Manovikara (Mental disorders) In Ayurveda

Ayurveda aims at preservation and promotion of heath, and prevention and cure of diseases through the concepts of positive physical and mental health. Management of mental disorders or psychological medicine was an area of specialization even during caraka’s time (500 B.C.) Caraka suggests that, treatment for mental illnesses should be south through an expert in the field of mental illnesses. Chakrapani (11 A.D.) commenting on this statement, uses the phrase ‘manasaroga bhesaja vetti’ (Knowers of treatment for mental illnesses).

These references fortify the above statement. But unfortunately, due to historical reasons, Ayurvedic literature dealing exclusively manas and manasavikara, are not available. However, the scattered aphoristic material related to manas and manasavikara as available in the Ayurvedic treatises are richly useful in understanding manas and treating mental disorders only if they are carefully collated in view of our present needs. It is also a fact that various mental disorders are being treated for centuries over, by Ayurvedistis with the help of these ancient literary descriptions.

In statute of Mental Health and Neuro Sciences, Bangalore, has been studying from 1971 the role of Ayurveda in understanding and the management of various mental disorders. In the following lines, it is attempted to delve systematically on some of the important aspects of manas and manovikaras described in ayurveda.

Ayurveda has duly recognized the individuality of manas (psyche) and sarera (body) and their inseparable and interdependent relationship in a living body. The following descriptions available in the classics of Ayurveda, bear proof to this statement. While defining ‘Ayu it is said that ‘life is the combined state of body, senses, mind and soul. Further, the expectant parents are advised to contemplate on the physique, complexion, and mental traits they wish to have in their child, in support of their desire. Indicating the influence of manas even at the embryonic stage, Ayurveda states that ‘the foetus grows steadily with the help of the reproductive element, the five protoelements namely, prthvi, Ap, Teja Vayu and Akasa, the subtle mind and sap of food taken by mother.

The statement that ‘manifestation of manas occurs during 5th month of pregnancy in the foetal body’ indicates the coexistant nature of mind and body. Indicating the direct influence of manas on certain physiological functions, it is said that anger, and fear could cause diaphoresis. Similarly, grief and anger are counted among the causes of the loss of breast milk. Describing the role of manas in the digestion of food consumed, Ayurveda advises that food should be consumed with rapt attention.

Defying this, is liable to allow the food go wrong way or injure the health or the food is not properly placed in the stomach and there is no appreciation of either the good or bad qualities of food taken. Further, indicating the need of mental poise for drug action Ayurveda says that no one who has not rid oneself of the evils of both mind and body beginning with the gross ones, can ever expect to reap the benefits resulting from vitalization therapy.

Vayu which is one of the tridoshas (the three bioentities viz., Vata, Pitta and Kapha which are generally more related to shareera) is said to be the controller and prompter of manas. It is also said that the excited vayu depresses mind, gives rise to fear, grief, stupefaction, feeling of helpness, delirium etc. These descriptions enable one to conclude that Ayurveda is perhaps the earliest system of medicare to have certain clear concepts about the psychosomatics. Manah Swaroopa:

(Concept of mind): According to caraka, ‘that entity which is responsible for thinking is known as manas’. It is said to have been inherited from the previous birth and evolved from the compination of vaikarika and tejasa ahankara. It is acetana (inactive) by itself but gets cetana (activeness) from atma (soul). It is called a dravya (substance).

Although beyond sensory perceptions, it is called so since it has got both action and quality, coexistent within itself. It is connected to both jnanendriya sensory centres) and karmendriya (motor centres). That is why it is called Ubhayatmaka (combined psychomotor entity).

Manas is understood by its actions which are, indriyabhigraha (sensory and motor perceptions and control), svasyanigraha (self-control), uha (speculation), and vicarya (thinking) .Its objects are those, which are chintya (thought about), vicarya (discriminated from), uhya (speculated upon), dhyeya (aimed at), and sankalpya (decided upon) . Manoguna (qualities of mind): Manas has two basic qualities viz., anutva (atomic nature) and ekatva (unitary nature). But it is difficult to understand these qualities directly and clearly. Therefore, manas is said to be constituted of 3 more operational qualities viz., stave, rajas and tamas.

These are understood by the role the play in the emergence of three different mental response patterns. For example, satwa or kalyana bhaga is understood by self-control, knowledge discriminative ability, power of exposition, etc. Rajas or rosabhaga is understood by violence, despotic envy, authoriatativeness, self-adoration, etc. tamas or moha bhaga is understood by dullness, non-action, sleep etc.

Manasthana (location of mind): Manas is said to be active throughout body except nail ends, hairs, and such other structures. Its seat of control is said to be between siras (head) and talu (hard palate). Also, it is said that siras is the seat of all senses. Since the senses are controlled by manas, it is necessary to consider siras in understanding manas.

Similiarly Hrdaya (heart) is also said to the seat of chetana or atma. Since manas is always associated with atma an different emotion generally influences blood circulation, consideration of hridaya will also be important while studying manas. Jnanotpatti (mechanism of knowledge): Manas indicates both presence and absence of cognition. Knowledge occur when the sequential relationship in the order of indriyartha (sensory objectives), indriya, (sense organ), and manas with atma (soul) is established. Manasaroga Samprapti (pathogenesis of mental disorders) Generally for all types of mental disorders, alpasatwa (weak mind), manovahasrota (channels conveying manas/conveyers of manas), manasadosha viz., Rajas and Tamas and tridosha viz., Vata, pitta and Kapha are said to be responsible, according to ayurveda . Alpasatwa which is the most important component is indicative of premorbid personality.

Involvement of saririka dosa is more prominent in Ubhayatmaka vikara like unmade apasmara etc., than in manasavikara viz., kama, krodha, abhyasuya etc. similarly manadosa will be more vitiated in the latter group than in the former. Manoroga Nidana (Aetiology of mental disorders): Emotional disturbances, volitional transgression, unwholesome food is said to be the causes of mental disorders, in general.