A Comprehensive Guide to Depression Treatment in Ayurveda

Depression is a complex mental health disorder that affects millions of individuals worldwide. It can have a profound impact on a person’s daily life, relationships, and overall well-being. In this comprehensive article, we will delve into the definition, causes, symptoms, treatments, home remedies, and prevention strategies for depression, drawing upon current research and expert opinions.

Definition of Depression

Depression, also known as major depressive disorder (MDD) or clinical depression, is a common and serious medical illness that negatively affects how a person feels, thinks, and acts. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work, school, or in relationships. Depression is not simply feeling sad or down temporarily; it is a persistent and pervasive condition that requires professional intervention for effective management.

Causes of Depression

The exact cause of depression is not fully understood, but it is believed to be the result of a combination of genetic, biological, environmental, and psychological factors. Some individuals may be more predisposed to depression due to genetic vulnerability, while others may develop it in response to certain life events or stressors. Common factors that contribute to depression include:

1. Genetics: Research suggests that depression can run in families, indicating a genetic predisposition to the disorder.
2. Brain Chemistry: Imbalances in neurotransmitters, such as serotonin, dopamine, and norepinephrine, may play a role in the development of depression.
3. Life Events: Traumatic events, loss of a loved one, relationship problems, financial difficulties, or major life changes can trigger depression in susceptible individuals.
4. Medical Conditions: Chronic illnesses, such as cancer, diabetes, or heart disease, as well as certain medications, may increase the risk of depression.
5. Substance Abuse: Alcohol or drug abuse can exacerbate or trigger depressive symptoms.

Symptoms of Depression

Depression can manifest in various ways, and symptoms may vary from person to person. Common symptoms of depression include:

1. Persistent feelings of sadness, emptiness, or hopelessness
2. Loss of interest or pleasure in activities once enjoyed
3. Changes in appetite or weight
4. Insomnia or excessive sleeping
5. Fatigue or loss of energy
6. Feelings of worthlessness or guilt
7. Difficulty concentrating or making decisions
8. Irritability or restlessness
9. Thoughts of death or suicide

It’s important to note that experiencing one or more of these symptoms does not necessarily mean a person has depression. Diagnosis should be made by a qualified mental health professional based on a comprehensive evaluation of symptoms and their impact on daily functioning.

Treatments for Depression

Depression is a treatable condition, and various therapeutic approaches can help individuals manage their symptoms and improve their quality of life. Common treatments for depression include:

1. Psychotherapy: Cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and other forms of talk therapy can help individuals identify negative thought patterns, learn coping skills, and develop healthier ways of thinking and behaving.
2. Medication: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs), may be prescribed to help regulate brain chemistry and alleviate depressive symptoms.
3. Lifestyle Changes: Engaging in regular exercise, maintaining a healthy diet, getting adequate sleep, and avoiding alcohol and drug use can have a positive impact on mood and overall well-being.
4. Support Groups: Participating in support groups or seeking support from friends, family members, or peers who understand what it’s like to experience depression can provide validation, encouragement, and practical advice.
5. Electroconvulsive Therapy (ECT): In severe cases of depression that do not respond to other treatments, ECT may be recommended. This procedure involves administering a controlled electric current to the brain to induce a brief seizure, which can alter brain chemistry and alleviate symptoms.

Home Remedies for Depression

In addition to professional treatment, there are several self-care strategies and home remedies that may help alleviate depressive symptoms:

1. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, yoga, or progressive muscle relaxation can help reduce stress and promote relaxation.
2. Creative Outlets: Engaging in creative activities such as painting, writing, gardening, or playing music can provide a sense of purpose and accomplishment, as well as serve as a distraction from negative thoughts.
3. Healthy Lifestyle Habits: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, as well as staying hydrated and limiting caffeine intake, can support overall physical and mental health.
4. Establishing Routine: Establishing a daily routine and setting achievable goals can provide structure and stability, which may help alleviate feelings of aimlessness or lethargy.
5. Social Support: Maintaining connections with supportive friends and family members, even if it’s through virtual means, can provide emotional support and reduce feelings of isolation.

Prevention of Depression

While it may not be possible to prevent depression entirely, there are steps individuals can take to reduce their risk of developing the disorder:

1. Prioritize Self-Care: Making self-care a priority by engaging in regular physical activity, getting enough sleep, eating a balanced diet, and managing stress effectively can help protect against depression.
2. Build Resilience: Developing healthy coping mechanisms, such as problem-solving skills, assertiveness, and positive thinking, can enhance resilience and help individuals navigate life’s challenges more effectively.
3. Seek Support: Building and maintaining strong social connections with friends, family, or support groups can provide a sense of belonging and emotional support during difficult times.
4. Limit Alcohol and Drug Use: Avoiding or moderating the use of alcohol and drugs, which can exacerbate depressive symptoms and interfere with treatment effectiveness, can help protect against depression.
5. Know When to Seek Help: Being aware of the signs and symptoms of depression and seeking help from a qualified mental health professional early on can facilitate timely intervention and improve outcomes.

Depression Ayurvedic View

Depression is a common mental disorder, and a significant contributor to major diseases across the globe affecting the people of all the communities. It is a state of mind in which there are persistent low moods and aversion to activities that affect a person’s thoughts, feelings, behavior, and sense of well-being. It is a disorder seen from the ages. It is earlier known as ‘melancholia’. Depression can become chronic or recurrent leading to the impairment of an individual’s ability to take care of routine life activities. Shareerika and Manasika dosha, jnanendriya, karmendriya, satwa bala, agni, dhatu, ojas, manovahasrotas, etc. are affected. Vishada, Avasada, Manodukhaja Unmada, and Kaphaja Unmada are the clinical conditions in Ayurveda that are correlated with depression.

Depression in Ayurveda

Depression can be understood concerning Shareerika dosha, Manasika dosha, Satwa bala, Jnanendriya, Karmendriya, Srotas, Agni, Dhatus, and Ojus. Based on the etiology, in Ayurveda depression is correlated with Vishada, Avasada, Manodukhaja Unmada, and Kaphaja Unmada as per several conceptual and clinical studies.

As known, every disease occurs due to disturbance in the dosha. The main dosha affected here is the Vata dosha. Among the forms of Vata dosha, Prana Vata and Udana Vata are affected, and hence the intellectual and emotional activities and memory are impaired. Vata also vitiates Pitta and Kapha dosha.

Manasika dosha are the Rajas and Tamas. Tamas is the dosha that is vitiated in depression and hence there is a lack of enthusiasm, lethargy, etc. symptoms.

Satwa Bala means the strength of the mind, and it is divided into Pravara, Madhyama, and Avara Bala. Studies have shown that people with Madhyama and Avara Satwa are prone to mental disorders since their mental capacity or strength is weak. Hence, depression is predominant in Madhyama and Avara Satwa.

Jnanendriya or the sense organs, are part of Sajnavaha Srotas. The functioning of sense organs is impaired. Karmendriya, the motor organs, and their functioning are also impaired. Hence, reduced speech, reduced activities, and reduced libido are the common complaints of depression.

Agni, the digestion capacity of an individual is good in a person who is healthy and mentally stable. When the person with Madhyama and Avara Satwa is afflicted with mental dysfunctioning viz, excess worry, fear, grief, that leads to reduced appetite and the person does not feel interested in taking the food. With this, the Agni deteriorates.

As Agni has deteriorated, the Ahara rasa is improperly formed, and thereby the rasa Dhatu is not properly nourished. Further, all the Dhatu are improperly formed and thus there is Dhatu Kshaya. This will influence the mind in return and thereby the synchronization of body and mind is disturbed.

Ojus, the essence of all Dhatu, also is affected because the seven Dhatu are not nourished properly. This in turn will cause fear, worry, grief, over-thinking, etc.

Manovaha srotas, the channels of the mind are involved in depression, with all the factors that are discussed above influencing the Manovaha Srotas leading to depression.

Vishada, Avasada, Manodukhaja Unmada, and Kaphaja Unmada can be correlated with the condition of depression.

Vishada and Avasada are the manobhava (qualities of mind) as well as manovikara (diseases related to mind). Both are synonymous with each other. In Manodukhaja Unmada, the symptoms viz, complaining about lost objects or people, weeping, pallor and fainting, and emotional withdrawal are seen.

In Kaphaja Unmada, the symptoms are Sthanam eka deshe (does not want to go anywhere or meet people), lalasinghanaka srava (discharge from mouth and nose), sauchdwesha (poor personal hygiene), rahaskamatha (prefers to stay alone), thushni bhava (person becomes silent), achankramana (reduced physical activities), anannabhilasha (aversion towards food), bhibhatsyatwam (feeling of disgusting).

Management of depression in Ayurveda

The treatment for depression is classified as daivavyapashraya chikitsa, yuktivyapashraya chikitsa, and satwavajaya chikitsa.

Daivavyapashraya Chikitsa is the treatment that is done in the form of Mantra recitations, performing rituals that are pious, religious, Homa, Yajna, Bhajans, Upavasa, etc. feed the mind with positivity and relieve negative thoughts.

Yuktivyapashraya Chikitsa is the treatment with medicines and purificatory procedures. Snehana (oleation) therapy involves the Snehapana (intake of medicated ghee). This acts on vitiated Vata dosha and Pitta dosha.

After the course of Snehapana, Abhyanga (oil massage) can be given which brings the vitiated dosha to the gastrointestinal tract and calms the aggravated mind.

Snehana is followed by Swedana (fomentation). The mild form of purificatory therapies like emesis and purgation help to eliminate the dosha. Since the Vata Dosha is predominant Basti karma (enema therapy) is also the choice of treatment.

Medicines that stimulate mental functioning like Brahmi (Bacopa monnieri), Mandukaparni (Centella asiatica), Jyotishmati (Celastrus panniculatus), Shankhapushpi (Convolvulus pluricaulis), etc. are administered either in the form of single drugs or compound formulations.

After the purification, Rasayana Karma (rejuvenation therapy) helps rejuvenate both body and mind.

Satwavajaya Chikitsa is a form of treatment that encourages the patient to adopt a positive mindset. Reassurance to the patient, music therapy, aroma therapy, meditation, pranayama, the practice of Yoga, positive affirmations, and counseling are the measures to be taken. Achara Rasayana is a distinctive therapy that aims to follow the moral and behavioral code of conduct explained in Ayurveda. Good personal conduct, good mental conduct, good social conduct, good moral conduct, and good religious conduct are the guidelines that make the person stay healthy, help in reversing the disease process, encourage the mind of the patient, and both sensory and motor functioning are strengthened.

Conclusion

Depression is a prevalent and debilitating mental health disorder that requires comprehensive treatment and support. By understanding its causes, symptoms, and treatment options, individuals can take proactive steps to manage their condition and improve their overall quality of life. Through a combination of professional treatment, self-care strategies, and social support, individuals can effectively cope with depression and move toward recovery.

Depression is the most common mental disorder affecting all the communities in the world. There are no direct references in Ayurveda to depression as a disease. Manobhava and Manovikara viz, Vishada and Avasada, forms of Unmada like Manodukjaja Unmada and Kaphaja Unmada. Vata dosha is the predominant dosha involved, Tamo dosha, Manovaha srotas, etc. are affected by the condition of depression. Madhyama and Avara satwa bala are prone to depression. The treatment of depression can be given in three forms, daivavyapashraya chikitsa, yuktivyapashraya chikitsa, and satwavajaya chikitsa.

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References

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. National Institute of Mental Health. (2020). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml
3. Mayo Clinic. (2020). Depression (major depressive disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
4. DEPRESSION – AN AYURVEDIC OUTLOOK, Journal of Ayurveda & Holistic Medicine, 2017 (Mar-Apr), Volume 5, Issue 2, page. 12-23.
5. DEPRESSION – AN AYURVEDIC REVIEW, International Journal of Research in Ayurveda and Pharmacy, 2019, Volume 10, Issue 3, page. 13-17.