HOLISTIC APPROACH

TO
MANASA ROGA

BY Prav
 Introduction
• Increase incidence of mental diseases.
•Ayurveda – Boon to patients of mental disorders.
•By the self must be upheld
The self should not be let down
The self indeed is its dear relative
The self indeed is the enemy of self
(Bhagavat Gita)

BODY MIND
 AYURVEDA

SUKHAYU DUKHAYU HITHAYU AHITHAYU

(PERSONAL LIFE) (SOCIAL LIFE)

HEALTH

PHYSICAL MENTAL SOCIAL

(WHO,1948)
MENTAL ILLNESS
It encompasses a broad range of conditions characterised
by patterns of abnormal behavioral and psychological
signs and symptoms that result in dysfunction.
(DSM-IV,1994)

Interrelationship between body and mind

• Depends on initial vitiation
• Classification of Manasa Roga
• For proper diagnosis and management
Classification of Manasa Roga

A) Diseases with primary mental origin and

predominantly mental symptoms.It is called
as Kevala Manasika Rogas.

For example- emotional disorders like

Lobha (Greed), Moha (infatuation), Kāma (lust),
Krodha (anger), Irshyā (competitive tendency),
Dvesha(envy), Mātsarya(Jealousy), Rāga( Love, passion),
Bhaya(Fear), Śoka(sorrow), Harshya(ecstasy),
Vishāda (dejection, Sadness), Asuyā (Jealousy),
Dainya(Miserable state) etc. comes under this group.
B) Disease with primary mental origin and
predominantly physical Symptoms.

1) Unmāda
2) Apasmāra
3) Apatantraka
4) Bhayaja and Śokaja Atisāra
5) Kāmaja and Śokaja jwara
6) Nidranāśa
7) Shandha
In this type due to initiation of Mānasa
dosha, Sharira dosha get involved but the symptoms are seen
at Sharira level so these may be called as Mano- Sharirika i.e.
psychosomatic disorders.
C) Diseases with primary physical origin and
predominantly mental symptoms.

The etiology and pathogenesis of such diseases are

found of somatic nature but symptoms of these diseases
are of psychological nature. The following diseases can
be included in this category.
1) Atatvābhinivesha
2) Mada
In this pathogenesis Sharirika
doshas are initially involved which leads to vitiation of
Manas doshas, so these diseases can be called as
Sharira- Manasika i.e. somato- psychic.
d) Diseases with primarily physical origin and
predominantly physical symptoms

All somatic diseases can be included in this group

but there are some diseases in which they have primarily
physical origin and predominantly physical symptoms,
showing very similarity to mental diseases.

Mūrcchā,Sanyāsa are the diseases included in this category.

E) Diseases with primarily idiopathic origin and
predominantly mental and physical symptoms

The etiology and pathogenesis of some diseases cannot be

found in systemic manner or we are unable to give the
scientifically rational logic behind the etiopathogenesis.

All type of diseases which are described with the concerns of

Āgantuja Unmāda, Grahabādhā & Upagraha, Pisāca, Bhūta
etc. can be include in this category.
 Definition of mental diseases

• Manas as Adhistana of Roga

• Vitiation of Manasika Dosha

• Disturbance in Buddhi, Sanjna Jnana, Smrti etc.

COMMOM CAUSES OF MENTAL ILLNESS

ISTASYA ALABHAT

LABHAT ANISTASYA
(CA.SU.11)
• ALPA SATVA

• TRIVIDA KARANA
ASATMYENDRIYARTHA SAMYOGA
PRAJNAPARADHA
PARINAMA

SOCIAL FACTORS:
1. SEX

CHILDHOOD
ADOLESCENCE

2. LIFE EVENTS ADULTHOOD

3. EXPRESSED EMOTIONS

4. UNEMPLOYMENT
5. WORKING ATMOSPHERE

6. AREA OF RESIDENCE

7. HOMELESSNESS
7. SOCIO-ECONOMIC CLASS

8. SOCIAL ATTITUDE

9. SOCIAL SUPPORT

SUPPORT
SOCIAL CONSEQUENCES OF MENTAL DISEASES

DISABILITY

STIGMA

EFFECTS ON FAMILY
CULTURAL ASPECTS
1.CONCEPT OF AETIOLOGY
AND CURE

2.ENVIRONMENTAL
SANITATION

3.MOTHER AND CHILD CARE

4.PERSONAL HYGIENE AND

CONDUCTS

5.SEX AND MARRIAGE

 Common signs and symptoms
Unmadam punar Mano buddhi SajnaJnana Smrthi
Bhakthi Shila Chesta Achara vibhramam vidyat. (Ch.Ni 7/5)

Unmada is vibhrama of Manas,Buddhi, Sanjnajnana, Smruti,

Bhakti, Shila, Chesta, and Achara.
Here vibhrama means the total disability to perform assigned
function or dysfunction of particular entity.
Of the eight aspects considered in definition, the first 5
represents different dimension of Manas and latter 3, its
reflections.
1.Mano vibhrama
Svanigraha (Self-control) and Indryabhigraha
(Control over indriyas) are the functions of Manas.
Cintyam, Vicharyam, Ūhyam, Dheyam,and
sankalpa are the objectives of Manas.
Vibhramsa of Manas would affect both the
functional and objectives of Manas.

Illusion and hallucination ?

2. Buddhi vibhrama
The Karma of Buddhi is to take a decision by
which it differentiates right from the wrong one,
useful from the harmful ones. (Chakrapani on
Cha.Ni.7/3).
Naturally when it gets affected, one fails to make a
decision or takes wrong decisions due to which he
lands in a dilemma.
The other aspects of Buddhi, such as intellect,
grasping power, and understanding may or may
not get affected (Cha.su.1/99).
3. Sanjnajnana vibhrama
Loss of orientation towards person, place and time is
seen in this condition even though he cannot tell his
identity.
It may see to such an extent that he cannot feel fire,
which burns his body (Chakrapani on Cha.Ni.7/3).
4. Smruthi vibhrama
Impairment of memory is seen up to a certain
extent in all the individuals. In senility loss of
immediate and recent memory is common, but the
remote memory may be intact. On the contrary, a
psychiatric patient may have all the three types of
memory loss or any of them.
5. Bhakti vibhrama
Desires, wish, interest etc. are called as Bhakti.
When this entity gets impaired, patient shows
excessive interest, Withdrawal symptoms or very
odd interest (Chakrapani on Cha.Ni.7/3).
Withdrawa1 symptoms are like less or not
indulging in any talk, not interested in talk, not
interested in taking food, not dressing properly etc.
He may show intensively withdrawal symptoms
also like not interested in his day-today activities,
job, diminished pleasure in such things, which he
likes previously. He may show interests in strange
things or in those things, which are different from
his previous interest and looks odd.
6. Shila vibhrama
The disturbance in the usual habits and
temperament is Shila vibhrama due to which
patient shows exaggerated emotions at improper
place and time or inappropriate reactions

For example - Calm and quiet person may

change into a person with an arrogant attitude
and also patient may laugh hearing sad news.
7. Chesta vibhrama
Chesta is controlled and relevant motor activity
which when gets impaired a person does vishama
Chesta like Asthane Rodana, Gayana, Nartana,
Vadana etc., playing an instrument at improper
place and time with abnormal body postures.
He may show Atichesta (Hyperactivity) or
Achesta (Hypo activity) like excessive wandering,
Less activities respectively.
8. Achara vibhrama

The person violates all ethics and manners.

His behavior and and social attitude would be
unfair, improper irrelevant. This is called as
Achara vibhrama.
Patient may remain undressed, unhygienic or
have odd dressing.
• Samanya Unmada lakshana like –

• Dhi vibhrama - Distortion of Buddhi

• Satva pariplava- Fluctuation, wavering of mind
• Paryakula drusti - Anxious look
• Adheeratha - fear, anxiety
• Abaddha Vak - Uncontrolled irrelevant, incoherent
talk.
• Shunya Hridaya - Feeling of hollowness of Manas.
 CHIKITSA
• VIKARA ANUTPATTIKARA CHIKITSA
PREVENTIVE MEASURMENTS

• VIKARASYA CHIKITSA
CURATIVE MEASUREMENTS
 PREVENTIVE ASPECTS

• TYAGAHA PRAGNAPARADHASCH

• INDRIYOPASHAMANA

• SADVRITTA PALANA
 CURATIVE ASPECTS
1. DRAVYA BHOOTA CHIKITSA
• Shodhana Chikitsa
• Shamana Chikitsa

2. ADRAVYA BHOOTA CHIKITSA

• Bandhana
• Tadana
• Tamograha pravesha. etc
 General principles of management

• Yukti vyapashraya

• Daiva vyapashraya

• Satvavajaya
 Yukti vyapashraya

•Antah parimarjana – Shodhana and Shamana

•Bahi parimarjana – Murdhi Thaila

•Shastra pranidhana
 Panchakarma

•Definition

•Area of utility
 According to the Involvement of
Dosha.

•VATA – BASTHI

• PITTA – VIRECHANA

• KAPHA – VAMANA
 Benefits of Panchakarma in
Manasa Roga
•Hridya Shuddhi

•Indriya Shuddhi

•Buddhi Shuddhi

•Manah Prasada
 Management of Mental Disorders
according to the Faculty involved

• MANOVIBHRAMSHA - MEDHYA RASAYANAS

• BUDHI VIBHRAMSHA - GNANA VIGNANA &

MEDHYA RASAYANAS

• CHESTA VIBHRAMSHA - BHAYA DARSHANA

GHRITHA
ARE VERY IMPORTANT OUSHADHIS IN THE
MANAGEMENT OF MENTAL DISORDERS.

MOORDHNI TAILA
• SHIRO ABHYANGA
• SHIRO PICHU
• SHIRODHARA-IN CHITTODWEGA
• SHIROBASTI - IN NIDRANASHA
 ACHARA RASAYANA
 PHYSICAL AND MENTAL CONDUCTS
 NO INVOLVEMENT OF DRUGS
 MAINTAINS THE TOTAL LIFE PROCESS
(Cha. Chi.1/30)
One who speaks truth
One who is free from anger
One who abstains from alcohol and sexual congress
Avoids over strain
One who is devoted to repetition of holly chants and cleanliness
One who is habituated in taking milk and ghee
Regular sleep
Wholesome diet
Knowing about oneself
Control over his sense organs etc
The persons who follows the above conducts will not be pray for
diseases and good conducts will lead to physical mental and spiritual
healthy state
 MEDHYA RASAYANA DRAVYAS
Mandukaparni Svarasa
Yastimadhu Choorna with milk
Guduchi Svarasa
Shankapuspi Kalka (Cha.chi 1/30-31)

Brahmi
Jyothishmathi
Ashwagandha.
 Usage of Rasoushadhis in Manasa Roga

Unmadagajakesari Rasa
Vatakulantaka Rasa
Manasamitra Vati
Saraswatharista with Gold etc.
 SATWAVAJAYA CHIKITSA

Punar Ahithebhyo Arthebhyo Manonigrahaha

TECHNIQUES
• GNANA - ADHYATMA GNANA
• VIGNANA - SHASTRA GNANA
• DHAIRYA – ANUNNATI CHETASAM
• SMRUTI – ANUBHOOTARTHA SMARANAM
• SAMADHI – VISHAYEBYO NIVARTHYATMANI
MANASO NIYAMANAM
 SCOPE OF SATVAVAJAYA
• BY REGULATING THE THOUGHT PROCESS

(CHINTYA)
• BY REPLACING THE IDEAS(VICHARYA)
• BY CHANNELING THE PRESUMPTIONS (UHYA)
• BY POLISHING THE OBJECTIVES (DHYEYA)
• BY PROPER GUIDANCE & ADVICEFOR TAKING
RIGHT DECISION (SANKALPA)
Trivarga Anveshsna - Contemplation of the three
objectives of life.(Dharma, Artha, and Kama)

Tadvidyaseva - Service of those who are well versed

in the treatment of mental diseases.

Atmajnana - Self-realization.

Kula-kala, desha, bala Jnana - The knowledge

about ones own self, country, family, age, vitality, and
ability.
Opposite therapy

Kama x Kopa or Bhaya

Bhaya and Krodha x Kama
Shoka x Harsha
Harsa x Shoka
Asūya x Bhaya and Krodha
Irshya x Kama and Bhaya
Lobha x Shoka and Bhaya
 DAIVA VYAPASHRITA CHIKITSA
•Ayurveda is a spiritual science, having divine roots. As per
the Ayurvedic texts Brahma, the Lord of Creation himself
first imparted the knowledge of Ayurveda. It was practiced by
the Devatas first and then passed down to ‘Bhu-loka’ to
relieve mankind of all sufferings.
•The term Daiva vyapashraya is concerned with all the
unknown circumstances, which are beyond the purview of
reasoning.
• In Ayurveda, Deva has been used in the various senses like
unknown past deeds, etc. The evils of past life karmas cannot
be cured by the scientific methods of medicine because the
diseases so happened are related to past deeds.
As Ayurveda accepts purva janama, it is rational need to
device methods, which can effectively deal with Daivakrut
diseases.

Charaka says Karma that has done in Punarjama is

considered as Daiva.The diseases that are caused by such an
effect are known as Daivakrta.

These Daivavyapashraya methods create confidence and

remove the fear and pessimistic tendencies. It may in some
way indirectly help the patient in gathering confidence.It
works at the level of mind and there by influence the body.

Ayurveda explains the spiritual therapy for the mental

disease in a unique way.It acts through vibrations which
stimulates the cosmic consciousness to heal so its direct
effect is invisible.
In Bhagavadgita chapter 2/62-63 says,

Attachment desire anger delusion

loss of memory destruction of discrimination
Death.

“While contemplating the objects of the senses, a person develops

attachment for them, and from such attachment lust develops and
from lust anger arises. From anger complete delusion arises and
from delusion bewilderment of memory.
When memory is bewildered intelligence is lost, and when
intelligence is lost one falls down again into the material pool or he
dies.
Employed to detach from desires and thereby
attain Moksha (salvation).

It mainly includes practices of yoga. It guides an

individual on how to gain control over his unstable
mind and thereby slowly detach it from sensory
objects and culture the emotions.
The following treatment in the shape of good deeds is
recommended for diseases caused by Deva (C.Su.11/54).
Mantra- Sacred Hymes
Aushadha
Mani - gems
Mangala-auspicious offerings
Bali - gift
Upahara - oblations
Homa
Niyama
Prayascitta- atonement
Upavasa - fasting
Svastyayana – chanting mantra
Pranipata – worshipping god
Yatragamana - pilgrimage
 Common Manasa Roga

•Unmada
•Apasmara
•Atatva abhinevesha
•Vishada
•Chittodvega
•Madataya etc.
 Unmada
•Vataja unmada – Snehapana, Mrudu shodhana

•Pittaja unmada – Virechana

•Kaphaja unmada – Vamana

•Bhutonmada – Teekshna shodhana

 Apasmara

•Vega kala – Sanjna prabhodhana nasya

•Vegantara kala –
1.Vataja apasmara – Basti
2.Pittaja apasmara – Virechana
3.Kaphaja apasmara – Vamana
 Atatvabhinevesha

• Shodhana – Snehana, svedana, Shodhana

• Shamana – Brahmi, Medhya Rasayana etc.

 Vishada

• Sarvanaga Abhyanga

• Nasya – Panchagavya ghrita, Kalyanaka ghrita etc.

 Chittodvega
•Shirodhara
•Murdhni taila

Madataya
•Shodhana
•Shirodhara
 Probable mode of action
•Sarvanga abhyanaga
•Murdhni taila
•Svedana
•Vamana
•Virechana
•Basti
•Nasya
•Raktamokshana
Sarvanga abhyanga

Relationship between Twacha and Manas

Soothing and relaxing

Murdhni taila

Actions on marma

Vascular effect

Nervine effect
 Svedana -Along with neurological problems

Vamana and Virechana

•Guna
•Mild Irritation
•Removal endogenous toxins ( Ama )

Basti
•Vayu and manas
• Best for vata dosha
 Nasya
• Shringataka marma
• Vascular and Nervine effect
• Cavernous sinus

Raktamokshana
•Raktaja vikaras like mada, moorcha etc.
• Pittaja manasika vikaras
 CONCLUSION
1. Principles of sadvritta and achara rasayana laid down in Ayurveda
highlights the importance of socio-cultural factors in the
maintenance of mental and social health.

2. A stable and harmonious equilibrium between man and his

environment is needed to reduce man’s vulnerability to mental
diseases and to permit him to lead a more productive and satisfying
life.

3. By Ayurvedic line of treatment with psychotherapy and spiritual

therapy one can able to treat mental diseases effectively.
 REFERENCES

1. CHARAKA SAMHITA

2. SUSHRUTA SAMHITA

3. ASTANGA SANGRAHA

4. ASTANGA HRIDAYA

5. SYNOPSIS OF PSYCHIATRY - KAPLAN & SADACK

6. POSTGRADUATE PSYCHIATRY - LOUIS APPLEBY

7. OXFORD TEXTBOOK OF PSYCHIATRY

8. PREVENTIVE & SOCIAL MEDICINE - PARK