E-ISSN:2456-3110

Review Article

Anxiety

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 8 AUGUST
Publisherwww.maharshicharaka.in

Anxiety - Unlocking the Dynamics and Management in Ayurveda

Naidu S1*, GR Ratre2, Naik S3
DOI:10.21760/jaims.9.8.30

1* Shraddha Naidu, Post Graduate Scholar, Department of Samhita Siddhant, Shri NPA Govt Ayurveda College, Raipur, Chhattisgarh, India.

2 GR Ratre, Reader, Department of Samhita Siddhant, Shri NPA Govt Ayurveda College, Raipur, Chhattisgarh, India.

3 Shrikant Naik, Lecturer, Department of Samhita Siddhant, Shri NPA Govt Ayurveda College, Raipur, Chhattisgarh, India.

Ayurveda has the most ingenious approach to achieve complete health as it doesn’t leave any domain unattained, especially mental health. Rajas & Tamas Manas Dosha are responsible for all the psychic disorders including Anxiety which is usually characterized by hyperactivity, state of excessive worry, fear and poor decision-making ability. Its psychopathology affects humans on somatic level as well. Mental health concerns touch most people’s lives directly or indirectly, it can affect a person’s work productivity, their personal and professional lives and in severe cases destroy their quality of life. Ayurveda takes two approaches Drug therapy like use of Medhya Rasayan, through internal as well as external method which enhances the function of intellect & non-drug therapy like Aachar Rasayan, Satwavajaya Chikitsa & Yoga therapy. Anxiety is more chronic as it often overshadowed by other health conditions like GIT problems. Hence exploring presenting problem involving mind-body relationship and finding a synergistic solution is the need of the hour, to reduce the stigma associated with it, by understanding Anxiety in depth from Ayurveda’s point of view.

Keywords: Ayurveda, Anxiety, Satwavajaya, Chitta

Corresponding Author How to Cite this Article To Browse
Shraddha Naidu, Post Graduate Scholar, Department of Samhita Siddhant, Shri NPA Govt Ayurveda College, Raipur, Chhattisgarh, India.
Email: 		Naidu S, GR Ratre, Naik S, Anxiety - Unlocking the Dynamics and Management in Ayurveda. J Ayu Int Med Sci. 2024;9(8):196-200.
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https://jaims.in/jaims/article/view/3740

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-07-06 2024-07-16 2024-07-25 2024-08-04 2024-08-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.54

© 2024by Naidu S, GR Ratre, Naik Sand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Anxiety is understood as the state of apprehension or uneasiness arising due to the anticipation of insecurity or assault. It is pathological when it is unreasonable, exaggerated, recurrent and causing a significant psychophysiological distress.[1] With an increasing population & subsequently increasing socio-economic stress, incidence of Anxiety is also on the rise.

In the present post-Covid scenario there seems to be a marked rise in the occurrence of anxiety and depression in primary care settings. A global increase of 13.8% to 25.6% in the prevalence of anxiety disorders has been reported in the Lancet. A similar 25% increase has been reported by WHO.[2] The range of increase (23.7% to 35%) reported from India also seems to fall in line with the global concerns.[3]

While enumerating Nanatmaja Vyadhi of Vata (disorders caused exclusively due to vitiated Vata), Ananvasthita Chittatwa is mentioned by Charaka.[4] But no detailed descriptions about this condition are available in texts. By collating these descriptions, it is possible to conclude that Chittodvega or Udvega is a Manasavikara caused by imbalanced Manas (mental) Doshas viz., Rajas and Tamas implicating two of three bodily Dosha, viz., Vata, Pitta and Kapha. Thus, Udvega appears to correspond with anxiety disorders as recognised in psychiatry. This article would shed light on some of practical aspects which often go unnoticed, because of adopting conventional approach in understanding Anxiety.

Materials and Methods

To fulfil the aim and objectives Ayurveda literature, available information on internet, Journals, Research papers and Articles are referred, to study the concept of Psyche (Chitta), Anxiety (Chittodvega), which will be discussed ahead.

Etymology and Definition

Chitta: Derived from root ‘Chitta’ means ‘to perceive, fix mind upon, to observe, to aim at, to intend, to understand, to know’. Udvega: derived from root ‘Ud’ means ‘upward movement, separation, upon, on, over’ So Chitta (mind) + Udvega (anxiety) = Chittodvega (Anxious state of mind).

Chittodvega has been used by Charaka more classically under Manodoshavikara along with emotional disturbances like the Kama (lust), Krodha (anger), Lobha (greed), Moha (infatuation), Irshya (envy), Maan (arrogance), Shoka (grief) and Chinta (Worry).[5] Even though the word Chittodvega is not explained by Acharya Sushruta, Dalhana the commentator of Sushruta Samhita has mentioned Chittodvega as a synonym with the term Shoka (grief).[6]

According to Acharya Chakrapani ‘Chitta Udvignata Chittodvegaha’.

What happens during Chittodvega?

Vitiation of Rajas and Tamas are considered a prime factor in the causation of Chittodvega. Tamas can’t manifest its movement without Rajas, indicating its key role in disrupting the balance. Manoabhighata (mental trauma) is considered the triggering factor for mental disorders. Tridoshas additionally play a crucial role in the manifestation of this disease. Aggravated Vata is liable for mental disturbance and gives rise to symptoms like fear, grief and confusion. Among the five varieties of Pitta, Sadhaka Pitta is responsible for Buddhi (intelligence), Medha (memory), Utsaha (enthusiasm), achievements and its vitiation produces mental disturbance.[7,8] Among the varieties of Kapha, Tarpaka Kapha vitiation results in the manifestation of Chittodvega. Considering the Dhatus involved in the disease, Ati Chinta or excess thinking is a causative factor for Rasa Dhatu Dusti which again manifests both bodily and mental symptoms.[9]

On the basis of the classical data and clinical observations, Udvega can be understood as a mental condition with the following signs and symptoms[10]

  • Bhaya (fear)
  • Asthairya (diffidence/lack of resolution)
  • Vepathu (tremor)
  • Hrtkampa (palpitation)
  • Sheegrakopa (irritability, short temper)
  • Swedabahula (excessive sweat)
  • Trtbahula (excessive thirst)
  • Mukhashosha (dryness of mouth)
  • Galashosha (throat of dryness)

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  • Vakshoparodha (chest constriction)
  • Anavasthira Chittatwa (fickle mindedness / restlessness)
  • Sada (fatigue)
  • Mukha/greeva Peshee Prasarana Nirghatana (expansion of pulling the muscles of face/neck)
  • Smrtikshaya (receding memory)
  • Vamachinta (negative thinking)
  • Angashoola (bodyache)

Anxiety can be deconstructed, or broken down, into the two core symptoms of fear and worry. These symptoms are present in all anxiety disorders, although what triggers them may differ from one disorder to the next. When the mind is agitated or anxious, it is unable to detract itself from the harmful or irrelevant objects. This explains that abnormal state of mind such as Anxiety neurosis is a result of abnormal Swasya Nigraha.[11] This is also a precursor for much grave mental disorders like Unmada (Insanity) & Apasmara (Epilepsy). Thus, early identification could be beneficial to the individual.

Relationship between GIT and Mind

Food is not simply processed in the gastrointestinal tract, but it has a greater impact on the mind as well, which is evident from the sutra mentioned in Charak Samhita: food should always be consumed at a favourable place along with those factors which pleases the mind, as it shields the mind from those things which might cause trauma or harm, as a result of this habit; individuals don’t suffer from any mental problems.[12] Ayurveda further emphasizes on the significance of avoiding the consumption of incompatible food combinations which causes severe diseases like - Visphota, Shoka, Mada, Vidrudhi, Gulma, Yakshma, destruction of Teja, Bala, Smriti, Mati and Chitta.[13]

This should raise a concern as the number of people suffering from these conditions are increasing gradually, when body suffers physically people run for instant medical help, but when damage is much more sensitive, specially at mental or emotional level, people become extra cautious fearing judgement, which delays treatment worsening person’s condition further. Therefore, when it comes to adopting right food practices Ayurveda stands at forefront of other nutrition sciences.

Decoding the History without Biases

An intelligent Vaidya should know the meticulous stages of diseases, the body, Agni, Bala and Manas through its increase, site, and debilitating condition. That is why history taking is very crucial.[14] History is about tracing what happened in the past, and when a practitioner takes history from any patient, he/she should keep clarity about how they are making the diagnosis in their mind based on past cases of similar nature. But before jumping at any conclusion keep the mind open for differential diagnosis or the right primary diagnosis, because more often than not; patient comes for a secondary health problem but the real cause is uncovered during the history taking. Most patients that come with digestive issues are suffering from stress, improper sleep, over-working themselves at work or over-indulging their senses into insignificant pursuits, consuming nutritionally compromised processed food all the time, no physical exercise. All of this comes into light when history is properly taken and then proper strategy is made to combat with the condition.

Management through Classical Approach

Ayurveda has three treatment modalities - Daivyapashray Chikitsa, Yuktivyapashray and Satwavajaya Chikitsa.

  • Daivyapashray (faith therapy)- It creates confidence in the patients by removing the fear and negative tendencies indirectly helping the person, it involves Mantra (chanting specific verses from spiritual texts), Aushadha (wearing sacred herbs), Mani (wearing precious gems), Mangala (propitiatory rites), Upahara (offerings), Gamana (pilgrimage) etc.
  • Satwavajaya Chikitsa is a concept of Ayurvedic psychotherapy that is non pharmacological in approach.

Charaka Samhita considers that in the vitiation of Doshas, fear, anger, grief is also contributes its share in the deterioration of the body. So, from a preventive aspect -

  • Achara Rasayana which has direct effect on potentiation of Satva Guna of mind has been suggested to overcome the Vikaras of
  • Mental disorders caused by Kama, Shoka, Bhaya should be countered by inducing the opposites passion in order to neutralize the causative ones.

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  • Sadvrutta (code of virtues) should be followed.
  • Reading of scriptures that stimulate the intellect, staying in the company of sages; respecting and providing service to them as a disciple should, igniting the curiosity to identify & realize oneself (knowledge of one’s Desha, Kula(lineage), Bala, Kala, Strength), understanding the good and bad, learning patience, enhancing memory, achieving the state of Samadhi.[15]
  • In practice, meditation or Dhyana is also helpful to have better control over activities of mind as advocated in the Patanjal Yogasutra along with Yoga for an overall health.

It has been stated that the mind being always directed towards its objects, cannot be taken away from the undesirable objects without patience thus Satwavajaya Chikitsa focuses on control of the mind or mental restraint from stressors, which can be attained via spiritual knowledge, philosophy, fortitude, remembrance, and concentration.[16]

Dharaniya Vega such as Lobha (greed), Shoka (grief), Bhaya (fear) etc. must be restrained as they induce a variety of mental conflicts at the level of individual psyche causing poor mental health of the individual besides their untoward impact on the society including the family and relatives.

Yuktivyapashraya has two approaches - Shodhan and Shaman Chikitsa. According to Ayurveda, our senses are the channels through which our mind is fed. All the knowledge that we possess is transferred to the brain through our senses. In order to keep the mind healthy, our senses should be well taken care of and stimulated in a manner which will not feed it with wrong impressions.[17]

Procedures like Nasya, Dhoompana, Shirodhara, Shirobasti, Karnapurana, Gandusha, Netratarpan and Shiroabhyanga should be used based on patient’s condition and other factors like season, chronicity of the disease etc.

These would bring all the vitiated Vata present in the head region into a balanced state which would in turn bring Pitta and Kapha into its normal physiology. Based on the body condition, the chronicity and the age of the patient, procedures like Basti, Vaman, Virechan should be employed accordingly so that all the aggravated Dosha could be brought into harmony and normal functions could be restored.

Drugs which are used chiefly in these procedures are:

The efficacy of Sankhapuspi (Convolvulus pluricaulis), Brahmi (Bacopa monnieri), and Ashwagandha (Withania somnifera) in patient populations and Mandukaparni (Centella asiatica) and Tulsi (Ocimum sanctum) in animal models have been reported.[18] Recently, Ashwagandha has been recognized as a treatment for Anxiety and Stress in the United States. Used as a broad-spectrum remedy in India for centuries, Ashwagandha (Withania somnifera) was reported by the five human trials included in a systematic review by Pratte et al. to improve outcomes on anxiety and stress scales.[19]

Discussion

Chittodvega is a Manovikara distinguished by Udvega Avastha of Manas (excited state of mind) which denotes increased Rajas (quality of mind) and the increased state of Vata and Pitta Dosha manifests in the form of symptoms like Ati Chinta and Bhaya. With the current lifestyle and food habits of people, supported by the data on Anxiety, it’s time we acknowledge this disorder as significantly as other mental conditions like Depression, Anger etc. because Ayurveda though an ancient science, is still far ahead when it comes to figuring health status of individuals at every stage.

Early diagnosis could save many lives that suffer later because they didn’t get the required medical attention at the right time, so conditions like Anxiety shouldn’t be dismissed as trivial. The current trend of eating bizarre food combinations which is considered incompatible in Ayurveda has impacted people’s mental health. This is evident with the rise in the people dealing with mental conditions at some point of their lives irrespective of their age. All those fancy foods are of predominantly Rajsik nature (which vitiates Rajas dosha) which not just affects the GIT but it reduces the Satva making the psyche weak, initiating the chain of greed, anger, fear, over thinking etc. persistently happening and ultimately leading to Chittodvega.

Conclusion

Ayurveda has always been the advocate of ethical health practices be it mental, physical, social or other domain of health.


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Right from defining health by including a happier soul, senses & mind to understanding the significance of acknowledging those factors that indirectly affect the mental health leading to problems like Anxiety. This begins as fear gradually worsening with time if not managed at the proper time, but by adopting right code of conduct following proper daily & seasonal regimen as instructed in Ayurveda, health could be maintained holistically. Physical activities like practice of Yoga and meditation for the mind would ensure harmony of life; making the Satva dominant essential for a happier life.

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