• A Learner’s Guide to Ayurvedic Principles and their Possibilities in the Management of Mental Disorders. It gives Ayurvedic Ways of Treating Depression. 

Introduction

The body and the mind are broadly considered the seats of disease by ayurveda. Among them, the mind is often overlooked. The World Health Organization identified in 2019 that one in every eight individuals lives with a mental illness. This necessitates proactive interventions from all healing systems to combat these ailments, on a global scale.

Ayurveda possesses effective tools and interventions to address mental disorders, but they need to be updated with newer etiologies, pathological mechanisms, diets, regimens and interventional supports.

Dr. L. Eduardo Cardona Sanclemente, through his book, “Ayurveda for Depression” does the same, proficiently. This book is about his encounter with ayurveda as a scientist, patient and healer. But it turns out not only to be a book on mental disorders, but a useful handbook to the basics of Ayurveda, its healing principles and practices. 

This article was first published on Aryavaidyasala.com

About the author

Dr. Sanclemente, DSc, PhD, MSc, is a clinical biochemist, a doctorate holder in ‘the physiopathology of nutrition’ from Sorbonne University, Paris, and holds a master’s in ayurveda from Middlesex University, UK. He has been further trained in Ayurveda at centers like AVP and Udupi, and he is currently a practitioner and preacher of integrative medicine. 

Part I: The author meets Ayurveda

In the initial part, he introduces Ayurveda to the reader. Here, the core objective of Ayurveda has been appropriately briefed as ‘restoration of balance’. The spectrum of disorders including depression has been mentioned following it. 

The objectives of the book are also clearly stated in the first chapter, the introduction. Introduction of ayurvedic concepts and practices, how they can be utilized to optimize the body-mind consciousness axis, and how it can be appropriated to the current context in the light of contemporary sciences.

The next chapter details ayurveda, its brief history, basic tenets and relevant literature.

He delves into the details of pancamahaabhootas and explains their presence in modern language. In the following chapter, doshas and allied concepts have been explored in detail. He identifies tridoshas as variables that differentially manifest at various levels, broadly prakrti and vikrti praana, tejas and ojas as the culmination of the tridoshas and the emphasis given to prakrtis, i.e., janma-prakrti, deha prakrti, dosha-prakrti and maanasa-prakrti are noteworthy.

Brief, yet comprehensive questionnaires to assess the dosha composition in prakrti and vikrti have been attached. Intricate points of clinical significance like vikrti masking prakrti have been highlighted.

Part II: Understanding Depression with Ayurveda 

The author, after a generalized description of his objectives in the first section, moves on to specific areas, starting with understanding ‘the physiology and pathology pertaining to mind’. 

He starts with the identification of one’s type of depression and mental constitution. He explains the ayurvedic approach to mental disorders while he advises observing the mental phenomenon as a third person (the concept buddhi), and self-awareness (aatma-vijnaana) in beauty and brevity. His bifurcation of thoughts as individual and universal phenomena reflects his deep understanding of the interaction between the individual (vyashti) and the universe (samashti) as the dynamics of life. He also extrapolates the concept of aama into the mental plane, visualizing it as rigidity or stenosis of the mind resulting from repressed thoughts. The mental state of an individual is a result of a continuous interplay of the tridoshas (vaata, pitta, kapha) and trigunas (sattva, rajas, tamas) and their response to intrinsic and extrinsic agents. The clinical features of vrddhi and prakopa of doshas in the mental plane are delineated. 

Kapha-predominant psychic disorders present as inactivity, hopelessness, lack of desire, pitta as refusal to accept failure, anguish, desolation, and vaata as delusion and paranoia as per the author.

To conclude, he glimpses through the essential components of the mind: dhee, dhrti and smrti. Dhrti has been defined as the recall element of the mind, but an addition to it can be the conventional definition of dhrti, which is determination and control over the mind.

Part III: Ayurvedic Ways of Treating Depression

This section starts with the particularization of depression, and how ayurvedic principles fit into the current understanding of depression. The therapeutic goals of ayurveda in every disease including depression is the restoration of the genetically determined physiological baseline, and optimization of environment, which has been aptly pointed out.

The author’s approach to anti depression protocols in ayurveda reiterates that the solutions to complex problems need not be complex. Feasible daily and seasonal regimen (dinacaryaa, rtucaryaa respectively), diet and nutrition, gut health maintenance (through cleansing and other salutogenic measures), exercise, meditation, yoga, praanaayaama, sleep, and proper social conduct have been mentioned with corroborative evidence at necessary places. He also adds careful observations on sleep disorders predominant in each dosha. 

The personalization he brings into each practice resonates with the principle that it is the patient that should be treated, not the disease. The evidence corroborated to explain the effect of exercise in depression also provides its underlying mechanisms, i.e., kynurenine, myokines, beta endorphins, etc. While describing yoga, he highlights the importance of the sequence of its ashtangas. Yama and Niyama are prerequisites for the remaining to be effective.

The influence of the gut on health has been explained through multiple mechanisms. The gut microbiota as a major pillar of health has been an area of knowledge that has evolved in the past decade or two, and the author has given a comprehensive account of the same. Bacteroidetes, firmicutes and other genera governing the gut, the impact of diet, disease and drug on the same, and their variation with special reference to mental disorders have been studied in varying details. The author’s collation of the same will surely bring clarity in the existing ideas regarding this topic and shall streamline the directions of further inquiries. 

In the next chapter, the author enumerates the ayurvedic procedures like oil massage (abhyanga), other pancakarma procedures, oil pulling (gandoosha), and allied areas like vital points (marma), hymns (mantra), aromatherapy, etc. have been mentioned here. It is noteworthy that the timely evacuation of physical urges and suppression of mental urges have been included under the treatment section.

An approach to diet and nutrition from both the Ayurvedic and modern viewpoints ensues in the subsequent chapter. The author explains simply and precisely the framework ayurveda uses to identify the properties of food or medicine. A careful analysis of gunas has also been conducted. Then, the agents common to both medicine and the body, the bhootas are explained in the plane of foods. Then he moves on to describe the agents in the body that facilitate digestion and metabolism, and explains the vitiation of the same, leading to aama.

Etiologies, clinical manifestations and feasible tools have been attached to each segment, making the reading of this book a process of immediate translational value. The portions of paramount relevance, like ashta aahaara vidhi visesha aayatana and viruddhaahaara have been mentioned in detail. The importance of a customized diet tailor-made to fit one’s dosha status is highlighted. 

In the tenth chapter, the author comprehensively collates the biochemical, statistical, industrial and philosophical purviews on herbs and formulations. He mentions solutions that range from kitchen remedies like asafoetida to herbo-mineral preparations like Unmaada-gajaankusa rasa. He has enlisted the medhya rasaayanas, and their specific properties, and has added to the list non ayurvedic herbs like Ginseng, Chamomile and Maca, making the solutions more universal in nature.

 The author clearly reiterates that every herb is not for everyone, and some of them need not be approved by the Food and Drug Administration, USA. This chapter demands sensibility from the authors not to consider them as alternatives to expert consultation. The emerging use of Cannabis and the Indian base of its practice has also been highlighted.

The succeeding chapter relates depression to diet and nutrition. It starts from the basics that life receives inputs from its surroundings through the five senses, assimilates them, and responds through the five motor faculties. He insists on balancing the trigunas among these inputs, mainly through food and emotions. Here, he has not limited the list of foods and regimens to those mentioned in the classics. Rather, he has added foods from various parts of the globe, and most of them are empirical and appropriate.

Our mental health is significantly influenced by contaminated food and environment. Social media is one of the major ‘indriyaarthas’ today. A Vaidya starting to treat depression without state of-the-art knowledge of these is like an unarmed warrior on a battlefield. The author alludes the viewers to food additives like sodium benzoate, monosodium glutamate, artificial sugars like sucralose and aspartame, and other chemicals that affect us from the outside and inside. Devices like cell phones and ovens and the way they are likely related to depression are mentioned. In the chapter that follows, he delineates the endocrine mechanisms governing depression and touches on the topic ‘kosas’ briefly. 

Ayurveda describes more about the solutions for depression but less about the means to attain them.

The author approaches every single tool possible to do the same. He resorts to the Indian Philosophy and epics, especially Mahabharata, Bhagavadgita and Ramayana.

The book is adorned with multiple, useful appendices, including diet recommendations, Sanskrit terms glossary and an exhaustive index. The references add authenticity to his statements.

Conclusion

Throughout his work, the author demonstrates that the ayurvedic and conventional concepts need not always be contradictory and can be complementing. Technical terms in ayurveda often refer to abstract entities and demand utmost care in translation. The book ensures that the integrity of the meaning of Sanskrit terms is preserved to the best possible extent during translation.

The hard work done to bring usefulness and translational value to the book is highly commendable. There is an evident difference of perspective as the ayurvedic fundamentals have stemmed from Indian philosophical schools and the author is from another system. But the perspectives are fresh and can undoubtedly open new avenues for discussion and implementation in practice.

The book ‘Ayurveda for Depression’ is an epitomic work, that can be authoritatively recommended to a beginner who wishes to know ayurveda and a healer who ventures to manage mental disorders using ayurveda, and through this work, hopefully the principles and practices of ayurveda shall be appreciated globally

Author is a PhD Scholar, Department of Kaumarabhritya, All India Institute of Ayurveda, New Delhi. E-mail: kpkarthik131@gmail.com

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