E-ISSN:2456-3110

Review Article

Psychological Disorders

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Conceptual understanding of Madya (Alcohol) as a Nidana for Mananovikara (Psychological Disorders) w.s.r. to Alcohol Use Disorders

Shilpa1*, Shrilatha Kamath T2, Shailesh Y3, Punith P4
DOI:10.21760/jaims.10.5.9

1* Shilpa, Second Year Post Graduate Scholar, Department of Kayachikitsa and Manasaroga, Shri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

2 Shrilatha Kamath T, Professor and HOD, Department of Kayachikitsa and Manasaroga, Shri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

3 Shailesh Y, Assistant Professor, Department of Kayachikitsa and Manasaroga, Shri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

4 Punith P, Assistant Professor, Department of Kayachikitsa and Manasaroga, Shri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.

Substance use disorder is a critical issue affecting individuals and society. While commonly seen in adolescence, it spans in all age groups and genders, contributing to psychological disturbances. Among substance, Alcohol is widely used due to its availability, making it a major psychoactive substance globally. Alcohol Use Disorder (AUD) is characterized by a complex array of behavioral and physical manifestations, including symptoms such as depression, interpersonal conflicts, insomnia, withdrawal, increased tolerance and persistent cravings. As of 2024, the WHO estimates that approximately 400 million people globally are living with alcohol use disorder. Alcohol, referred to as Madya, is classified as an intoxicating substance that when consumed excessively, disrupts the equilibrium of both the Shareerika and Manasika Dosha. Acute intoxication resulting from alcohol consumption primarily affects the mind, which is believed to vitiate the Manoguna with the Hridaya serving as the locus for this disturbance. This imbalance is thought to manifest in psychological disorders, particularly those driven by desires and negative emotions such as Kama, Krodha, Mana, Lobha and Shoka. Chronic and inappropriate use of alcohol exacerbates these effects, leading to significant adverse consequences across various domains of life including occupational, social, physical and mental well-being. The psychological ramifications of alcohol use are often as profound as its physiological effects, underlining the need for a comprehensive understanding of alcohol’s role in the etiology of mental health disorders with particular emphasis on AUD. This article seeks to explore the intricate relationship between Madya and the manifestation of psychological disturbances, offering a nuanced perspective on the intersection of substance use and mental health.

Keywords: Madya, Manobhavas, Manovikara Chikitsa, Alcohol use disorders

Corresponding Author How to Cite this Article To Browse
Shilpa, Second Year Post Graduate Scholar, Department of Kayachikitsa and Manasaroga, Shri Dharmasthala Manjunatheshwara College of Ayurveda, Udupi, Karnataka, India.
Email: 		Shilpa, Shrilatha Kamath T, Shailesh Y, Punith P, Conceptual understanding of Madya (Alcohol) as a Nidana for Mananovikara (Psychological Disorders) w.s.r. to Alcohol Use Disorders. J Ayu Int Med Sci. 2025;10(5):48-54.
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https://jaims.in/jaims/article/view/4224/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-08 2025-04-25 2025-05-05 2025-05-15 2025-05-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 11.98

© 2025 by Shilpa, Shrilatha Kamath T, Shailesh Y, Punith P and 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].

J Ayu Int Med Sci 2025;10(5)48
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Shilpa et al. Madya (Alcohol) as a Nidana for Mananovikara

Introduction

Alcohol use disorder (AUD) is characterized by cluster of behavioral & physical symptoms, including depression, social & interpersonal issues (such as violent conflicts), insomnia, withdrawal symptoms, tolerance, & craving. In India, prevalence of AUD was recorded at 2.6% in 2010, with alcohol dependence affecting 2.1% of population. According to National Mental Health Survey of India (2015-2016), prevalence of AUD among adult men rose to 9%. Alcohol-attributable fraction (AAF) of all-cause mortality in India stands at 5.4%, with 62.9% of deaths due to liver cirrhosis linked to alcohol consumption.[1] AUD is contemporary clinical condition marked by compulsive alcohol consumption leading to loss of control associated with withdrawal symptoms such as anxiety, tremors, transient visual and auditory hallucinations.

Manovikara is a mental disorder. In Ayurveda, it refers to various conditions affecting the Mana (mind) due to imbalances in the Mano Guna (Satva, Raja and Tama) and Shareerika dosha (Vata ,Pitta and Kapha).[1] Ayurveda classifies Madya as Visha (toxin) and Oushadha (medicine) based on its Guna (properties) and Matra (dosage).[2] However, excessive and improper consumption disrupts the balance of both Shareerika and Manasika dosha (Raja and Tama), leading to adverse effects on Ojas (the vital essence responsible for immunity and mental resilience).[3] The properties of Madya including Laghu (lightness), Ushna (heat), Tikshna (sharpness), Sukshma (subtlety), Amla (sourness), Vyavayi (pervading nature), Ashu (quick action), Ruksha (dryness), Vikasi (expansiveness) and Vishada (non-sliminess) are fundamentally opposite to the qualities of Ojas.[4] This antagonism depletes Ojas and leads to Durmana (weakening of mental resilience) and increasing vulnerability to various Manovikara like Unmada (psychosis), Apasmara (epilepsy), Chittodvega (anxiety) and Vishada (depression).[5] This article explores how Madya acts as a Nidana for Manovikara (psychological disorders) and its implications in contemporary mental health.

Objectives of the study

1. To understand the Ayurveda concept of Madya (Alcohol) as a Nidana for Manovikara (Psychological disorders w.s.r. Alcohol use disorders).

2. To examine the effect of Madya on the Manas, leading to Manovikara (Psychological disorders w.s.r. Alcohol use disorders).

Madya and Oja

Madya is defined as a Dravya (substance) that vitiates the Buddhi (intellect) and causes Mada (intoxication). It is predominantly associated with Tamoguna (the quality of darkness, inertia or ignorance).[6] Ojas is the vital essence of all Dhatu (tissues) and is responsible for biological strength, vitality and immunity in the body. It represents the essence of health and well-being. Ojas exhibits ten properties, which are Guru (Heavy), Sheeta (cold), Mridu (soft), Shlakshna (smoothness), Bahala (density), Madhura (sweet), Sthira (stable), Prsanna (fresh), Picchila (slimy) and Snigdha (unctuousness).[7] These properties are opposite to those of Madya, which disrupts the balance of Oja.

Since Madya is Tamoguna Pradhana and exhibits opposite qualities of Ojas, excessive consumption of Madya can lead to Ojakshaya (depletion of immunity and mental resilience). This depletion impacts on Manas which leads to the manifestation of Manovikara.

Due to Nidana (Atimadyapana) in an Alpasatva (weak mental strength) person, vitiation of Shareerika and Manasika Dosha takes place. Thus, vitiated Dosha takes shelter in the Hridaya (Sthana of Oja, Buddhi, Indriya, Atma and Manas) in turn causes disturbances in the function and will destroy the Oja, leading to the manifestation of Manovikara[8] such as Unmada (psychosis), Apasmara (Epilepsy, Vishada (depression) and Chittodvega (anxiety) etc.

Role of Madya on Manobhava (Emotional status):

A. Raja, Tama Doshajanya Manobhava[9]

1. Kama (lust) - desire to obtain the object.
2. Krodha- anger
3. Lobha (greed) - A Strong desire to attain things that do not belong to oneself.
4. Moha (Delusion) - A false belief.
5. Irsha (Jealousy) - Sense of intolerance with the wealth or success of someone.
6. Mana (Pride) - Sense of superiority complex.
7. Mada (Neurosis) - Madness or intoxification
8. Shoka (Grief) - Due to loss of desired ones
9. Chinta- Worry


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10. Udvega- Anxiety

B. Raja, Tama and Vata, Pitta and Kapha Doshajanya Manobhava[10]

1. Unmada - Psychosis
2. Apasmara - Epilepsy
3. Apatantraka - Hysteria
4. Atatwabhinivesha - Obsession
5. Bhrama - Vertigo
6. Tandra - Drowsiness
7. Klama - Neuresthenia
8. Mada - Psychoneurosis
9. Murccha - Fainting
10. Sanyasa - Coma
11. Madatyaya - Alcoholism
12. Gadodvega - Hypochondriasis

Madya and Manovikara

Madya leading to Vishada: When an Alpa Satva person indulges Atimadyapana, it disrupts the balance of Tridosha, particularly aggravating Vata and Pitta. Excessive alcohol consumption weakens the Satva (clarity and harmony) while increasing Tamas (inertia) and Rajas (agitation), leading to mental instability. This imbalance depletes Ojas (vital energy), resulting in Vishada (depression). and produces Lakshana like, Atichintana (excessive thinking), Bhaya (fear), Dukha (sorrow), Smritinasha (loss of memory), Alpavak (less talkative), Asthirata of Mana (instability of mind). Over time, dependency on Madya creates a vicious cycle of emotional distress, further deepening feelings like Shoka (Sadness) and Manodainyata (hopelessness).[11]

Madya leading to Unmada: Excessive consumption of Madya aggravates Vata and Pitta Dosha, impairing the Manovaha Srotas (mental channels) and disturbing the Oja (Sthana of Satva, Buddhi, and Indriya). Especially Laghu, Ruksha Ushna Tikshna Sukshma and Vyavayi, Guna of the Madya leads to vitiation of Shareerika and Manasika Dosha causing a disturbance in Satva. This leads to Chittavibhrama (perplexed mind), Buddhivibhrama and Smritivibhrama. It Produces Lakshanas like, Tushnibhava (Mutism), Rahaskamata (prefer isolation), Shouchadvesha (Aversion to cleanliness), Bibhatsata (Frightening appearance), Smritibhrama (devoid of memory), Amarsha (Irritable), Krodha (Anger), Vinagnabhava (nakedness) and Roopanaam Aprshastanam hallucinations and delusions etc.[12]

Madya leading to Apasmara: Nidana Sevana (Atimadyapana) leads to aggravation of Shareera and Manodosha and reaches the Hridaya (Sthana of Satva and Buddhi), disrupts the Satva, further leading to Manovahasrotodushti, influenced by Raja and Tama results in Smritinasha and produces symptoms like Tamapravesha (darkness infront of eyes), Bibatsa Chesta (erratic movements) appear, along with impairment of Buddhi (intellect) and Satva (mind).[13]

Stages of Madya

StagesLakshanas[14]Behavioral CorelatesOjas Awastha[15]Blood alcohol concentration
FirstHarsha (Happiness), Trupti (Relaxed)State of excitementOja not affected50-150mg%
SecondPralapa (Impaired speech), Moha (Confusion), Yuktayuktakriya (Inappropriate activities)State of in-coordinationOja get disturbed150-250mg%
ThirdVisanjna (Unconsciousness)State of comaSevere disturbance in the Oja>250mg%

Same can be understood in contemporary science as Alcohol use disorder:

Alcohol is a potent substance that induces both acute and chronic changes in nearly all neurochemical systems of the brain. It stimulates dopamine release in the brain's ventral tegmental area (VTA), which is part of the mesolimbic dopamine system associated with motivation and reward. This dopamine release influences the nucleus accumbens (NAc) and the prefrontal cortex, reinforcing drinking behaviours. Although alcohol does not directly bind to dopamine receptors, it interacts with key neurotransmitters such as glutamate, gamma-aminobutyric acid (GABA), and serotonin (5-HT). Additionally, alcohol affects the endogenous opioid system, including endorphins and enkephalins.

Alcohol disrupts the balance between excitatory and inhibitory neurotransmitters. Specifically, it inhibits N-methyl-D-aspartate (NMDA) glutamate receptors while enhancing GABA receptor activity, creating an inhibitory effect. Chronic alcohol use results in neuroadaptive responses, increasing neuronal excitability due to NMDA receptor upregulation and alterations in glutamate signalling.


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These changes contribute to drinking-related behaviours and withdrawal symptoms. Prolonged alcohol exposure further disrupts glutamate and GABA signalling, leading to neuronal hyperexcitability during cessation. This hyperexcitability manifests as withdrawal symptoms driven by increased NMDA receptor activity and altered glutamate signalling pathways. These adaptations enhance vulnerability to alcohol-related cues, fostering addiction by reinforcing compulsive drinking behaviours. Additionally, the GABA system undergoes alterations, contributing to anxiety, insomnia, nausea and vomiting, hallucinations, restlessness and agitation, and occasionally seizures.and discomfort associated with withdrawal. Over time, cycles of neuroadaptation and withdrawal perpetuate repetitive behaviours, characterizing alcohol dependence. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, poor judgment, slurred speech, problems with attention or memory, poor coordination and "blackouts" where individuals don't remember events. Elevated blood alcohol levels can lead to permanent brain damage, coma or even death.[16]

Management

Ayurveda recommends three types of Chikitsa viz., Daivavyapasraya Chikitsa (divine or spiritual therapy), Yuktivyapashraya Chikitsa (logical therapy) and Satvavajaya Chikitsa (psychotherapy) for treating mental illnesses.[17] Daivavyapasraya Chikitsa includes Mantra (holy recitation), Ausadha (amulets), Mani (gem therapy), Mangala (auspicious rites), Bali (religious sacrifice), Upahara (gifting), Homa (fire rituals), Niyama (self-restrictions), Prayaschita (atonement), Upavasa (fasting), Swastyayana (chanting of auspicious hymns), Pranipata (observance to the God) and Gamana (pilgrimage). These are considered as divine therapy. In this condition, surrendering oneself to God may help an individual’s spirituality and understand the inner sense of God.[18]

Yuktivyapasraya Chikitsa: Medhya Rasayana in Ayurveda is a herbal formulation specially designed to enhance mental faculties and cognitive functions like intellect, concentration, memory, attention and thinking. It primarily focuses on nourishing the mind and improving mental abilities hence it is considered as a cognitive enhancer.

Bruhatrayee and Laghutrayee have mentioned various Medhya Rasayana such as Shankhapushpi (Convolvulus prostrates), Brahmi (Bacopa monnieri), Yashtiamadhu (Glycyrrhiza glabra), Guduchi (Tinospora cardifolia), Mandukaparni (Centella asiatica) for treating Manovikara and promoting overall mental well-being. These drugs also help in correcting the deranged Dhi, Dhriti and Smriti.[19] In accordance with severity of the condition and presentation of the symptoms, Doshavastha and Adhisthana of Vyadhi can be predicted and appropriate Shodhana line of management can be adapted.[20]

Sattvavajaya Chikitsa: Satvavajaya plays a major role in the management of Manovikara by enhancing five factors which are Jnana, Vijnana, Dhairya, Smriti, and Samadhi to achieve Manonigraha (self-control). Jnana is the knowledge about self and the surroundings; right knowledge of self is impaired in this condition. Vijnana is considered as the scientific knowledge, to enhance this factor family therapy or interpersonal therapy can be adapted. Dhairya is to keep the mind stabilized and to have the courage to face the societal criticism. Smriti on the other hand is considered as the recollection of the past experiences and here group therapy can be adapted to make an individual feel included. Samadhi is a state of deep mental stillness and equanimity which helps in withdrawing oneself from all the external materialistic things. Counselling therapies such as Santvana (consolation) and Ashvasana (assurance) can be adapted to provide an emotional support in self-awareness and personal development.[21]

Discussion

The intricate relationship between Madya and Manovikara in Ayurveda presents a holistic understanding of alcohol-induced psychological disturbances, bridging traditional concepts with contemporary science. Madya, characterized by properties like Laghu, Ushna, Tikshna, and Vyavayi, predominantly embodies Tamoguna. Its opposite nature to Ojas - the vital essence responsible for strength, immunity, and mental stability - explains its depleting impact on physical and mental health when consumed excessively. The concept of Ojakshaya aligns with the understanding of weakened immunity and cognitive dysfunction seen in chronic alcohol users.


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Atimadyapana leads to the vitiation of both Sharirika and Manasika Doshas, particularly Vata and Pitta, resulting in mental instability and disorders. When the Hridaya, the seat of Ojas, Buddhi, Indriya (senses), Atma and Manas, is affected, it results in the manifestation of various Manovikaras such as Unmada, Apasmara, Chittodvega and Vishada. These conditions are deeply rooted in the imbalance of Rajas and Tamas, leading to emotional disturbances like Krodha, Moha, Irsha and Shoka.

However, excessive or habitual intake of Madya leads to a range of detrimental effects on mental health. One of the significant psychological impacts of alcohol consumption is Vishada (depression or melancholy). According to Ayurveda principles, Madya, when consumed beyond a healthy limit, aggravates Pitta and Rajas, leading to an imbalance in Sattva - the essential component of a calm and balanced mind. This disturbance manifests as Atichintana (excessive thinking), Bhaya (fear), Dukha (sadness), Asthira of Mana (instability of mind) and Smritinasha which over time can progress to Vishada.

In Ayurveda, 'Apasmara' refers to Tridoshaja Vyadhi characterized by episodic loss of consciousness, memory impairment, and involuntary movements, closely resembling epilepsy.

The pathophysiology of Apasmara involves both Sharirika and Manasika Dosha. The pathogenesis begins with the accumulation of etiological factors such as Atimadyapana, leading to the vitiation of Dosha. These vitiated Doshas, particularly Vata, impair the normal functions of the Mana and Buddhi, resulting in the obstruction of Manovaha Srotas.

This obstruction disrupts the coordination between the Manas and Shareera, manifesting as the clinical features of Apasmara, including convulsions, frothy discharges from the mouth, and temporary loss of memory.

In contemporary science Alcohol is a central nervous system (CNS) depressant that acts on gamma-amino butyric acid (GABA) receptors, a major inhibitory neurotransmitter. It also affects the production of serotonin and dopamine in the nervous system. Excessive alcohol intake can lead to behavioral, cognitive, and psycho-motor changes at blood alcohol levels as low as 0.02–0.03 g/dl.

It can produce diseases such as bipolar mood disorder, major depressive disorder, generalized anxiety disorder, schizophrenia, insomnia and suicidal thoughts, tremors transient visual and auditory hallucinations. Long-term alcohol use depletes and reduces the number of neurotransmitters in the brain.

Daiva Vyapashraya Chikitsa, one of the threefold treatment modalities in Ayurveda, plays a crucial role in managing Manovikara. Rooted in faith-based and spiritual practices, it includes Mantra (chants), Aushadha (sacred herbs), Mangala (auspicious rituals), Bali (offerings), Homa (fire sacrifices), Upavasa (fasting) and Prayaschitta (atonement). These interventions help cleanse the mind, reduce negative Karma influences and restore mental equilibrium. In alcohol use disorders, Daiva Vyapashraya Chikitsa supports de-addiction by strengthening willpower, reducing psychological cravings and alleviating withdrawal distress through divine consciousness and positive reinforcement.

In Ayurveda, Satvavajaya Chikitsa, is a pivotal approach in managing Madya-induced Manovikara, which referring to mental disorders arising from excessive alcohol consumption. This therapeutic method focuses on strengthening the Satva to restrain it from unwholesome desires, particularly the craving for alcohol. Classical texts emphasizes that the essence of Satvavajaya Chikitsa lies in redirecting the mind away from harmful objects such as Madya through the Jnana (cultivation of knowledge), Vijnana (analytical thinking), Dhairya (courage), Smriti (memory) and Samadhi (concentration). The approach integrates counselling, meditation, and behavioural therapy, enhances self-control and mental resilience

By enhancing these mental faculties, individuals can develop resilience against the temptations of alcohol, thereby restoring psychological balance. This non-pharmacological approach aligns closely with modern psycho-therapeutic techniques, offering a holistic pathway to mental well-being.

Yukti Vyapashraya Chikitsa, a rational therapeutic approach in Ayurveda, plays a crucial role in managing Madya-Induced Manovikara. It involves a well-planned combination of Aushadha (medicinal therapy), Ahara (dietary modifications) and Vihara (lifestyle interventions) tailored to restore the balance of Dosha and Manas (mind).


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In conditions arising from chronic alcohol consumption, such as anxiety, depression, hallucinations and cognitive impairments, herbal formulations like Shankhpushpi, Brahmi, Ashwagandha and Guduchi are prescribed to strengthen the nervous system and promote mental stability. Detoxification therapies, including Panchakarma procedures like Vamana, Virechana, Basti and Nasya, help in eliminating accumulated toxins and restoring physiological equilibrium. Yukti Vyapashraya Chikitsa provides a comprehensive, holistic and sustainable approach to managing alcohol-induced psychological disorders while promoting long-term well-being.

Conclusion

Madya plays a significant role in the development of Manovikara by affecting the Satva, Manobhava and Buddhi. Atimadyapana disrupts the equilibrium of Dosha, impairs Buddhi and weakens Manas. Both ancient Ayurvedic texts and modern psychological studies highlight the detrimental effects of Madya on mental health, underscoring the importance of self-restraint and mindful living. Consequently, avoiding the use of Madya is essential for maintaining mental clarity, emotional well-being and a balanced life. Integrating Ayurveda treatments with Satvavajaya Chikitsa and lifestyle interventions can offer comprehensive care for individuals with alcohol use disorders, supporting long-term recovery and overall mental well-being.

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