Thursday, December 12News That Matters

Editorial – October

Everyone in his/her lifetime passes through the phase of nervousness, fear, feeling of something bad/worst to happen. Once such reaction is stronger and frequent, it is termed as anxiety disorder. Lack of information causes people to think anxiety as individualistic approach or mentality rather than disorder.
Anxiety includes panic disorder, agoraphobia, social phobia, specific phobias, stress disorders etc. American Psychological Association (APA) reports that one third of first year university students across the globe have symptoms of diagnosable mental disorders, including depression, panic disorder and generalized anxiety disorder. An estimate published in Times of India, 6th October 2013 reveals the prevalence of anxiety disorders among Indians as every fifth Indian is under the effect of anxiety disorders. A study at National Institute of Mental Health and Neuroscience at Bengaluru discloses anxiety as first step towards depression, specifically in elderly people, so treatment or control at this stage is important.
Studies expose GABA and Glutamate as main neuronal circuits involved in anxiety disorders, however extensive interrelationship of neurotransmitters with various feedback mechanisms and receptor structures are also observed associated with anxiety disorders. Anything affecting the homeostatic balance of neurochemicals based on physiological adaptation works as stressor. Corticotropin releasing factor acts as key mediator for this. Amygdala is primary modulator of anxiety inducing stimuli through stressful stimuli as in conscious state amygdala receives input from neurons in cortex while in subconscious state amygdala receives information bypassing the cortex.
Charak Samhita deals it by the name of Chittodvega in Vimanasthana 6/5. It is psycho-socio-behavioural problem triggered by specific or common stressor. Usually sedatives are prescribed in allopathic mdicine to treat anxiety disorders, but Ayurveda deals it
differently with medication and meditation. Ayurveda mentions the Rajasik and Tamasik reasons behind the problems of psychic disorders including anxiety. Meditation is suggested to increase the Satva and Satva is helpful in maintaing the bad effects of Rajasik and Tamasik. It works through concentration and control. Patient’s thought is backbone of cognitive behavioural therapy (CBT) for anxiety. Mindfulness is one of component of CBT. Mindfulness stands for acceptance of trigger in awareness of present situation through meditation.
Medication involves increasing the intellect by using Medhya Rasayana specifically Sankhpushpi as mentioned in Charak Chikitsasthana 1/3/31. This is an anxiolytic drug, having properties of sedation and healing working through neuronal circuits and electrolytes. Shirodhara and Jaladhara in Panchakrma technique are also widely used by Ayurvedic physicians to treat anxiety.
New inclusions of diagnostic and statistical manual (DSM) of APA is also supporting the concept of Ayurveda to treat anxiety by medication and meditation. Many works have already been done to relate the nurobiology with meditation and Yoga viz., increased CBF, activity of anterior parietal & occipital cortex, hypothalamic activity, increased blood flow in PFC etc. Further detailed study of neurochemical changes based on meditation, life-style changes, food habits etc. can reveal better options of Ayurveda in treatment of anxiety and othe psychosomatic disorders.

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