Introduction

Mental health is an essential element of general well-being that includes the emotional, psychological and social dimensions of a person's capacity to live. It influences how a person thinks, sees and acts in the world, and the kinds of relationships he or she develops with others. It enables individuals to cope with stress, relate to others, and make decisions wisely (World Health Organization, 2022). One of the most common mental health problems in society is anxiety, which can be broadly defined as a state of apprehension, tension, or uneasiness arising not just from actual danger but also from imagined danger. Anxiety disorders, including generalized anxiety disorder (GAD) and social phobia, panic disorder and specific phobias, are characterized by the appearance of excessive fear and behavioral disturbances which persist over time and significantly impair daily functioning (American Psychiatric Association, 2013). Because of their high prevalence, early onset, intractability, and heavy personal and societal costs, these disorders present a major public health problem worldwide. The global burden of anxiety disorders is large and growing. By 2019, 301 million people worldwide had an anxiety disorder, making it the most common form of mental disorder in the world (World Health Organization, 2022). This burden is not evenly distributed: anxiety disorders particularly affect women, young people and individuals living in stressful high-threat environments. Recent global estimates suggest an increase of 25.6% in the prevalence of anxiety after the COVID-19 pandemic occurred, reflecting higher levels of psychological distress prompted by uncertainty, social isolation, and economic instability (Naidu et al., 2024). Anxiety disorders in people aged 10 to 24 years rose by 52% between 1990 and 2021, with the most marked rise seen in those aged 20 to 24 (Global Burden of Disease Collaborative Network, 2022). In India, national mental health surveys show that up to 7.5% of the population have symptoms related to anxiety disorder and that many of them go untreated or undiagnosed (Gunathilaka et al., 2019). These figures highlight pressing need for effective, acce-ssible & sustainable forms of mental health care.

Ancient India has developed Ayurvedic medicine, a holistic and effective treatment when applied to mental imbalances Vitto nature close at hand.

In addition, Panchakarma therapy using Nasya (nasal administration), Shirodhara (pouring medicated oil on the forehead), and Abhyanga (therapeutic massage) have been used to soothe the nervous system and increase mental clarity. Its efficacy therefore lies rather in aiding digestion than blunting the pain of life, and as a method it has many beneficial side effects (Pillai et al., 2018). Furthermore, the psychological aspect of Ayurvedic management is explicitly treated through Satvavajaya Chikitsa, which focuses on mental conditioning, cognitive restructuring and self-awareness techniques.

This form of therapy resembles modern psychotherapeutic intervention measures and includes practices as mantra chanting, meditation, behavioural counselling and spiritual education. Yoga and Pranayama (breath control) are also incorporated into Ayurvedic treatment. Both enable an individual to strengthen his or her ability to face adversity with equanimity, improve emotional self-regulation and bring the body's physiology more into balance (Khatri et al., 2024).

When viewed from this standpoint, Ayurvedic treatments for anxiety are even more viable. In many low-income as well as middle-income countries, there exists weak mental health infrastructure and a dearth of professional staff. However, familiarity with needles (Lah and Lai, 2016), accessibility, affordability and cultural acceptability make Ayurveda an alternative or supplement to traditional care services--in particular for people living in the countryside and those with special needs also known as Rural Services Users is indeed of great human interest (Gunathilaka et al., 2019). It is in line with these considerations that, both globally and regionally, integrative medicine (using traditional medical systems as well as modern science to create an effective treatment strategy) is the trend.

The combination in China of Western medicine with its own powerful, integrated medical tradition offers real hopes for culturally sensitive, sustainable health care of poor peoples around the world. With energy for the integration and drive that comes from this new vision of life's purpose, researchers from different fields are coming together to examine ways in which integrated medicine can help raise levels of health where low but by no means uninformed people would seek such help.

Chittoudvega is caused by vitiation of Rajas and Tamas, coupled with disturbance to the Vata Dosha with special reference to Prana Vayu which governs our brain, sense faculties and soul (Naidu et al., 2024). Symptoms like agitation, fear, worry, sleeplessness, irrational thinking are seen as the result of this disturbed state of affairs. When the Vata Dosha is particularly disturbed it encourages these signs in an anxiety attack: intense and restless thought patterns.

Another related psychiatric syndrome in ancient Hindu literature is Unmada, which differs from Visha in that it is often referred to as a "psychosis. " By the extent of its severity mental illness was caused, nothing could match Unmada. Unmada is further divided into five types, according to whose Doshas are in dominance: Vataja, Pittaja, Kaphaja, Sannipataja (tridoshic) and Agantuja (external or exogenous factors such as trauma unwantedly coming into human life). Unlike Chittodvega, which is characterized by a less disturbance often seen in anxieties, Unmada is marked by severe delusions, hallucinations, disturbed speech and behaviour, and enormous cognitive instability (Samhita 7/10). This scale of mental dysfunction described in Ayurveda bears a stratification system that is indistinguishable from today's, at least coming forth from within the traditional context. Ayurvedic psychopathology is also greatly influenced by ancient Indian doctrine in its emphasis on Karma and Pragyaparadha (intellectual error). Pragyaparadha is described as one of the root causes of all diseases - bodily or mental. It is a transgression against wisdom, where an individual knows he is behaving in an unhealthy manner and as a result conducts himself, thinks or speaks in ways which cause unexpected harms to himself, others (Vaghbata 2010). This leads to the accumulation of disturbing forces, the disturbance of the Doshas and in the end, disease. So, in an anxiety context, Pragyaparadha would be present for unhealthy lifestyle choices, excessive thinking, ignoring emotional cues from inside and becoming disconnected with one's centre of spirituality. While attempting to culminate a stronger sense of identity, these potently disturb a person's mind and nervous system over time. Karma - both from prior lives and current existence - is also considered of great significance to the onset of mental diseases. Certain psychological disturbances are felt as karmic imprints, which give people specific mental propensities or life challenges (Karmic patterning).

Ayurvedic Interventions in the management of Anxiety

Anxiety, known to Ayurveda as Chittodvega, requires an individualized and comprehensive approach. In this way it is aimed at rebalancing the imbalances not just in the mind but also between body and soul. Ayurveda maintains that addressing anxiety should not only be to suppress the symptoms but to eradicate the fundamental Vikritis of Manas Doshas (Rajas and Tamas), bodily Doshas. The Sattva Guna, or pure and soothing quality of the mind as well as the intellect should be reinstated (Charaka Samhita, 2010). The Ayurvedic intervention in dealing with anxiety is a combination of herbal medicines and Panchakarma therapies, changes in lifestyle and diet, mind-body therapies such as Yoga and Buddhist meditation as well as psychological therapies under Satvavajaya Chikitsa.

The Ayurvedic pharmacological approach to coping with anxiety largely revolves around the use of Medhya Rasayanas – herbal drugs known to enhance mental clarity, cognitive function and mood stability. Indeed? Ashwagandha, Bacopa monnieri (Brahmi), Convolvulus pluricaulis (Shankhpushpi), Nardostachys jatamansi (Jatamansi) and Acorus calamus (Vacha) are the herbs most widely used in the treatment of anxiety within Ayurveda (Balkrishna & Misra, 2017). Azadirachta indica, an herb which is famous for its anxiolytic effect, thought to help protect neurons and act as an adaptogen (Brahmi) Ghee or it oi racks are made into Nasya therapy the place directly on the brain centres (Pillai et al., 2019). Another heavily studied herb, Withania somnifera (Ashwagandha), acts as an adaptogen - it helps to normalize levels of cortisol in the blood, reduce systemic inflammation and also bolster resistance against psychological stress (Khatri et al., 2062). Many clinical trials have now demonstrated Ashwagandha's ability to reduce anxiety scores in patients with generalized anxiety disorders, indicating some kind of mechanism which modulates the hypothalamic-adrenal gland "branch" of our stress response system (HPA).

Panchakarma therapies are also essential for controlling anxiety: According to Ayurveda, they are part of the package. How will serve the purpose here. Set a high standard for both itself and its readers Besides pharmacotherapy, Panchakarma therapies are indispensable in the Ayurvedic treatment of anxiety.

The Asanas characteristic of Yoga such as Shavasana (corpse pose), Balasana (the child's pose), and Sukhasana (easy seated pose) can relax muscular tension and calm the nervous system. Pranayama’s science of breath control techniques, the ages-old sister tradition to Yoga’s postures, also affords concrete practical benefits for dealing directly with such stress-related conditions as anxiety attacks and a sluggish metabolism in one’s life force (Srikrishna & Chandran, 2016).

For example, abating all irritants before going to bed will offset insomnia as surely as taking some heavy clod off your chest while crossing a river with bridge slings stretched between two boats hundred yards apart eliminates feeling short of breath as it half-suffocates you down on such wet or desolate soil! And every mental aspiration that does not take the shortest road to meeting our suffering patient’s needs hastens a monk’s departure from Shangri-La.

When Khatri et al. (2024) combined Ayurvedic oral therapy with Yoga practices in treating adolescents who suffered from general anxiety disorder, significant improvements were found in anxiety and anger scores. The study concluded that the results of integrated ayurvedic-management practices were positive and warranted further investigation by researchers elsewhere (al.Hussain, 2024).

May be in the present study, two teaching hospitals Neurobiological effects of Vipassana, Mindfulness-Based Stress Reduction Therapy mindfulness-based stress reduction therapy Mindfulness-based stress reduction Mindfulness-Based Stress Reduction MBSR applied acupuncture or other, and visualization tapes acted as control treatments. In both research sites patients were followed for three months after treatment ended.

Changes to diet also play an important role in managing anxiety; according to Gunathilaka et al. (2019), individuals with Vata-type anxiety symptoms should follow a Vata - pacifying diet. this involves warm, moistening foods that are somewhat wet and luscious such as cooked grains, vegetable-like roots (carrots) except radishes since they dry up quickly after being stored at room temperature overnight but can be very cooling if eaten raw in salads or simply on their own eaten for supper apart from one other thing Fruit would be taken with this meal), milder spices only (e.g. fennel instead of very hot pepper) and Dairy Sour Cream or lassi.

Table 1: Ayurvedic herbs traditionally used for managing anxiety symptoms (Balkrishna & Misra, 2017; Pillai et al., 2018).

Review of Clinical Evidence on Efficacy & Safety

In recent years, through systematic reviews, clinical trials, & observational studies, researchers have begun to evaluate scientifically how well various Ayurvedic interventions work for treating tensions. Except for traditional pioneer comes along an emerging body of evidence that evaluates how well they work & whether they are safe to use. A systematic review protocol developed by Thejaswini et al. (2019) outlined comprehensive plan to evaluate randomized controlled trials (RCTs) & non-randomized studies of Ayurvedic interventions in treatment of anxiety disorders.

This work empha-sized need for standardized outcome measures, such as changes in anxiety rating scales & reporting of adverse events, to verify Ayurveda’s therapeutic claims. Several individual studies & case reports have shown that Ayurvedic interventions can be positive in treating anxiety. Khatri et al. (2024) reported significant decreases in anxiety & anger scores among adolescents treated with Ayurvedic formulations such as Kushmanda Ghrita & Brahmi Vati, combined with Panchakarma therapies such as Nasya or Shirodhara. Similarly, Pillai et al. (2018) found that classical Ayurvedic management of herbal medicines & lifestyle counselling reduced anxiety symptoms without side effects normally associated with pharmacological treatments. From perspective of herbal medicine, Ayurvedic interven-tions have several advantages over allopathic approaches. Conventional benzodiazepines & selec-tive serotonin reuptake inhibitors (SSRIs), while being effective chemically, involve risks of depend-ency, cognitive impairment variably, sedation overtly & gastrointestinal disturb. clearly (Thakre et al., 2021). In contrast, Ayurvedic herbs such as Ashwagandha & Brahmi have been proven to modulate neuroendocrine pathways,

Public Health Relevance and Future Directions

Globally, anxiety disorders represent a significant and increasing public health burden which can hit people of any age or economic level. The World Health Organization said in 2022 that anxiety is one of the world’s leading causes disability, and that such a situation brings enormous economic and social costs with it

Traditional drug therapy models face challenges such as accessibility, side effects and patient noncompliance, especially in low-and middle-income countries (Gunathilaka et al. 2019) In this context, Ayurveda given its holistic approach which is affordable quite in line with the local culture appears to offer an exceptional solution for public health in the management of anxiety.

Ayurvedic interventions are inherently patient-centred, preventive, and promotive. They emphasize not only the cure of diseases but also increasing resilience and mental well-being by changes to daily habits, herbal therapies, mind and body exercises, as well diet and fasting rules (Naidu et al. 2024) In rural and resource-poor environments where mental health infrastructure is sparse, including Ayurveda as part of primary health care can provide an alternative or concern for biomedical treatments that is accessible.

Furthermore, the community-oriented nature of Ayurvedic practices, which involve everything from group Yoga movements to dietary counselling and local herbal remedies, harmonizes well with such public health strategies for health promotion and disease prevention as are currently being pursued. There is also growing global recognition of traditional medicine systems. The Traditional Medicine Strategy of WHO for the period 2014-2023 seeks to integrate traditional and complementary medicine into national health systems in order to achieve universal health coverages (World Health Organization 2013). In India, with AYUSH gaining mainstream foothold in the national health policies, this brings some hope for mental health care delivery; especially through health camps and wellness centres (such as those undertaking traditional medicine programmes) (Thakre et al. 2021). National health policies in India have started mainstreaming AYUSH system of (Ayurveda, Yoga, Unani, Siddha and Homeopathy) to enhance mental health care service in particular through wellness centres & health camps (Thakre et al., 2021).

Panchakarma therapies, Satvavajaya Chikitsa, and Yoga (Charaka Samhita, 2004; Khatri et al., 2024). Ayurveda's treatment of anxiety disorders, moreover, embraces both root causes and symptoms. Studies, more standardized practices by Phyllis godson Studies suggest that Ayurvedic herbs, such as Brahmi and Ashwagandha, have potent anxiolytic effects with fewer side effects than conventional pharmacotherapy (Balkrishna & Misra, 2017; Pillai et al., 2018). The advantages of Ayurveda treatments are that they focus on health care before disease strikes and promote mental fortitude. They are also cultural adaptable (or to civilian ways of life), have no further toxins added to them in the process, and are generally non-invasive-Gunathilaka et al. But limitations remain, the variance in medicine recipes, absence of norms of treatment of general Ministry of Health and Family Welfare in India (Thejaswini et al., 2019). Large-scale multicentric trials are needed, as are efforts to standardize Ayurvedic treatments for mental health. This should go hand in hand with research into integrative models that link Ayurveda and contemporary psychiatry. Future research should focus more on validating efficacy through rigorous trials and developing policies to ensure that the use of these therapies by communities is both safe and effective.

It is an abstract model, a medically-oriented science which points towards life as an entirely functioning whole. It is creative and conceptually embraces whatever spiritual dimensions are necessary for health. Ayurveda, unlike Western medicine, offers a long term and individual ameliorative strategy for managing a patient's anxiety disorder. Its approach involves not only the body's physical health but also mental well-being as well as spirituality-based therapy; it addresses all three dimensions equally. Ayurveda recognises the interaction between Manas Doshas [Rajas and Tamas], enhances Sattva and addresses the root causes of illness beyond just symptomatic relief- systemically utilizing herbal medicines, Panchakarma therapies that clean all bodily tissues at once, and mind-body practices such as Yoga and meditation (Charaka Samhita, 2004; Khatri et al., 2024). Examples are the anxiolytic effects of Brahmi and Ashwagandha, which also have a favorable safety profile. This represents a more effective and safer alternative than conventional pharmacological treatments. (Balkrishna & Misra, 2017).