Ayurvedic medicine is one of the world’s oldest and most complete systems of natural healing which offers comprehensive and holistic treatment for physical and mental disorders. It promotes physical health and healing of the mind through diverse methods focused on treating all the physical, psychological, and spiritual aspects of each individual affected with physical and mental disorders. In a review Of the literature from the classical Ayurvedic texts to current Ayurvedic literature As well as the most current Western Psychological / Psychiatric Approaches to the treatment of schizophrenia. I will research the causes, theories, and treatment methods utilized by these two divergent approaches in the treatment of schizophrenia and other mental disorders. In addition, I will also briefly describe some of the Ayurvedic’s spiritual therapies and factors to the treatment of mental disorders.
According to the National Institute of Mental Health, approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year have schizophrenia. Schizophrenia is found all over the world, in all races, cultures and social classes. It affects 1 out of 100 people worldwide. “More than two million Americans are affected by schizophrenia and approximately 1 percent of the population develops schizophrenia during their lifetime. More than 2 million Americans suffer from the illness in a given year and one out of every 10 people with schizophrenia commits suicide.” 1. (www.nimh.nih.gov). “Approximately 10 percent of people with schizophrenia (especially younger adult males) commit suicide.”(2). (www.nimh.nih.gov). “It is generally assumed that suicide is a problem only for those with major depression. This assumption is, unfortunately, not true. Suicide rates among people with schizophrenia are alarmingly high; in fact, suicide is the number one cause of premature death. Ten to thirteen percent kill themselves, and close to fifty percent attempt suicide at some point in their lives.”
(3). Keefe, H arvey, (1994). Number the citation+ give the page number from where you took quote.
Schizophrenia has been considered one of the most chronic, disabling, and difficult to understand of the mental disorders since ancient times. People with this illness suffer with a loss of individual potential and personal anguish, resulting in significant psychological and social consequences. People with schizophrenia suffer terrifying symptoms such as hallucinations, delusions, and distorted perceptions of reality, disordered thinking, lack of emotional expression and communication problems.
This often leaves them fearful, anxious, confused, and withdrawn for the rest of their lives. A wide range of reason or events can and might lead some people to run a risk for suicide, although this risk may be higher for individuals with schizophrenia. The underlying causes are the same for those who are afflicted with this disease. Some of the causes can be depression, feelings of hopelessness, being unemployed, being unmarried, experiencing deteriorating health and recent traumatic experiences and/or stress.
Due to those reasons listed above, schizophrenia is considered a devastating disorder like no other, causing pervasive and profound social, economic and personal impact on those afflicted. Most of the people with schizophrenia continue to suffer chronically or episodically throughout their lives. It has been estimated that no more than one in five individuals recover completely.
What is schizophrenia? Why is schizophrenia still considered one of the most fearsome and disabling mental disorders? What are the Western Psychiatric/psychological theories of Schizophrenia? What is the Ayurvedic interpretation of schizophrenia and mental illness? What are the treatment methods utilized by psychiatric/Psychological approaches and Ayurvedic medicine in the treatment of schizophrenia and other psychotic disorders? And, what Ayurvedic treatments are available for people suffering with mental illness? These are just a few questions that will be answered in the following pages.
According to Western Psychiatry, Schizophrenia is not a split personality condition, but a chronic relapsing psychotic disorder that primarily affects thought and behavior. According to DSM-V, schizophrenia is described as “ a disturbance that lasts for at least six months and includes at least one month of active-phase symptoms (i.e., two (or more) of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms)”. DSM-IV criteria identify five subtypes of schizophrenia: Paranoid type, disorganized type, Catatonic type, undifferentiated type, and Residual type. All of these vary by their degree of severity and symptomatology.
As noted by Dr. Halpern, Ayurvedic medicine offers the opportunity to understand the nature of the mind in a way that is completely unique and quite different from the variety of the Western Psychological and Psychiatric medicine models. “Ayurvedic medicine views psychotic disorders (schizophrenia) as the imbalance of energies on an inner level. According to Ayurveda and occult science, behind the gross physical is a subtle or astral body composed of the life-force, emotions and thoughts. The astral is a subtle form or underlying energy pattern of the physical, from which the physical is produced (3). Frawley (1989).
In the ancient texts of Ayurveda, there are detailed descriptions of mental disorders known as “Unmada”, and schizophrenia can be correlated with many of the types of “Unmada. Ayurvedic’s physicians describe schizophrenia as a disorder of the mind caused by the doshas (vata, kapha, and vata.) Moving in the wrong paths due to increased toxicity. According to the classical Ayurvedic texts, the Charaka Samhita, insanity is defined as, “the perversion of the mind, intellect, consciousness, knowledge, memory, desire, manners, behavior, and conduct”. It is denominated as insanity (umada) because it is madness (mada) of the mind caused by a deviation (unmarga) of the humors”. Swami Sada Shiva Tirtha, (1998).
The real causes of schizophrenia are unfortunately not known, however, there are several theories and hypotheses of the etiology of schizophrenia. Western scientists and psychologists do not yet understand all the factors that produce schizophrenia. An interaction of sociological, biological, and psychological factors seems to contribute to the condition. Schizophrenia also may result from various factors such as drug abuse, aging, and/or brain injuries and diseases.
One of the more influential views of the origins of schizophrenia is the theory of biochemical and brain dysfunction. This view attempts to “identify the biological abnormalities that are inherited or developed by persons with schizophrenia. The two most likely candidates are biochemical abnormalities and abnormal brain structure. It also involves disturbances of the brain’s chemistry, anatomy, and physiology, which in turn distort perceptions and subjective experiences. This hypothesis revolves around the idea that schizophrenic symptoms might be the result of overactivity of a neurotransmitter called dopamine.” Maxmen, J. & Ward, N. (1995). This theory is supported by the fact that drugs, which increase dopamine activity, can bring about a worsening of psychotic symptoms.
The treatment methods for schizophrenia with this biological view are based on clinical research and experience. (1)Antipsychotic medications treat the symptoms of the disorder, but do not cure schizophrenia. “These medications reduce the psychotic symptoms of schizophrenia and usually allow the patient to function more effectively and appropriately. Antipsychotic drugs appear to be the best treatment now available, but they do not cure schizophrenia or ensure that there will be no further psychotic episodes. The antipsychotic drugs include two major classes: dopamine receptor antagonists (for example: Chlorpromazine (Thorazine), haloperidol (Haldol), sulpiride) and serotonin-dopamine antagonists’ drugs (per example, risperidone (Risperdal) and clozapine (Clozaril)). Kaplan, S. & Sadock, B. (1998)
Genetic theories state that biology produces schizophrenia and environment alters its course. More specifically, genetic and other biological factors create various degrees of vulnerability to schizophrenia. Whether, and how severely, the predisposed individual Becomes schizophrenic depends on a mix of biological factors (e.g., severity of heredity, prenatal complications, or slow viruses). Genetic scientists believe that “some people inherit a biological predisposition to schizophrenia and, in accordance with a diathesis-stress model, come to develop the disorder when they are confronted by extreme stress, usually during early adulthood.” (Gottesman, 1991). Since schizophrenia tends to be familial, but does not follow a classical pattern of inheritance, the study of genetic factors in this disorder has been complicated. It is extremely unlikely that a single gene will ever be found that is responsible for all cases of schizophrenia in the population.
Another theory is based on psychosocial influences. The psychological view is based on the principle that “psychological factors are critical in the development of schizophrenia, (traumatic childhood experiences, intense negative intrafamiliar communication) substantially affect the extent of recovery; probability of relapse, overall quality of life, and the symbolic meaning attributed to the disorder.” Maxmen & Ward, (1995). The leading psychological explanations have come from the psychodynamic, behavioral, family, existential, and cognitive perspectives.
From the writings extracted from the classical text: the Caraka Samhita by R. K. Sharma and Bhagwan Dash, the causes of inanity are due to “having unhealthy foods which area spoiled, unaccustomed, contamined and using (food and drinks) improper manner; those who are dejected due to worry, grief, etc.), who are weak mind due to the effect of sudden increase of disease, emaciated persons indulging in activities in improper ways, doing mistakes in the method of worship, by doing sinful acts, loss of balance of mind, by the effects of strong poisons or weak poisons due to these reasons the doshas getting increased in the mind in persons of feeble mind, produces vitiation of the mind, and invading the manovaha shrotas channels of the mind / caused insanity”. Asthanga-Hrdaya of Vagbhta: the book eight branches of Ayurveda, (1994).
In current literatures, Dr. David Frawley describes that, “mental disorders are caused by emotional stress, poor upbringing, repressive religion, coming under the influence of disturbed individuals, sexual abuse or perversion, and taking drugs”. Frawley, (1989). Dr. Frawley further adds that metal illness are also caused by excess thinking or by the strain in yogic or meditation practices naively opening up to the influences the astral plane, and through occult methods”. He also states that “mental disorders, including schizophrenia are caused by a vitiation of sattva; that is, by a disturbance of the inherent clear quality of the mind. This occurs though excess rajas and tamas turbulence and darkness in the mind. Too much rajas involves excess of anger, hatred and fear, excessive nervousness, worry, and anxiety. Too much tamas involves excess sleep, dullness, apathy, inertia and the inability to perceive things as they are”. Frawley, (1996).
According to the Asthanga-Hydaya of Vagbhata insanity is a toxicity / disorder to the mind caused by dohas (vata, etc.) moving in the wrong paths due to their increase”. It also said that having unhealthy foods which are spoiled, unaccustomed, contamined and using (food and drinks) improper manner, those who are dejected due to worry, grief, etc.), who is weak mind due to the effect of sudden increase of disease, emaciated persons indulging in activities in improper ways, doing mistakes in the method of
worship, by doing sinful acts, loss of balance of mind, by the effects of strong poisons or weak poisons due to these reasons the doshas getting increased in the mind in persons of Feeble mind produces vitiation of the mind, and invading the manovaha shrotas channels Of the mind/ caused insanity”. All these corruptions causes the intelligence, understanding, and memory to go astray. Because of that, the body loses any sense of joy or sorrow, and wanders about purposelessly like a chariot which has lost its driver”.
According to ancient medical texts written by the first Ayurvedic physicians, There are six kinds of insanity that arise from each of the humors, from a conjunction of them, from mental anguish, and from poisoning. Regarding the development of mental illness, Ayurvedic physician’s states that “The corruption of certain mental and physical things can cause the inflammation of the humors in the heart of someone whose mental faculty is weakened. Next, it causes defilement of the intelligence, destruction of the pathways along which mind flows and, finally, insanity. Wujastyk, (1998).
Wind insanity: (vayu)
“Wind gives rise to the following: an emaciated body; inappropriate lamenting,
shouting, laughing, and smiling, as well as dancing, singing, playing music, talking,
posturing, bursting out; repeatedly and tunelessly imitating the sound of a flute, veena, or other instrument; frothing at the mouth; constantly wandering about; ceaseless talking; using things which are not ornaments as decoration; trying to travel on things which are not vehicles; being greedy for food, but spurning it once it has been obtained; bulging, Bloodshot eyes, and illness after foods had been digested.” Wajastic, (1998). Swami Sada Shiv Tirtha notes, “Vayu insanity is also caused by fasting or an excessive intake of dry or cold foods. This affects the heart and mind with worry, passion, and anger which results in distortion of memory and perceptions.” Swami Sada Shiv Tirtha, (1998).
Frawley states that when high vata, as excess ether, makes us ungrounded, spaced-out and unrealistic. We may have various wrong imaginations, hallucinations or delusions, like hearing voices. High vata in the mind manifests as fear, alienation, anxiety and possible nervous breakdown. There is insomnia, tremors, palpitations, unrest and rapid shifts of mood. Insanity of the manic depressive type or schizophrenia is an extreme vata imbalance”. Frawley, (1996).
Choler gives rise to threatening behavior, fury, and charging at people with fists stones,
and the like. The patient craves coolness shade, and water. He goes naked, and has a
yellow color. He sees thing which are not there, such as ire, flames, stars, and lamps.
Pitta insanity results from indigestion, excess of hot, pungent, sour, or burning foods and
liquids, excesses pitta afflict the heart of the person lacking self-control. Wajastic (1988).
Frawley notes that the “fire and heat of pitta cause the mind to be narrowed and contentious, fighting either with others or with themselves. High pitta in the mind causes agitation, irritation, anger, and possible violence. The overheated body and mind seek release in venting the build-up tension. Pitta types can become domineering, authoritarian or fanatic. When disturbed they many have paranoid delusions, delusion of grandeur or can become psychotic.” Frawley, (1996).
Phlegm causes the patient to lose any desire for food. It causes vomiting, and a reduction
in motivation, appetite, and conversation. It causes a lust for women. It causes the patient
to enjoy solitude. He dribbles mucus and snot, and is very frightening. He hates being
clean. He sleeps, and has puffy face. This insanity is stronger at night, and just after
eating. This is caused by the overeating and excessive use of oily foods. This is
aggravated kapha afflicts the heart, troubling the mind and memory. Wajastic, (1988)
Frawey stated that kapha type evolves attachment and lack of motivation lading to depression, sorrow, and clinging. The mind may be incapable of abstract, objective or impersonal thinking. There is lack of drive and motivation along with passivity and dependency”. Frawley (1996).
When there is a conjunction of all the sources of disease, and symptoms, then the
resulting insanity is dreadful. A physician should stay away from such a patient.
This caused by the excessed condition of all thee doshas. It is considered serious because
the therapies will aggravate one or more of the doshas. Therefore, this condition is
incurable. Wajastic, (1988).
Insanity cause by loss:
A person crushed by the unbearable loss of his possessions or of a loved one becomes
pale, depressed, and swoons frequently. “oh, oh” he groans. He wails for no reason. He
loses consciousness. He thinks a lot about the qualities of what he has lost. His mind is
Distraught with grief and he cannot sleep for worrying. He thrashes about. Wajastc, (1988).
Insanity caused by poison:
Poison makes the face dark the complexion, strength, and senses are all ruined. The
Patient is delirious even in between fits, and has bloodshot eyes. He should be avoided. Wajastic, (1988).
The primary method of treatment for these patients is the use of psychotropic medications, which aim to mitigate symptomology such as visual and auditory hallucinations, suicidal ideation, anxiety and depression. The proper treatment of schizophrenia may include a combination of different techniques.
Generally, medications for treating psychotic symptoms of schizophrenia are referred to as antipsychotic, or sometimes neuroleptics. Examples of standard antipsycotics include Thorazine, Mellaril, Modecate, Prolixin, Navane, Stelazine and Haldol. The newer antipsychotic drugs are called atypical antipsychotic medications are being used more and more frequently. They are called “atypical” because they do not have the same chemical profiles as standard medication and seem to work in a different way causing fewer side effects while helping patients to stabilize. Examples include Risperdone, Clozaril, Zyprexa and Seroquel. Most patients have to take medication regularly to keep their illness under control. It is not possible to know in advance which medication will work best for an individual. Many medication adjustments may be required. This period of trial and error can be very difficult for everyone involved. Some medications have unpleasant side effects such as dry mouth, drowsiness, stiffness, restlessness, muscle spasms, tremor, and blurring vision.
I have also observed that even patients who respond well to psychotropic medication continue to have secondary symptoms such as lethargy, disinterest, excessive sleep, lack of spontaneous emotions and other symptoms of relapse. In addition, patients often develop multiple medication adverse effect, but these can be corrected by lowering the dosage or controlled by other medications. Different patients have different treatment responses and side effects to various antipsychotic drugs.
“Other biological therapies such as electroconvulsive therapy, although less effective than antipsychotic drugs, may be indicated for catatonic patients and for patients who for some reason cannot take antipyshcoitc drugs. In the past, schizophrenia was treated with insulin and barbirute-induced coma, but these treatments are no longer used because of the associated hazards. Psychosurgery, particularly frontal lobotomy, was used from 1935 to 1955, and is no longer considered an appropriate treatment.”
Kaplan, S. (1998).
Although antipsychotic medications are the mainstay of the treatment for schizophrenia, research has found that psychosocial interventions can increase the clinical status. One of the main modalities used in psychosocial therapies is behavioral therapy. This therapy uses techniques such as token economies and social skills training to increase social abilities, self-sufficiency, practical skills, and interpersonal communication. Skills-based programs can lead to an improvement in life functioning and the subsequent discharge of people with schizophrenia who have had long-term stays in psychiatric facilities.
Cognitive therapy is used to improve cognitive distortions, reduce distractibility, and correct errors in judgment. Group therapy focuses on real life plans, problems, and relationships. “Because patients with schizophrenia frequently become ill during the critical career forming years of life (e.g., ages 18 to 35), they are less likely to complete the training required for skilled work. As a result, many suffer with lack of social and work skills and experience as well.” (www.nimh.gov). Rehabilitation programs emphasize social and vocational training to help patients and former patients to overcome difficulties in these areas. These programs include vocational counseling, job training, problem solving, money management skills, use of transportation, and social/communication skills training.
Although schizophrenia is not yet a “curable” disease, the treatment for this illness is more effective today than ever before, largely because of the careful thinking and research that has gone into it. The most successful treatment programs are the ones that use a multimodal approach. They use the proper treatment of schizophrenia that includes the following: medication, education, family counseling, residential and rehabilitation programs, self-help groups, nutrition, rest and exercise.
Ayurvedic medicine is a holistic system of medicine that treats mental disorders from mild stress to severe condition, including insanity (psychosis). “Ayurveda employs whole series of yogi and spiritual therapies, including meditation, pranayama, mantra, prayers, visualizations, and rituals called “spiritual therapy” (daiva cikitsa).’ Frawley, (1998).
Ayurvedic’s treatments methods first works on balancing the biological humors through appropriate physical remedial methods of diet, herbs, and exercise. One of the best Ayurvedic’s treatment for schizophrenia includes panchakarma chikitsa. Some Ayurvedic formulations are Mahakalyanak ghrita, Vachadi churna, Purana ghrita, and Saraswatharistha. According to Frawley, all psychological disorders, including psychotic disorders reflect imbalances of the three biological humors. He says, “Health problems, whether physical or mental, are not merely personal problems, but energetic problems in the mind-body complex. They are not so much personal or moral failings as an inability to harmonize the forces within us” Frawley (1996). The imbalances caused by the lack or harmony in our lives weaken the doshas that afflict the heart where there is less sattwa in ones’s life and the mind. The disease develops through the manovaha srota that sends psychic energy to the mind”
Frawley reports that for mental disorders, including schizophrenia treatments are similar that neurosis type and Pancha karma treatment is recommended as a stronger method.
Vata type insanity: Dr. Frawley states that nourishing and sedating herbs are required, especially ashwagandha and its various preparations. Sarpagandha, rauwolfia serpentine, is an important ayurvedic herb for mental disorders. Other good herbs include valerian, guggul, jatamansi and calamus. Other therapies recommended are oil and ghee therapies, including oil enemas. Oil and ghee if the air passages are not blocked and laxatives which are given with the oils and ghee to remove the blocks.
Pitta type Insanity: purgation is recommended, even with strong purgatives, is often helpful. The more violent type, the more purgation is required. Good herbs for this include rhubarb root, senna and aloe. Gotu kola is generally the best herb others are bhringaraj, sandalwood and passion flower. Shatavari is good for promoting a sense of love and compassion and is better for weaker pitta types. Also, oleation and fomentation therapies are recommended, then purgatives, followed by emetics. Also, medicated enemas evacuation from the head with jatamashi and gotu kola.
Kaph type insanity: is recommended spicy brain-stimulating herbs. The treatment is mainly expectorant, to clear phlegm from blocking the channels and obstructing mental functioning. Important herbs are calamus, basil, bayberry, sage, myrrh, and guggul, which have good expectorant action. Other formulas include trikatu with ghee or calams ghee.
Other miscellaneous therapies describe in current Ayurvedic texts include, Abhyanga, shirodhara, shirobasti, ghee to stimulate the mind, intellect, memory and consciousness; and applying thick ointments. In addition, other Ayurvedic treatments recommend different kinds of nasal medicines mixed with mustard and oil. It is also recommended face and head massage with mustard oil and the inhalation of mustard powder. Other more intrusive treatments recommended were bloodletting and shock treatment. Some alternative treatments recommended for the insanity by the first Ayurvedic physicians were to help the patient’s mind to become still by throwing the patient into a dry well and keep him hungry until he/she is emaciated; send a policemen to grab the patient and take the patient outside and intimidate him/her with corporal punishment, and threatening him/her in the name of the king; terrify the patient with name lions, elephants or snakes whose fangs have been drawn or with knives in one’s hands or with tribesman, enemies, or robbers; tie the patient up, flog him and then cast him/her into a pit or into a completely dark room which has no knives, stones, or people in it; and to friend may comfort the patient with conversations that inculcated virtue and profits; “ Wujastic, (1998).
1. brahmi ghee-( 4 days worth).
Ingredients: Brahmi- 50 mgs., shankha pushpin-50 mgs., Ashwagandha-50 mgs., jatamanshi 50 mgs., and Ghee -100 mgs. Dose: 1 tsp. 2 times daily.
Preparation: make a paste from the herbs and roll into a ball, boil the ghee and add the paste and cook for1/2 hour, and filter. Swami Sada Shiva irtha (1998).
2. Cow’s urine potion:
“Cow’s urine is cooked in about three kilograms of ghee, together with about 200 grams of asofoetida, dark salt, and a mixture of black pepper, long pepper and dried ginger this is the best thing for banishing insanity” Wajastic, (1998 ).
In the current body of literature, Dr. Marc Halpern writes, “All mental disease originates in a lack of clarity (sattwa) within the mind”. He adds, “The primary goal of spiritual healing is the cultivation of sattwa through proper lifestyle and through all five senses”. In addition, Dr. Halpern points out that some general principles are needed to heal the mind, including spending more time in nature, mediation practices, and yoga (8 limbs). He also adds that avoiding the influence of the media and eating a sattvic diet helps to restore the mind. Finally, it is also recommended to increase ojas and balance prana, tejas.
As noted by Psychiatric professionals, schizophrenia is not yet a “curable” disease, but the treatment for this illness is more effective today than ever before, largely because of the careful thinking and research that has gone into its main treatment method, antipsychotic medication. However, it is well known the multiple short and long-term mental and physical side effects caused by anti-psychotic medication. Some of the of the “less serious” side effects include dry mouth, diarrhea, constipation, cough, and blurry vision. And some of the more serious long term side effects include, tardive dyskinesia, low white blood cell count, neuroleptic malignant syndrome, memory loss, uncontrollable body movements, unexplained muscle weakness, suicidal thoughts, liver failure, diabetes, weight gain, digestive problems, heart disease, sexual dysfunction, degenerative disorders, among others. I believe the most successful treatment approaches are the ones that use a multimodal and holistic approach.
Ayurvedic medicine can be of great assistance to the treatment of people suffering from schizophrenia and other psychotic disorders. In addition to all the therapies described above, Ayurvedic Medicine employs a whole series of Yogic and spiritual therapies not yet explored by Western approaches for the treatment of mental illness. Some of these spiritual therapies include meditation, pranayanma, mantra, prayer, and visualizations besides its regular physical healing means and modalities to treat mental conditions such as herbal medicine, education, yoga, diet/nutrition, aromatherapy, and color therapy.
Unfortunately, Ayurvedic medicine is not totally yet incorporated as a complementary therapy to the treatment of mental disorder by Western Medical establishment. Although Western treatment methods for the treatment of schizophrenia are more effective today, still there is no cure and not a single effective Western treatment method for schizophrenia. Most of the western methods are more focused on improving their quality of life, minimize symptoms, prevent suicide, avert relapses, enhance the patient’s self- esteem, and to improve social and occupational functioning. In addition, Psychiatric treatment methods are to stabilize the patient’s symptoms, reduce the need for psychiatric hospitalizations and to increase the patient’s social and independent living skills. Unfortunately there is no scientific research done on Ayurvedic treatment for schizophrenia that can validate the effectiveness of its treatment methods. Finally, Ayurvedic medicine offers a great hope for people with psychotic disorders that can help them to live a more balanced life. As noted by Frawley, “Ayurveda teaches harmony with nature, simplicity and contentment as the keys to well being. Ayurveda shows us how to live in a state of balance in which fulfillment in a matter of being, not becoming. It connects us with the wellsprings of creativity and happiness within our own consciousness, so that we can permanently overcome our psychological problems”. Frawley, (1998).
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