neuro-transmitters like serotonin, nor–epinephrine, GABA metabolism through ANS, thereby normalize the deranged Manodoshas and Buddhi bramsha.
• In a study conducted by Kalpana S Patel et al. concluded that Panchakarma with Yoga Basti showed good results in Cerebral Palsy patients, especially in relieving the signs and symptoms and thus reducing the disability in children with Spastic CP and improving growth (height, weight, CC) and development (head holding and sitting), reducing spasticity of left upper limb, and spasm in patients.
• Bost N et al. conducted research study and concluded that massage therapy is a beneficial tool for the health of nurses as it may reduce psychological stress levels.
• Garner B et al. in a pilot study to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit concluded that massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. 
• Research studies conducted by Uebaba K et al. indicate that Shirodhara has anxiolytic and ASC-inducing effects, and it promotes a decrease of noradrenaline and exhibits a sympatholytic effect, resulting in the activation of peripheral foot skin circulation and immunopotentiation. 
• Kalpana D. Dhuri et al. have investigated the effect of Shirodhara on healthy volunteers and have concluded that a standardized Shirodhara leads to a state of alert calmness similar to the relaxation response observed in meditation. The clinical benefits observed with Shirodhara in anxiety neurosis, hypertension, and stress aggravation due to chronic degenerative diseases could be mediated through these adaptive physiological effects. 
• In a research study conducted by Neetu et al., it was found that while the drug and Shirodhara were both effective in improving the reaction time of ADHD-affected children, the drug combined with Shirodhara was superior to the drug used alone. 

 

There is a significant scope of developing Ayurvediya Manasa Vijnana on sound scientific footings as a living clinical disciple in Ayurveda.