Clinical approach to Sutika Unmaada w.s.r. to Puerperal Psychosis and its significance in Modern Era

Abstract

Pregnancy is the most exciting and joyous time in a woman’s life. Because she is the only creature having the amazing power of creation. Pregnancy and puerperium are at times sufficiently stressful to provoke mental illness. Today a high number of women continue to die during and after childbirth. Puerperal or Postpartum psychosis is very rare, but several mental health conditions are experienced by one or two in 1000 women in the first 1-4 weeks after having a baby. It is very serious as a mother may be at risk of self-harm and there is a risk of potential harm to the baby or other children. All puerperal psychological disorders grouped into three are- Postpartum Blues, Postpartum depression, Postpartum psychosis. Psychiatric illness with serious distortion of thought, behavior, perception, and gross impairment in reality testing are grouped as Psychosis. In Ayurvedic texts, Unmaada is described as a similar clinical condition. The seat of Manas is the heart. Psychiatrists prescribe Mood stabilizers, Antipsychotics, and Electroconvulsive therapy (ECT). These should be used with caution in breastfeeding (especially Sodium Valproate, Clozapine, and Lithium). A healthy diet and physical activity along with antipsychotics minimize the risk of weight gain. In Western Countries alternative medicines including Herbal, Homeopathy is most common nowadays. Some women may choose these to support well-being as they are seen as safer alternatives to medications. The holistic approach to mental health which integrates mind, body, and soul is offered by Ayurveda. This elucidates due importance of care of the mother at every phase of her life especially antenatal and postnatal care. In Ayurveda Unmaada is treated as somatic alteration, the main principle being to break the Aavarana or Manovaha Srotas. Thus Shodhana, Shamana, Satvavajaya Chikitsa are used for the management of Sutika Unmaada.