WhatsApp Discussion Series 35: Discussion on "Mano-avasad(Depression)" by Dr. Mayur Surana, Vd. Bhooshan Bhakkad, Dr. Dinesh Katoch, Prof. Deep Narayan Pandeya, Dr. Pankaj Chhayani, Dr. Pawan Madan, Dr. Raghuram Bhatta, Prof. KSR Prasad, Dr. Ashwini Kumar Sood, Dr. Janardan H. and others.

[3/31, 21:53] Dr. B S Sandhu Kurukshetra:

Ayurveda treatment alongwith counselling on lines of Sadvritta and Achar Rasayana definitely help the depression and other mentally ill patients.

[3/31, 22:07] pawan madan Dr: 

Do u really think that by counselling and sadvritt....a Real Case of Depression can be treated?

Do u have  some experience?

At one stage when Depression really troubles a patient....it would have changed into organic pathology and nothing works in this stage....

[3/31, 22:32] Pankaj Chhayani dr ndyad:

Depression:-

1) REACTIVE DEPRESSION:- Big blow to life(financial/marital/dear loss) and reaction to that develop depression. in this case Counselling works more along with medicines..

2) ENDOGENOUS:-

First due to biochemical/receptors/neurotransmitter dysfunctions or secondary to any other diseases someone get depression. After that depression he develop losses(marital/financial). This type really respond well to the medicine than counselling.

True clinical depression:-

➡ last longer, 

➡inappropriate to losses, ➡generelised feeling of hopeless ness/helplessness/worthlessness.

In Sadvritta Charaka says, न शोकमनुवसेत्:- न शोकमनुवसेदिति न चिरं शोकवशग: स्यात्।।

Suppose some women losses her husband and for six month, she is down in mood and gradually she come back to the life, this is normal bereavement time.

Suppose, other women says 17 year back I lost my husband and never enjoyed life, she is down from last 17 year, this is abnormal. In this case ,counselling/sadvritta works more than drugs...

[3/31, 22:33] Pankaj Chhayani dr ndyad: 

I believe real case of depression can be treated with Sadvritta/Counselling along with medicines. There is no role of medicines in reactive depression.

[3/31, 22:36] Prof. Deep Narayan Pandey: 

Largely true, and a combination of Sattavajay + Yukti vyapashraya is great.

[3/31, 22:42] Dr. Jui Shahane: 

Counselling & Sadvrutta r really important. But I dont think that only these factors help in cases of mild to moderate depression. Abhyang, nasya, & Basti show very good effect in mild or moderate depression.

[3/31, 22:42] pawan madan Dr: 

Very good explanation Pankaj ji.

But if u keenly observe...Reactive depresaion is actually not Depresaion.... its only a low mood......that's why only counselling works...

But if u see a Endogenous Depression........

.....many many times its not a result of some losses....

....when it comes....it is of no cause only.......Have seen this in 100s of cases......so I can say that........and sorry to say...no ayurvedic medicine works....

I am eger to learn this if somone shares his/her experience in treating such organic depresaion.

And this depresaion comes again and agaiin even if there is no any aggrvating sthiti/factor//cause.....

[3/31, 22:42] pawan madan Dr: True...

[3/31, 22:43] Jui: 

[3/31, 22:43] Janardan H Dr: 

I have worked under psychiatrist. In a depression / anxiety patient, so not do the counselling first. He will not  a be in a position  to hear you.  Start medicines for a month or two. Let the medicines act first. Let the patient develop perspective and then do the counselling. 

However in a patient with suicidal thoughts, counselling is needed up front to the patient and precautions are to be explained to her attendees not to leave the patient alone, no sharp objects nearby etc.

[3/31, 22:46] pawan madan Dr: 

Truely true..

In a real depreaaion patient is not n a condition to listen/understand any dam counselling....

Even after taking med for months and doing rounds of counselling as soon as he withdraws his medicine...attacks of  depression usually come back.....

I feel some permant changes must have been there in the brain of such patients....

[3/31, 22:46] Pankaj Chhayani dr ndyad: 

In cases of suicidal thoughts आप्त सेवन is needed. Here, Aapt can be grand father/ grand mother/ brother/ friends...

[3/31, 22:47] Mayur Surana Dr. : 

No medicines work...neither shodhan..my experience too!

[3/31, 22:47] pawan madan Dr: 

Sorry sir.....Seems more theretical..

[3/31, 22:48] Pankaj Chhayani dr ndyad: 

[3/31, 22:48] Janardan H Dr: 

Apta is anyone who is  accompanying the suicidal patient.  

1. We cannot expect grannies to accompany the patient 

2. The one who has accompanied the patient to the doctor probably cares more for the patient than anyone else. 

3. There is literally no time to get the desired apta to the clinic.

[3/31, 22:49] Janardan H Dr: 

Meds / therapies are required for 12-18 months with very slow and gradual withdrawal of medicines.

[3/31, 22:51] pawan madan Dr: 

True....

But koi bhi med esp ayu 3 mahine me kuch to kaam shuru hi karnaa chaahiye na.....ke aise hi med khilaate rahe bas......

Bcause this doesnt happen.....or may be I dont know...

[3/31, 22:52] Jui: Right!!

[3/31, 22:53] Janardan H Dr: 

Even allopathic antidepressants don't work much except for sleep correction. So we should just keep trying and trying and trying without we getting into depression 

[3/31, 22:55] Pankaj Chhayani dr ndyad:

Depression can be taken under Aagantuja jwara.

Kam jwara- काम्यैरथैँ- by providing desired object

मनोगनै अथेँ- by providing pleasant object, आश्वासन- consolation, इष्ट लाभ

Krodha jwara- सदवाक्यै- by true advise.

[3/31, 22:55] pawan madan Dr:

 

Any allo. med starts acting in a perfect 3 weeks time and pt starts feeling better.

Then just keeps on taking...

[3/31, 22:57] pawan madan Dr: 

Sir...kuch nahi hota...

Have tried ...

[3/31, 23:01] Pankaj Chhayani dr ndyad: 

Sorry sir, I can't satisfy you on whatssapp. But I treat pts and I believe in these methods of Great(father) psychiatric Caraka.

[3/31, 23:01] Vishal arora Pathankot Dr: 

Right sir.

We need to empower the God's own Medicine. 

[3/31, 23:04] Pankaj Chhayani dr ndyad:

Giving medicine and doing counselling both are different, if 10 vaidyas give Brahmi to same type of pts,there will be same effect. But in counselling,it never happens like medicine.

[3/31, 23:05] pawan madan Dr: 

I wud call u some day.

[3/31, 23:05] Pankaj Chhayani dr ndyad: 

Most welcome

[3/31, 23:10] Pankaj Chhayani dr ndyad: 

There is great Vaidya, named Pachabhai Damania, who perform Daiva vyapashrya chikitsa on manasa rogi.

Hardik Patel is also in this group who is disple of Pachabhai, I request him to share his experiences.

[3/31, 23:12] Prof. Deep Narayan Pandey: 

भारी अवसाद में भी योग लाभकारी है - - पढ़िये क्लिनिकल ट्रायल के परिणाम। In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity.

http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0173869

[3/31, 23:14] Prof. Deep Narayan Pandey: 

https://link.springer.com/article/10.1007/s10943-015-0113-7

[3/31, 23:14] Jagdish Nama Dr: 

Thanx sir ji

[3/31, 23:16] Prof. Deep Narayan Pandey:

http://onlinelibrary.wiley.com/doi/10.1002/da.22502/full

[3/31, 23:32] pawan madan Dr: 

Thanks Pankaj ji

Would wait for his response..

[3/31, 23:32] pawan madan Dr: 

Thanks Pandey sir..

Would go through these links tomorrow..

[3/31, 23:55] Bhushan bhakad Vd. Nasik:

Agreed... Diagnosis to kijiye pehle.. depression wale ka diagnosis Grahani bhi ho sakta hai, udavart bhi ho sakta hai.. and in this condition patient will not be benefited at all with even kgs of brahmi, etc drugs acts on mind nd brain.

[3/31, 23:57] Bhushan bhakad Vd. Nasik:

Though I m less experienced still will say ayurved is legend in such cases.. we are making mistakes in perfect diagnosis, Nidan parivarjn..  treatment to sab log thoda Bhot same hi denge.. but ni.pari., diagnosis matters a lot.

[4/1, 00:01] Bhushan bhakad Vd. Nasik: 

Anna se mind ka poshan. Manovah rogi should not eat in hotels, पणिकाशन; asth vidh ahar vidhi visheshaytan, etc etc Etna bada ho sakta.. 

And I don't think this is follwed by every vaidya.. theory theory bolke chod diye jate hai Ye Sare points...

[4/1, 00:04] S A Soni: 

करोति विण्मारुतमूत्रसङ्गं क्रमादुदावर्तमतः सुघोरम् ।

रुग्बस्तिहृत्कुक्ष्युदरेष्वभीक्ष्णं सपृष्ठपार्श्वेष्वतिदारुणा स्यात् ॥६॥

आध्मानहृल्लासविकर्तिकाश्च तोदोऽविपाकश्च सबस्तिशोथः ।

वर्चोऽप्रवृत्तिर्जठरे च गण्डान्यूर्ध्वश्च२ वायुर्विहतो गुदे स्यात् ॥७॥

कृच्छ्रेण शुष्कस्य चिरात् प्रवृत्तिः स्याद्वा तनुः स्यात् खररूक्षशीता ।

ततश्च रोगा ज्वरमूत्रकृच्छ्रप्रवाहिकाहृद्ग्रहणीप्रदोषाः ॥८॥

वम्यान्ध्यबाधिर्यशिरोऽभितापवातोदराष्ठील *मनोविकाराः* ।

तृष्णास्रपित्तारुचिगुल्मकासश्वासप्रतिश्यार्दितपार्श्वरोगाः 

[4/1, 00:04] Bhushan bhakad Vd. Nasik:

for better councelling vaidya's pran vayu and satva should be of good quality.. if not he can't do good councelling.

[4/1, 00:07] Bhushan bhakad Vd. Nasik: 

Vataj Grahani me मनस: सदनं !

[4/1, 01:53] Vd Ranga Prasad Ji Chennai: 

[4/1, 05:27] Shridutta Trivedi Dr: 

[4/1, 05:31] Pankaj Chhayani dr ndyad: 

[4/1, 05:37] Shridutta Trivedi Dr:

great manas rog chikitsak to bhagvan shrikrishan bhi the jinhone arjun ka depression door Kiya tha esa muje lagraha he...ye bhagvad geeta me manas rog ki chikitsa bhi di gai he

[4/1, 05:48] Pankaj Chhayani dr ndyad: 

Arjun Vishad yoga- भयं विषादेन । Arjun was frightened by great warriors like Drona, Bhishma. He was excusing. Here, according to Ayurveda, Arjun shows Vishad due to Bhaya...

[4/1, 06:29] Prof. Deep Narayan Pandey:

 

[4/1, 06:49] pawan madan Dr: 

Good morning all...

[4/1, 07:08] pawan madan Dr: 

Ji sir.

अति धन्यवाद. हालाकि मै निदान सही हो इस बात का ध्यान अवश्य रखने की कोशिश करता हू पर फिर भी आपने बहुत अच्छी बात खी . मै और भी ध्यान रखुन्ग.

डिप्रेशन के हर रोगी मे पूर्ण इतिव्रित्त लेता हू.

बहुत सारे केसो मे कोइ शरीरिक व्याधि या लक्षण नही मिलते एवम जिन शरीरिक व्याधिओ मे मान्सिक विषाद या भय या शोक मिलता है..........असल मे वह भी उस उस व्याधि के दुख या परेशानी की वजह से त है एवम मै उस शोक या विषाद को Depresaion नही समझता. 

ये सब स्थितिया based on the context होती है.

दूसरी तरफ जब typical depression होता है तो सब कुछ disturb जाता है. सब लक्षण आ सक्ते है........जैसा के आपने इन्गित किया  

और जैसे ही रोगी depresaion क इलाज करवात है.....ये सब अनुषन्गी लक्षण गायब हो जाते है.

कही गलती हो तो pls guide करे !

[4/1, 07:11] pawan madan Dr: 

A pt of typical depression doesnt do all this. He already have lost interest in such things.

[4/1, 07:12] pawan madan Dr: 

Here विषाद would mean confusion and not depresaion.

[4/1, 07:13] D C Katoch sir: 

सुप्रभात । सोचा था आज पहली अप्रैल को फूल बनाएँगे । पर Depression की चर्चा देखकर फूल बनाने का मूड ही चेन्ज हो गया ।  भाइयों!  Depression    पैदा करने में वातावरण (  वाह्य एवं आभ्यन्तर ) का बहुत योगदान होता है - वातावरण को बदलना ही Depression की चिकित्सा का सफल सोपान है।

[4/1, 07:16] pawan madan Dr: 

Gd mng sir.

आपका कहना सही है पर वातावरण को बदलना हमेशा ही चुनौति रहा है और ये almost near impossible hai. Only we can change ourselves our mind and not others.

Pls guide...

[4/1, 07:22] Katoch sir: 

सभी स्थितियाँ साध्य नहीं होतीं । साध्य स्थिति होने पर ही आपके समीचीन (Judicious) प्रयास व प्रयोग कार्मुक होतें हैं अन्यथा नहीं ।

[4/1, 07:24] pawan madan Dr: 

[4/1, 07:28] Katoch sir: 

One can not change the social determinants of diseases and health risks but important is to modulate lifestyle factors, behaviour  and life conditions in accordance with patient's needs and circumstances.

[4/1, 07:44] Dr B K Mishra Ji:

 

Absolutely Correct

[4/1, 07:51] Bhargava Thakkar MD (Patan):

 

 Bahya vatavaran ko puri tarah nahi badal sakte parantu abhyantar vatavaran ko dhi dhairya aatmadi vigyan se achchhe se badal sakte hai yahi parinam me madadrup hota hai 

[4/1, 08:02] Katoch sir: 

"Only we can change ourselves our mind and not others"- not possible -Prakriti can not be changed. Adapting, adjusting to and adopting the circumstances  is different called Acharan/Vyavhar Parivartan.

[4/1, 08:06] pawan madan Dr: 

[4/1, 08:29] pawan madan Dr: 

Ji sir I meant the same..

...acceptence

...understanding

...adjusting

Are the key factor by which we can change ourselves..... i don't mean changing PRAKRITI...

[4/1, 08:30] pawan madan Dr: 

Ji I meant the same...

[4/1, 08:32] pawan madan Dr: It doesnt mean....

[4/1, 09:02] Katoch sir: 

Fine. Words also change the perception. You are right.

[4/1, 09:09] Mayur Surana Dr.: 

I think we have discussed that earlier...Even Prakriti can change...

यावदग्नेः समीभावात्...(च.वि.६)

प्राकृत दोष (inner core--च

इ.१)- वैकृत दोष (outercore--based on which we assess prakruti) (अ.सं) so definitely outer core can be changed...

[4/1, 09:12] Katoch sir: 

Yes with Samshodhan- Nidan Parivarjan.

[4/1, 09:26] Mayur Surana Dr.:

By following the upakram of that particular dosh repeatedly till samibhaav of Agni is achieved...

[4/1, 09:33] Dr. Bharat Delhi: 

How prakriti can be changed ?

[4/1, 09:34] Dr. Bharat Delhi: Please elaborate

[4/1, 09:39] Mayur Surana Dr.:

Its a very broad concept...Need to type a lot...May be I l try to gather some earlier chats and post u personally sir..

[4/1, 09:48] Mayur Surana Dr.: 

प्राकृत दोष व वैकृत दोष(अ.सं)

प्राकृत दोष सप्तविध प्रकृतिके रचयिता--धातुसंज्ञक..

जन्मोत्तर निर्मित दोष वैकृत दोष..

गर्भ के आहाररस के मलसे उत्पन्न दोष वैकृत दोष है

अरिष्टात प्रकृतिर्हियते विकृतिश्चाभिवर्धते..(च.इ.१२)-

मतलब प्राकृतदोषाओका ह्रास होता है, वैकृत दोषोकी वृद्धी होती है...हम प्रकृती परीक्षण करते है तब वास्तव मे वैकृत दोष देखते है और उस हिसाब से so and so प्रकृतिरुच्यते ऐसा बोलते है--वास्तविक वैकृत दोषोकाही आकलन करते है.

वास्तव मे  वैद्य का कर्तव्य इन वातलाद्य सदातुराओको तद् तद् दोषोपक्रम करना जबतक अग्नि सम नही होता ये महर्षि चरक की श्रेष्ठ अपेक्षा है

 Outer core (वैकृत)and inner core (प्राकृत दोष)of genome...

We can assess only outer core...as an example may be inner core is of कफ,outer which we assess by Prakruti examination is वात..

We have to do वातस्य उपक्रम , to that pt.so long that its entire outer core changes...

In this process naturally  Agni will become sama which suits its inner core--d ideal definition of swastha प्रसन्नात्मेंद्रिय मनः can happen coz of this...

May be d genome can be changed in a positive or negative way...

 Many things like LINE's, introns can be considered part of epigenetics (वैकृत दोष) which might influence d genome (प्राकृत दोष)...

[4/1, 10:21] S A Soni: 

[4/1, 10:52] pawan madan Dr:

 

Nice explanation...

Prakrit dosh sthiti........that which *was* present at the time of conception qhich reflect that a person should be like that............but the 6 types of factors as described in charak jaati, desh, kaal, kula, vaya and pratyanmitta..........are some factors which can alter *that earlier* doshasthiti which may be called as *vaikrit dosha* sthiti.

[4/1, 10:56] Dr. Bharat Delhi: 

The changes/ variations due to vaya, desha etc are outer layer added. They can't be interpreted as change in prakriti.

[4/1, 10:58] Dr. Bharat Delhi: 

Rather some features like 'mahaa-lalaat' can be assigned more importance as they withstand age related changes.

[4/1, 10:59] pawan madan Dr:

True.......ham bhi wahi predict karte hain jo outer layer hai..

[4/1, 11:06] Dr. Bharat Delhi: CSIR-

Ayurgenomics Unit along with collaborators (north, south, east n west of country ) had screened thousands of  subjects and found that variability can have many causes but still some features remain unchanged. For example few  anatomical structural proportions, physiological tendencies remains almost same in prakriti groups across the cohorts of different region.

[4/1, 12:11] S A Soni: 

[4/1, 12:15] Manu Vats Dr Patiala: 

[4/1, 12:22] Vd Ranga Prasad Ji Chennai:

Patient ka Negative emotions ko vaidyon ka Emotional Intelligence (atma jnAn) se address kar sakte . 

Lekin, uska dhI-dhrti-smrti vibhraSHTa hua conditions jaise -

Depression

Maniac Depressive state

Schizophrenic 

Senile Dementia 

aise prabhUt avasthaon mein, sirf counseling se kuch kAmyAb nahin hote.

Us rugnon mein, thought process zyAdA se zyAdA - mithya yoga of Satva-indriya-man axis par hotA rehti hein. Chalatva of mental thoughts utni honge ki, counseling se uska mental tranquility ko theek karna mushqil se mushqil hote hein. 

Yaha mera (atma vivechana ko practice post zaari karte bhi) practical observation hein. 

Us taraf ka rogiyon mein, Adhya medicines aur shiras ka Sambandhit poorva karma jaise shiro -pichu; basti vagera , phir counseling ke sAth mani mantra aushadha ka upayog kramena kar diya to hi, thoda se thoda kaamyaab hotaa hein. 

Aur bhi, dhIre se dhIre hi result miltI hein. 

Other experts following Atma vicecana may differ in there view. 

[4/1, 12:30] pawan madan Dr: 

Fully true and practical..

[4/1, 12:45] Katoch sir: 

Yes, Vikritavastha of doshas is acquired whereas Prakritavastha is inborn. That is why in Dashviddh Pariksha both Prakriti and Vikriti are examined to make an assessment of the nature of morbidity and the strength/Bala of the individual.

[4/1, 12:47] Vd Ranga Prasad Ji Chennai:

 

[4/1, 13:11] Ashwini Kumar Sood Dr: 

What line of chiktsa should we follow in major depression leaving aside counselling ?

[4/1, 13:26] Prof. KSR Prasad Tachnoayurveda: 

Takradhara is the best.

[4/1, 13:27] Mayur Surana Dr.: 

Why n how Takradhara helps ?

[4/1, 13:30] Prof. KSR Prasad Tachnoayurveda: 

It makes beta and gama waves converted to alpha which promotes serotonin release.

[4/1, 13:31] Mayur Surana Dr.:

It doesn't happen with Taildhara?...How Takra influences beta n gamma waves ?

[4/1, 13:34] pawan madan Dr: 

Thats true..

happens with taildhra also.

[4/1, 13:40] Ashwini Kumar Sood Dr: 

In how much time taila/takra dhara will results in serotonin release ?

[4/1, 13:41] Ashwini Kumar Sood Dr: 

So that the pt gets relief.

[4/1, 13:51] pawan madan Dr: 

We usualy do for -40 mins.

We dont measure serotonin but reaults come .

[4/1, 13:51] pawan madan Dr: 30-40 mins

[4/1, 13:52] Dr. Bharat Delhi: 

Any evidence of brain wave pattern change ?

[4/1, 13:55] Ashwini Kumar Sood Dr: 

Which oral medicine is considered gold standard for major depression ?

[4/1, 13:58] Ashwini Kumar Sood Dr: 

Of course serotonin can't be measured but if results are satisfactory then it's ok !

[4/1, 13:59] Mayur Surana Dr.:

I feel Kalyanak ghrut- 

भूतोपहतचित्तानां गदगदानामचेतसाम्

[4/1, 14:04] Ashwini Kumar Sood Dr: 

Is it stimulant type of GHRUT Mayurji taking care of all the symptomatology of MAJOR DIPRESSION in your view ?

[4/1, 14:07] S A Soni: 

ते च विकाराः परस्परमनुवर्तमानाः कदाचिदनुबध्नन्ति कामादयो ज्वरादयश्च ॥८॥

चक्रपाणि

विकाराणां शारीरमानसानां परस्परं संसर्गमाह- ते च विकारा इत्यादि। अनुवर्तमाना इत्यनेन यदैव ज्वरादयः कामादयो वा बलवत्त्वेन (अथवा वाऽबलवत्त्वेन इति पाठः !) चिरकालमनुवर्तन्ते, तदैवानुबध्नन्ति प्रायः; यदा तु स्तोककालावस्थायिनो भवन्ति, न तदा प्रायोऽनुबध्नन्तीत्यर्थः। किंवा, अनुवर्तमानाः परस्परबलमभिवर्धयन्तः। 

*अत्र च परस्परशब्देन शारीराणां शारीरेण, मानसानां मानसेन, शारीराणां* *मानसेन, मानसानां शारीरेण चानुबन्धो ज्ञेयः॥८॥*

Definitely depression or other psychiatric problem affects the sharir doshas and intake of modern antidepressants further worsen the situation of patients because of suppression of all physiology of body including intestinal movement. 

This phenomenon is never desired as per basics of Ayurved. It never allows us to restore the shuddha dhatu in the body and resulting the condition as pawan sir is mentioning. So it's a vicious cycle. Organic damage many times is irreversible or partially reversible. So the wholesome individualized approach including all (as honourable members are suggesting)is needed. Merely taking pills shirodhara  etc may some time not sufficient.

I didn't see even a single cured patient of chronic depression with modern medicine. It creates dependency. 1 patient I saw that could discontinue drugs because of improvement in business and family relation. May be it is a coincidence.

History is also important in this context as few days back I  put the reference of garbhopaghatakar bhav of Charak sharir; that must be taken into consideration.

Alcoholism or other abuses prior/ in fertile age affect the Psyche undoubtedly.

I remember that once Khandal Sir described in his post during the discussion on depression in  Ayurvedapeeth that ojas should be targeted in depression with appropriate Pathyakram. Pawan Sir may remember that.

I know it's very easy to write and speak about depression; management is very big big task especially in maniac depression.

[4/1, 14:09] Mayur Surana Dr.: 

I consider depression as Mandya of sadhak pitta...where buddhi medha and abhimaan of d patient is hampered...

Where Depression with Anxiety is there or  Rakta involvement is there I will prefer this ghrut...

When pure sadhak agni mandya is there I will prefer Lashunadya ghrut from Unmadadhikar...

[4/1, 14:10] pawan madan Dr: 

Havent found any till date...

Tried many..

Only St John Wort. (Cap Ayudep) give some reaults in mild type of depraaion in 3-6 weeks timw..

[4/1, 14:11] Mayur Surana Dr.: 

Though I agree that its a herculean task to cure pure depression ...where most of d time hetu is not there...or sometimes even after d cause of depression is removed,-d depression persists... d condition is irreversible...

[4/1, 14:12] Mayur Surana Dr.: 

What r d contents sir ?

[4/1, 14:13] pawan madan Dr: 

Yes sir.

Right...I remember...

but really very hard to address such cases...

[4/1, 14:13] S A Soni: 

Firm believer of karya-karan-vad...! 

We should review if not finding proper cause.

[4/1, 14:14] pawan madan Dr: 

St John wort

an african herb.

[4/1, 14:16] pawan madan Dr: 

If somebody has some article by Jamdagni sir on depression.......might give some directions...

[4/1, 14:16] Pankaj Chhayani dr ndyad:

श्रद्धावान लभते कायँसिद्धि। It's better if pts are treated in IPD

[4/1, 14:17] S A Soni: Ultimate Truth

[4/1, 14:18] pawan madan Dr: 

[4/1, 14:18] S A Soni: 

Difficult if behavioral changes are there in patient.

[4/1, 14:18] Pankaj Chhayani dr ndyad:

  yes sir, its difficult. But if we will not do then who will do??

[4/1, 14:19] pawan madan Dr: 

मरीज कुछ भी करने, सुनने, समझने, मानने, जानने के लिये तैयार ही नही होता.

फिर कैसे होगा ?

[4/1, 14:20] pawan madan Dr: 

इसी लिये तो ये सब प्रवन्चना कर रहे है हम

ताकि कुछ कर सके !!

[4/1, 14:20] Pankaj Chhayani dr ndyad: 

Long term antidepressant/antipsychotic are too much harmful, even pts develop delusion, in these conditions task becomes too much tough for us..

[4/1, 14:21] S A Soni: 

Some time tadan Trajan bhaya etc may be applied in limited extension if possible......

[4/1, 14:22] S A Soni: 

[4/1, 14:22] pawan madan Dr: 

कर के देख लिया ये भी सर..

[4/1, 14:24] S A Soni: 

If possible

Once refer a patient to Dr Pankaj at Nadiad, where IPD is well equipped as well as managed.

[4/1, 14:25] Pankaj Chhayani dr ndyad: 

Its (Bhayadi) indicated in specific situation like आचार विभ्रंशे !

[4/1, 14:25] pawan madan Dr: 

ये सही कहा आपने...

[4/1, 14:26] pawan madan Dr: Surinder sir

[4/1, 14:27] S A Soni: 

It will also depend person to person.

Some time astrological yoga or combination does responsible.

Especially if the moon is affected.

Astro remedies sometime helpful.

[4/1, 14:28] pawan madan Dr: 

[4/1, 14:31] Pankaj Chhayani dr ndyad: 

True sir, दैव योग भी होने चाहिये।।

क्रियाघ्ना कमँजा रोगा...

मंत्र बहोत ही प्रभावशाली है, आखिर मे वैध ही विग्नाता, शासिता, योक्ता है ।

[4/1, 14:32] Jagdish Nama Dr: 

I also observe these. 

So meditation is better than medicine

[4/1, 14:34] Pankaj Chhayani dr ndyad: 

I observed this in my childhood in my town. Some Maniac persons always frightened by Police or some fearful persons.

[4/1, 14:39] Praveen Medi Dr: 

Kalyan grita  dealt in "Unmada" is clinically found to be useful more in depressive individuals than Mania. 

Infact consumption of grita makes a person hyper-active  after its long term use. It's our clinical observation 

[4/1, 14:42] Prof. KSR Prasad Tachnoayurveda: 

Manasamitravatakam

[4/1, 14:42] S A Soni: 

Each psychiatric/depression patient needs individualized approach /attention. We should listen to them each and every aspect of life including  very personal history so deeply as charak has instructed *antaratma pravesh* then only we would be able to open tied knots at the level of trust. 

If Patient shows interest to visit to you then it is a  first sign of success of initiation of treatment. Your behavior and personality should draw the attention of patient as 1 member said as vaidya should be sattvavan whom patient should follow.

[4/1, 14:44] Ashwini Kumar Sood Dr: 

[4/1, 14:44] S A Soni: 

[4/1, 14:46] Prof. KSR Prasad Tachnoayurveda: 

Minor to moderate anxiety depression headache or even psychosomatic diseases like psoriasis and vitiligo are well treated with manasamitravatakam and takradhara in 15 to 30 days

[4/1, 14:47] Prof. KSR Prasad Tachnoayurveda: 

No other medicines required 

If added there will be added results.

[4/1, 14:47] S A Soni: 

[4/1, 14:48] Bhushan bhakad Vd. Nasik: 

Yes. Manas mitra vatakam very good results.

[4/1, 14:48] Ashwini Kumar Sood Dr: 

Major depression has to be different imaged from bipolar disorder where pt has two types of symptoms. Pts with bipolar disorders are becoming more in no.

[4/1, 14:49] S A Soni:

                                    Important one

                                                                

[4/1, 14:49] Prof. KSR Prasad Tachnoayurveda:

the diagnosis and selection of treatment is with physician

[4/1, 14:49] Ashwini Kumar Sood Dr: 

No one medicine works in all stages of depression.

[4/1, 14:50] Prof. KSR Prasad Tachnoayurveda: 

The above mentioned is common to all .. dose vary

[4/1, 14:50] Ashwini Kumar Sood Dr: 

Pt passes from one stage of anxiety to other stage of hyperactivity at the other time.

[4/1, 15:25] Ashwini Kumar Sood Dr: 

Very appropriate NIDAN.

[4/1, 15:51] Katoch sir: 

On Jyotishmati and Vatkulantak Ras I have lot of confidence for treatment of depression. 

[4/1, 16:05] Ashwini Kumar Sood Dr: 

Actually DEPRESSION is now called as MOOD DISORDER.

[4/1, 16:06] Ashwini Kumar Sood Dr: 

Or chemical imbalance of mind.

[4/1, 16:37] Katoch sir: 

Chemical imbalance (Dosh Vaishamya) of body with mind.

[4/1, 16:45] pawan madan Dr: 

[4/1, 16:46] pawan madan Dr: 

Thanks for sharing sir.

[4/1, 16:46] pawan madan Dr: 

Dhanyvaad sir.....

[4/1, 16:52] Anupma Patra Dr:

 

Very nice point u ve raised sir,what I always use to say. Without proper diagnosis in ayurveda how can we search out proper solution for it?

I think most of the characteristics of depression will come under kaphaj unmaad or some may come under other varieties.

If we will follow the proper management of that definitely we will got success.

[4/1, 16:54] pawan madan Dr: 

Yes....

most of the time in my cases of depression the nidaan is kaphhaj unmaad

[4/1, 17:07] Anupma Patra Dr: 

Thank u sir 

 फिर तो यहीं पर डिस्कशन ख़तम। जो केसेस कफज उन्माद में जारहे हैं उनको वैसे हि चिकित्सा करनी पड़ेगी सफलता के लिए। पहले  शोधन जरुरी है। कैसे संभव होगा इसके वारेमें  बड़े बड़े विद्वान् सोचेंगे तो कुछ न कुछ हल निकल ही आएगा । मेरे समझ से आयुर्वेदिक मानस विकार की अलग हॉस्पिटल की भी जरुरत है। 

Then the increasing problem can be solved. For prevention many steps can be taken as advised in ayurveda.

[4/1, 17:08] J K Pandey Dr. Lukhnau: 

Superb bhushan sir.,

[4/1, 17:10] Shridutta Trivedi Dr: 

[4/1, 17:10] Prof. KSR Prasad Tachnoayurveda:

 

[4/1, 18:11] Raghuram Dr Banguluru:

 *Blueprint for effectively handling ‘depression through Ayurveda*

*Nice discussions* taking place on depression and the strategies to deal with it!!

I have a *good long experience* of dealing with this challenging condition in my clinical practice, thought of sharing on this elite platform.

*Stage 1* -

 *Nidana Parivarjana* – enlisting the causative factors, trying to isolate them or strategies to satisfy some unfulfilled wishes

 *Motivating Dhee, Dhairya and Atma gnana* (effective counseling)

 *Deepana Pachana* – I feel is again mandatory, ama and morbid doshas, sroto-avarodha should be dealt in initial stages. Out of many permutations and combinations that I have used (including Chitrakadi vati, Trikatu Churna, Panchakola etc), *Kalyanaka Kashayam with Gorochanadi Vati* is one best choice I would advocate.

 *Krimihara Chikitsa* (de-worming) – I have always done, though might look unconventional and non-theoretical

*Stage 2* –

*Bahir Parimarjana* –

I have seen *best results* with this combination:

 *Abhyanga-Udwarthana-Swedana* -(+NityaVirechana on treatment days with Gandharvahastadi kashayam / Eranda Tailam / Narayana Churnam etc) + *Shiro Vasti*

*Definitely include Udwarthana* in treatment protocol, has damn good results

*Other strategies* –

 *Dhanyamla dhara* (sarvanga, for ama and to ignite agni, in mandagni and high kapha, high ama conditions)

 *Shiro-Taila/Takra dhara*

 *Sarvanga Dhara* (Pizhichil)

*Antah Parimarjana* –

 *Vamana & Nasya* – ideal choices, I have done Nasya in all patients at one or the other stages

*Others* -

 *Virechana* – after Vamana in the form of Sadhyo or krama virechana to expel toxins / Nitya Virechana during bahir parimarjana

 *Vasti* – can be done after recovery from symptoms, even in stage 3, i.e. follow up period (strictly depends on the wisdom of doctor, not as a rule, I have personally administered Vasti in worst cases of depression in the follow up period as and when I have seen the patient getting better)

*Stage 3* -

 *Rasayanas*

 *Disease modifying medicines* – Among many effective disease modifying medicines, *Manasamitra Vatakam* or vati, Kalyanaka Ghrita, Kalyanaka Kashayam, Gandharvahastadi Kashaya, Varanadi Kashayam, Gorochanadi Vati, Mahavata vidhwamsini Rasa, Vatakulantak Ras, Saraswatharishtam, Swarna Bhasma, Makaradhwaja, *Shiva Gulika*, Kushmanda Rasayana, Jyotishmati, are some of the best medicines I have prescribed in my practice.

 *Lifestyle corrections* , wholesome diet, exercise

 *Yoga and Meditation*

 *Periodic check-ups* and treatments (repeat for preventing recurrences)

The above said list might look like total syllabus put together, but I have seen good results with all these in different conditions when given in different combinations.

 *Variety with skilful permutations and combinations* is the key. The stage of the disease, the vyadhi and atura bala should be accessed along with thorough rogi and roga pareeksha before planning the treatment protocol. Correction of exogenous factors (manipulating causative and triggering factors) is mandatory.

Ultimately *Chikitsa Chatushpada* , its ‘religious and serious’ approach towards effective body-mind healing is the key for success. A blend of *Yukti, Kalanurupi and Avasthanusara chikitsa* will give good results, if not the best.

After all this, I still feel that this area of *understanding mind and healing it is the toughest job* and it needs to be bettered and mastered over a period of time and still there will be a quest for better and better remedies!!

[4/1, 18:24] shekhar singh MP: 

[4/1, 18:24] pawan madan Dr: 

The most imp things pointed out ..

....deepan paachana

..there must have been some aama formed due to all causes and that has been maintainong sthaansanshrya somewhere in the brain..........which we are missing to hit...

....and the krimihar chikitsaa......which ultimately results in 'Gara-visha' formation probably and manifesting in the form of depression.

Thanks for enlightening sir.

Will take care  these factors...

[4/1, 18:28] Mayur Surana Dr.: 

Most important thing is graha-nashak Chikitsa, क्रियघ्नाः कर्म योगः...accordingly suggesting him daan, tree plantation, guru Seva etc...

[4/1, 18:30] Raghuram Dr Banguluru: 

Thanks Pawan sir, yes I hv indeed seen the positive effects and good outcomes of Deepana Pachana and Krimighna Chikitsa in many diseases, ama is an important factor to be considered

[4/1, 18:30] Raghuram Dr Banguluru: 

[4/1, 18:35] Samta Tomar Dr Jmngr: 

this year's WHO s theme is on" depression- let's talk". It is directly relate with ayyurvedic concept of manovirechana , catharsis...let the patient be free to express himself whatever is holding him back. Just speak up..I agree with pandey sir that charak is the great psychiatric _ that's why he mentioned chikitsa under aahar , vihaar ,shodhan ,shaman chikitsa..so in treating  depression Ayurveda has the answer ..I think charakacharya with his trikaal gyan came to know that soiety is going to be complicated day by day..psychological disorders will only prevails...

[4/1, 18:37] Bhargava Thakkar MD (Patan): 

[4/1, 18:39] Prof. Deep Narayan Pandey: 

[4/1, 18:55] pawan madan Dr: 

One imp thing...

In some pts who were on antidepressnts and were normal with the med...

I advised them to take *Dyanamic Meditation Technique* given by OshO and to do that for few days.

That worked really very good.

[4/1, 19:07] Gajanan Myanamwar: 

For decrease in shadripu of mind slowing of swas gati is very important

deep long breathing is very important

along with medications according dosh dushya dushti.

[4/1, 19:10] Ashwini Kumar Sood Dr: 

Every aspect of the disease properly covered 

[4/1, 19:17] Katoch sir: 

This is holistic approach by chance, not by rule.

[4/1, 19:26] pawan madan Dr: 

May be.

But this helps the person to do catharsis of the mind which benefits.

This catharsis can be done with other methods also like 

...Sudarshan kriya....also.

[4/1, 19:45] shekhar singh MP:

 "Mystic Rose"

21 Day's Meditation program by osho can be more beneficial.

7 Days continue Crying

7 Days continue Laughing

7 Days Total Silence

[4/1, 19:48] Sandip Verma Dr: 

[4/1, 20:06] Anju Navle Dr: 

[4/1, 20:18] S A Soni: 

Raghu Sir !!

Excellent systemic presentation.

Udavart and Grahani chikitsa emphasize Deepan pachan too.

[4/1, 20:21] ajay navale dr: 

And one important aspect of krimi 

[4/1, 20:22] S A Soni: 

[4/1, 20:23] S A Soni: 

Correction of Dhatu poshan is little extension usually may be  ignored in chronic cases.

[4/1, 20:25] ajay navale dr: 

[4/1, 20:35] Gururaja Bose Dr: Raghu sir

[4/1, 20:42] pawan madan Dr: 

Yes...truely

Mystic Rose....

[4/1, 21:24] Satish Sharma ji Dr: 

agantuj jwar chikitsa maharog (attatwabhinivesh)chiktsa aachar rasayan dhi dhirti atmadi vgyanam mano dosh aushadhamparam satwajay chikitsa omkar jap vishnusahashra nam avam dhyan  (meditation )labhkari ho sakata hai sir ji.

[4/1, 21:30] Katoch sir: 

Again I would say by chance, not by rule in every case and by the same practitioner in his different patients. Reason - adoption of the procedure/technique by the patient may be there, may not be there.

[4/1, 21:47] pawan madan Dr: 

[4/1, 21:48] Anju Navle Dr: 

Isn't it a part of vyayaam along with medication?

Because whatever is inside gets expelled out.

This is my thought

[4/1, 22:09] Anju Navle Dr:

very well compiled Raghu Sir !!

********************************************************************************************************

Above discussion held on 'Kaysampraday" a Famous WhatsApp discussion group  of  well known Vaidyas from all over the India. 

Compiled & edited by

Dr.Surendra A. Soni

M.D.,PhD (KC)

Associate Professor

Dept. of Kaya-chikitsa

Govt. Ayurveda College

Vadodara Gujarat, India.

Email: surendraasoni@gmail.com

Mobile No. +91 9408441150