AYURVEDA : ANCIENT WISDOM FOR MODERN PSYCHIATRY Sudha Prathikanti, MD University of California, San...
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Transcript of AYURVEDA : ANCIENT WISDOM FOR MODERN PSYCHIATRY Sudha Prathikanti, MD University of California, San...
AYURVEDA : ANCIENT WISDOM
FOR MODERN PSYCHIATRY
Sudha Prathikanti, MDUniversity of California, San Francisco
www,prathikanti.com/teaching
AYURVEDA:AYURVEDA:SCIENCE OF LIVINGSCIENCE OF LIVING
COSMOS
VATA PITTA KAPHA
moves transforms binds
SPACE AIR FIRE WATER EARTHFIVE GREAT BHUTAS
THREE GREAT DOSHAS
AYURVEDA: AYURVEDA: THE THREE GREAT DOSHASTHE THREE GREAT DOSHAS
Each dosha has specific expression Each dosha has specific expression in every dimension of human being:in every dimension of human being:
Vata moves ---> body, mind, subtle energyVata moves ---> body, mind, subtle energy
Pitta heats ----> body, mind, subtle energy Pitta heats ----> body, mind, subtle energy
Kapha binds ---> body, mind, subtle energyKapha binds ---> body, mind, subtle energy
..
There is implicit and explicit understanding that There is implicit and explicit understanding that
body, mind and spirit are manifestations of the same life-force.body, mind and spirit are manifestations of the same life-force.
AYURVEDA:AYURVEDA:IMPORTANCE OF INDIVIDUAL CONSTITUTIONIMPORTANCE OF INDIVIDUAL CONSTITUTION
Each person has unique Each person has unique constitution of 3 doshas constitution of 3 doshas
Constitution ascertainedConstitution ascertainedthru careful history & examthru careful history & exam
PulsePulse Body Build & WeightBody Build & Weight Tongue, Skin, Hair, NailsTongue, Skin, Hair, Nails CirculationCirculation Climate ToleranceClimate Tolerance
Speech / Motor ActivitySpeech / Motor Activity Emotional TendenciesEmotional Tendencies Memory & CognitionMemory & Cognition Eating / Elimination PatternsEating / Elimination Patterns Sleeping PatternsSleeping Patterns
..
VATAVATA
Lean, bony buildLean, bony buildRapid walk and talkRapid walk and talkErratic appetite & staminaErratic appetite & staminaSensitive to wind & coldSensitive to wind & cold
Quick, flexible mindQuick, flexible mindLearn fast, forget fastLearn fast, forget fastLess willpower, resolveLess willpower, resolveEasily anxious, unsettledEasily anxious, unsettled
Respond well to:Respond well to:Regular, long sleepRegular, long sleepFrequent meals: warm & richFrequent meals: warm & richWarm, moist climateWarm, moist climate
..
PITTAPITTA
Medium buildMedium buildForceful walk & talkForceful walk & talkStrong appetite & staminaStrong appetite & staminaSensitive to heatSensitive to heat
Sharp, penetrating mindSharp, penetrating mindLike to plan & leadLike to plan & leadGreat willpower, resolveGreat willpower, resolveEasily irritable, competitiveEasily irritable, competitive
Respond well to:Respond well to:Moderate sleepModerate sleepRegular meals: cool & sweet Regular meals: cool & sweet Cool climateCool climate
AYURVEDA: CONSTITUTIONAL TYPESAYURVEDA: CONSTITUTIONAL TYPES
..
KAPHAKAPHA
Large, hefty buildLarge, hefty buildSlow walk and talkSlow walk and talkSteady appetite & staminaSteady appetite & staminaSensitive to fog & coldSensitive to fog & cold
Deliberate, steady mindDeliberate, steady mindLearn slowly, good memoryLearn slowly, good memoryComplacent, forgivingComplacent, forgivingEasily depressed, clingyEasily depressed, clingy
Respond well to:Respond well to:Less sleepLess sleepFewer meals: light & spicy Fewer meals: light & spicy Warm, dry climateWarm, dry climate
AYURVEDA:AYURVEDA:HEALTH AS HARMONIOUS LIVINGHEALTH AS HARMONIOUS LIVING
Health: Health: living in balance living in balance with basic constitutionwith basic constitution
Illness: Illness: living out of balance living out of balance with basic constitutionwith basic constitution
..
VATA EXCESSVATA EXCESS
-- Significant anxiety -- Significant anxiety -- Insomnia-- Insomnia-- Anorexia-- Anorexia-- Weight loss-- Weight loss-- Motor agitation-- Motor agitation-- Compulsive talking-- Compulsive talking
KAPHA EXCESSKAPHA EXCESS
-- Profound anhedonia-- Profound anhedonia-- Hypersomnia-- Hypersomnia-- Hyperphagia-- Hyperphagia-- Weight Gain-- Weight Gain-- Apathy & Listlessness-- Apathy & Listlessness-- Paucity of speech-- Paucity of speech
AYURVEDA: AYURVEDA: DEPRESSION ASDEPRESSION ASDOSHA IMBALANCEDOSHA IMBALANCE
AYURVEDA:AYURVEDA:REMEDIES FOR DOSHA IMBALANCEREMEDIES FOR DOSHA IMBALANCE
Purification Procedures Purification Procedures Food & SpicesFood & SpicesHerbal MedicineHerbal MedicineHerbal Massage & BathHerbal Massage & BathYoga Asanas & ExerciseYoga Asanas & ExercisePranayamaPranayamaMeditationMeditationSensory ExperienceSensory ExperienceSocial ExperienceSocial ExperienceAttention to Nature Attention to Nature
TimeTime ClimateClimate EnvironmentEnvironment
Dosha-correcting remedies may be applied to every dimension, Dosha-correcting remedies may be applied to every dimension, not just dimension where symptoms manifestnot just dimension where symptoms manifest
EVIDENCE BASE FOR AYURVEDIC EVIDENCE BASE FOR AYURVEDIC REMEDIES IN PSYCHIATRYREMEDIES IN PSYCHIATRY
PANCHAKARMAPANCHAKARMA
HERBSHERBS
HATHA YOGAHATHA YOGA
MEDITATIONMEDITATION
AYURVEDA RESEARCHAYURVEDA RESEARCH WORLDWIDE WORLDWIDE
India BritainGermanyAustralia
Photo 6Photo 6
Steam chamberSteam chamber
PANCHAKARMA:ABHYANGA &SVEDANA
PANCHAKARMA:SHIRODARA
Photo 4Photo 4 PANCHAKARMA:NASYA
PANCHAKARMA STUDIESPANCHAKARMA STUDIES
Open controlled trial: Normal subjects undergoing Open controlled trial: Normal subjects undergoing panchakarma had reduction in depression, anxiety, panchakarma had reduction in depression, anxiety, overall distress compared to subjects taking didactic overall distress compared to subjects taking didactic classes (classes (Schneider, Cavanaughet et al 1990))
Open controlled trial: Subjects with Parkinson’s Open controlled trial: Subjects with Parkinson’s Disease receiving both panchakarma and an Disease receiving both panchakarma and an Ayurvedic herbal remedy exhibited more Ayurvedic herbal remedy exhibited more improvement in neurological symptoms than did a improvement in neurological symptoms than did a small control group receiving only the herbal remedy. small control group receiving only the herbal remedy. (Nagashayana, (Nagashayana, Sankarankutty, et al 2000).Sankarankutty, et al 2000).
Many other panchakarma studies for medical Many other panchakarma studies for medical conditions are summarized in “Scientific Basis for conditions are summarized in “Scientific Basis for Ayurvedic Therapies” by Lakshmi Mishra (CRC Ayurvedic Therapies” by Lakshmi Mishra (CRC Press: 2003)Press: 2003)
Photo 5Photo 5
AYURVEDIC HERBS
PSYCHOTROPIC HERBS IN AYURVEDAPSYCHOTROPIC HERBS IN AYURVEDA
Bacopa MonnieraWithania somnifera
Valeriana jatamansi
Convolvulus pluricaulis
Rauwolfia serpentina Centella asiatica
Mandukparni
Jatamansi
Sarpagandha
AshwagandhaShankpushpi
Brahmi
Antipsychotic Effect
-- Rauwolfia * -- Centella (in polyherbal) Anxiolytic Effect
-- Valeriana -- Centella* -- Withania -- Convolvulus -- Bacopa *
Antidepressant Effect
--- Withania --- Convolvulus
Soporific Effect
-- Valeriana * -- Centella (in polyherbal)
Cognitive Enhancement
-- Centella* -- Withania * -- Convolvulus -- Bacopa *
SAFETY ISSUES WITH AYURVEDIC RMEDIESSAFETY ISSUES WITH AYURVEDIC RMEDIES
Mass Production Mass Production
Over-the-counter AvailabilityOver-the-counter Availability
Plant ContaminantsPlant Contaminants
Misidentification of HerbsMisidentification of Herbs
Circumventing De-toxificationCircumventing De-toxification Unorthodox CombinationsUnorthodox Combinations
Herb-Drug InteractionsHerb-Drug Interactions
HATHA YOGAHATHA YOGA
Randomized controlled trialsRandomized controlled trials Pranayama + asana reduces symptoms in Pranayama + asana reduces symptoms in
depressed college students depressed college students Pranayama equivalent to tricyclic in treating Pranayama equivalent to tricyclic in treating
depressed psych inpatientsdepressed psych inpatients Hatha yoga + methadone equivalent to Hatha yoga + methadone equivalent to
psychotherapy + methadone in reducing psychotherapy + methadone in reducing relapse in opiate usersrelapse in opiate users
Yoga breathing improves spatial memory Yoga breathing improves spatial memory learning in normal schoolchildrenlearning in normal schoolchildren
Hatha yoga reduces anxiety & depression Hatha yoga reduces anxiety & depression in normal adultsin normal adults
Non-randomized controlled trialsNon-randomized controlled trials Hatha yoga equivalent to swimming in Hatha yoga equivalent to swimming in
producing mood benefits in women, may producing mood benefits in women, may be superior to swimming in menbe superior to swimming in men
Hatha yoga superior to muscle relaxation and Hatha yoga superior to muscle relaxation and visualization in improving mood and alertnessvisualization in improving mood and alertness
Hatha yoga related to higher life satisfaction, Hatha yoga related to higher life satisfaction, better overall mood, better coping with stressbetter overall mood, better coping with stress
MEDITATIONMEDITATION
Chronic anxiety (TM, MBSR)Chronic anxiety (TM, MBSR) Chronic pain (RR, MBSR)Chronic pain (RR, MBSR) Chronic insomnia (RR)Chronic insomnia (RR) Recurrent Depression (MBSR)Recurrent Depression (MBSR) Overall emotional well-being Overall emotional well-being
(RR, MBSR)(RR, MBSR) Less anxiety and depressionLess anxiety and depression Increased sense of controlIncreased sense of control Increased empathy Increased empathy
INTEGRATIVE MEDICINE:INTEGRATIVE MEDICINE:THE BEST OF BOTH WORLDSTHE BEST OF BOTH WORLDS
Integrative Medicine might restore the soul to medicine…
the soul being that part of us that is most important but the least easy to delineate.
Richard Smith
British Medical Journal January 2001