E-ISSN:2456-3110

Review Article

Pathophysiology of Depression

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 11 NOVEMBER
Publisherwww.maharshicharaka.in

Understanding the pathophysiology of Depression by Ayurveda Basic Principles

Asiwal K1*, Kumawat N2
DOI:10.21760/jaims.9.11.37

1* Keshav Asiwal, Post Graduate Scholar, Pg Department of Rog Nidan Evum Vikriti Vigyan, Mmm Govt Ayurved College, Udaipur, Rajasthan, India.

2 Neha Kumawat, Lecturer, Department of Kaumarbhritya Bala Roga, RB Ayurvedic Medical College Jalesar Road, Agra, Uttar Pradesh, India.

Depression is a serious mental health concern that will touch most people's life directly or indirectly affecting 350 million people worldwide. Most people do not want to acknowledge it due to societal pressures and awkwardness. But slowly, people are accepting the challenges related to mental health and learning to be okay with it. In Ayurvedic classics Vishada and Avasada are the two mentioned conditions which have close resemblance with depression. Acharaya Charak quote Vishado Rogavardhanam i.e., it is the most foremost factor to worsen the condition of any disease. Psychopathology of depression may even extend up to somatic level. As there are multiple correlations, understanding the pathology of depression by means of Ayurveda basic principles such as Sharirika Dosha (bodily humor), Manasika Dosha (attributes of psyche), Satwa Bala (strength of mind), Agni (biological fire), Dhathu (tissues sustaining the body), Srotas (channels or pathways of the body) and Ojas (vital essence of life) is essential. A better understanding of depression can help in effective prevention and treatment and will help reduce the stigma associated with the condition, and lead to more people seeking help.

Keywords: Vishada, Avasada, Satwa Bala, Dhathu, Srotas

Corresponding Author How to Cite this Article To Browse
Keshav Asiwal, Post Graduate Scholar, Pg Department of Rog Nidan Evum Vikriti Vigyan, Mmm Govt Ayurved College, Udaipur, Rajasthan, India.
Email: 		Asiwal K, Kumawat N, Understanding the pathophysiology of Depression by Ayurveda Basic Principles. J Ayu Int Med Sci. 2024;9(11):267-270.
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https://jaims.in/jaims/article/view/3791

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-10-08 2024-10-18 2024-10-28 2024-11-08 2024-11-17
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© 2024by Asiwal K, Kumawat Nand 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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Keshav A et al. Understanding the pathophysiology of Depression

Introduction

Manasika Bhava (Emotions) are basic feelings of human life. But when a person's emotions, thoughts or behavior frequently trouble them or disrupts their lives and those around them, they may be suffering from mental illness. Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years. Approximately 280 million people in the word have depression. When it comes to matters of health, Ayurveda prioritizes the mind and its diseases. Every great work on Ayurveda simultaneously describes the physical ailments and their psychological effects. The mind and its disorders are studied in the Ayurveda scriptures, especially in relation to Bootha Vidya. This highlights the need for specialization and the therapeutic significance of the topic. In contemporary times, it is imperative to investigate and assess the true impact of a treatment in every area of expertise through the confirmation of scientific study. This holds true for all complementary and alternative medical systems in the modern day. Thousands of years ago, Ayurveda identified mental illnesses are also pertinent in the modern era.

Depression is such an area where many studies have been done and it is very well correlated with Vishada, Avasada, Manodhukhaja or Adhija Unmada and Kaphaja Unmada. According to WHO, depression is expected to account for more lost years of healthy life than other disease by 2030 except for HIV/AIDS.[1]

Depression and Sharirika Dosha

Every ailment has a predominant humour, according to Ayurveda. The humour that controls all bodily and mental processes, Vata, is vitiated, and this leads to the majority of the classic symptoms of depression. Prana Vata is the motivator and controller of manas2 among the five types of Vata. Another property of Prana Vata is Manodharana (control of mind). So, when intellectual, emotional, and motor activities are affected, there will be vitiation of the humor. Udana Vata which is helpful in energy, memory and motivation is also responsible for manifestation of the disease. In mild and moderate depression where there is agitation, anxiety and loss of weight, the role of Vata can be explained.

Few symptoms are noticed to be due to Kapha, the humor which sustains & lubricates body and mind.

Doshic predominance of symptoms

Symptoms of depressionDosha
Sadness of moodVata
Lack of pleasureVata
Sleep disturbancesVata
Appetite changesKapha
Easy fatigabilityVata
Psychomotor retardationKapha
Guilty feelingVata
Poor concentrationVata
Suicidal ideationVata

Depression and Manasika Dosha

Rajas (attributes activity) and Tamas (attributes inactivity) are the two Manasika Dosha. Manasika Dosha generally vitiates the mind and causes various psychological conditions. In depression predominant dosha is Tamas as it is the characterized by inactivity, ignorance, and apathy. The affected always look dejected, nihilistic and averse to virtuous living; suffer from inertia, lethargy and excessive sleep.[3] So depression is a condition of Tamo predominance over Rajas that Madhyama and Avara Satwa comprised the majority of the themes. Even in clinical practice, there is a clear correlation between psychiatric disorders and Satwa.

Depression and Satwa Bala

The conjunction of Shareera (body), Indriya (sense organs), Satwa (mind) and Atma (supreme soul) leads to healthy life.[4] This establishes the connection between the mind and body in an organism. Based on the Satwa Bala (power of the keeping in mind), people can be categorized Ashigher, Madhyama (middle), and lower, Avara (inferior) psychic capacity.[5] Mental illnesses are more common in those who have Madhyama and Avara Satwa. Within the same context, Acharya Charaka states that a weak mind can turn a slight disease into a serious one.[6]

Depression and Agni

Agni is responsible for all bodily transformations and metabolism in addition to its digestive qualities. The psychological traits of fear, rage, dejection, greed, and excessive thinking, among others, directly affect the Agni's functions.


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A food taken even in proper time and right quantity does not get digested in disturbed state of mind.[7] The brain and sensory organs may suffer from a decreased food intake. In case of depression, the symptoms like loss of interest and reduced level of energy are due to reduced Utsaha (enthusiasm) which is a function of Agni.[8]

Depression and Dhatu

Health is the result of the supreme soul, sensory organs, mind, and body humours, tissues, and waste products being in an equilibrium state.[9] So, Dosha and Agni, there is relationship with Dhathu towards mind. An impaired Agni is not capable of metabolism and thus the foremost Dhathu Rasa (the fluids of body- first result of metabolism) is improperly formed. This results in the hampering of whole process of metabolism and depletion of further Dhathu such as blood, muscle tissue, fat, bones, bone marrow and semen. Hridaya is the seat of mind and Rasavaha Srotos (channels carrying Rasa Dhathu). Any vitiation of one can cause imbalance the other. Chinthyanam Ati Chinthana (excessive thinking) causes Rasavaha Srotho Dushti. Depletion of Rasa Dhathu[10] is characterized by clinical symptoms such as restlessness, loss of focus, sound intolerance, palpitation, pains and aches, and weariness even with mild work.

Depression and Srotas

In depression, the initial etiology affects the mind. So, the involvement of Manovaha Srotas, the channels related to the mind in pathogenesis is crucial as in Unmada.[11]

Through these routes, the vitiated dosha becomes dislodged and the manifestation spreads. Since the human body is composed of multiple channels of this type[12] the concept of Manovaha Srotos might be interpreted as the psycho-neuro-body axis, or the link between the mind and body. When someone is insane, the other person will be influenced.

Depression and Ojus

Ojus is the end product of proper Dhathwagni Vyapara (metabolism). Ojus constitutes the essence of all Dhathu[13] Ojus being located in Hridaya, combines with Rasa and circulates through the vessels and performs the Tarpana (nourishment) of the entire body.

Because of its shared location, relationship between Ojus & mind can be understood. Depression & weaker Ojus share many psychological symptoms, such as fear complex, persistent weakness, anxiety, loss of complexion, cheerlessness, emaciation etc. are similar to that of depression

Discussion

Mental disease is adequately categorized in detail in Ayurveda. Manasa Vikara is considered to be impairment of general mental functions the presence of weak psyche (Alpa Stwa), vitiation of Sharirik and Manas Dhosas (Raj & Tam) and also by vitiation of Manovah Srotas this may occur firstly as involvement of Manas Dosha while physical involvement is secondary or sometimes the primary involvement is Sharirik Dhosa and subsequently Manas Dhosa get involvement). If the primary involvement is because of Sharirik Dhosa and for subsequent mental impairment the treatment is mainly with the drugs. Samprapti is a phenomenon from vitiation of Dosha till the Roga Pradurbhava. Manasa Vikara usually runs a sequential process from minor general behavioral symptoms to the marked alteration of Budhi, Dhriti and Smriti.

Conclusion

Depression affects people of all ages, from all walks of life in all countries. It results in mental suffering and impairs a person's capacity to perform even simple tasks, sometimes having upsetting effects on interpersonal interactions in the home and in society. The worst-case scenario for depression is suicide. It is a consequence of derangement of vital factors of the body such as Tridosha, Triguna, Rasadhathu, Manovaha Srotos, Satwa, Agni and Ojus. According to etiology and pathogenesis the disease can be correlated to Avasada, Vishada, Manodhukhaja Unmada and Kaphaja Unmada and can be treated accordingly seeing all factors. So, understanding the disease in Ayurvedic approach will provide patients with help, hope and feel worth. Positive attitude by holistic approach of Ayurveda aids in uplifting mind.

References

1. World Health Organization. The world health report. 2001, Mental Health: New Understanding, New Hope. Geneva. 2001.


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2. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Chikitsa Sthana, chapter 28, verse no.6, 2 edition; Varanasi; Chaukamba Prakashan; 1992; 616

3. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Sutra Sthana, chapter 21, verse no.35, 2nd edition; Varanasi; Chaukambal Prakashan: 1992: 118

4. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Sutra Sthana, chapter 1, verse no.42, 2nd edition; Varanasi; Chaukamba Prakashan; 1992; 8

5. Yadavji Trikamji (editor). Charaka samhitha. of Charaka, Vimana Sthana, chapter 8, verse no.119, 2nd edition; Varanasi;Chaukamba Prakashan; 1992; 280

6. Yadavji Trikamji (editor). Charaka samhitha. of Charaka, Vimana Sthana, chapter 8, verse no.119, 2nd edition; Varanasi; Chaukamba Prakashan; 1992; 280

7. Yadavji Trikamji (editor). Susrutha samhitha of susrutha, Sutra Sthana, chapter 46, verse no.400, reprint edition; Varanasi; Chaukamba Sanskrit samsthan; 2012; 251

8. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Chiktsa Sthana, chapter 15, verse no.3, 2nd edition; Varanasi; Chaukamba Prakashan; 1992; 512

9. Yadavji Trikamji (editor). Susrutha samhitha of susrutha, Sutra Sthana, chapter 15, verse no.41, reprint edition; Varanasi, Chaukamba Sanskrit samsthan 2012; 75

10. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Sutra Sthana, chapter 28, verse no.9-10, 2nd edition; Varanasi; Chaukamba Prakashan; 1992; 179

11. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Chikitsa Sthana, chapter 9, verse no.5, 2nd edition; Varanasi; Chaukamba Prakashan; 1992; 468

12. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Vimana Sthana, chapter 5, verse no.3, 2 edition; Varanasi; Chaukamba Prakashan; 1992; 249

13. Yadavji Trikamji (editor). Charaka samhitha of Charaka, Sutra Sthana, chapter 17, verse no.75, 2nd edition; Varanasi; Chaukamba Prakashan: 1992: 103

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