Diploma Ayurvedic Practitioners Course Module 7 30 st& 31 ...€¦ · high blood pressure stroke...

Diploma

Ayurvedic Practitioners Course

Module 7

30th & 31st March 2019

Course Materials

AYURVEDA INSTITUTE UK

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Madathya (Alcoholism)

&

Unmadha (Mental Disorder)

Madathya (alcoholism) – the allopathic perspective


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The following italicized passages are taken from the NHS online service which provides information and advice to the public on the causes, symptoms and treatment of these disorders. It is useful to review the allopathic understanding of the disorder and the approach taken to treatment both for comparative purposes and in order to better explain to the patient. Please note that not all information provided is replicated here.

Overview Alcohol misuse means drinking excessively – more than the lower-risk limits of alcohol consumption. Alcohol consumption is measured in units. A unit of alcohol is 10ml of pure alcohol, which is about:

half a pint of normal-strength lager a single measure (25ml) of spirits A small glass (125ml) of wine contains about 1.5 units of alcohol.

Lower-risk limits To keep your risk of alcohol-related harm low, the NHS recommends:

not regularly drinking more than 14 units of alcohol a week if you drink as much as 14 units a week, it's best to spread this evenly over three or more days if you're trying to reduce the amount of alcohol you drink, it's a good idea to have several alcohol-

free days each week Risks of alcohol misuse Short-term The short-term risks of alcohol misuse include:

accidents and injuries requiring hospital treatment violent behaviour and being a victim of violence unprotected sex, unplanned pregnancy or sexually transmitted infections (STIs) loss of personal possessions, such as wallets, keys or mobile phones alcohol poisoning – this may lead to vomiting, seizures (fits) and falling unconscious

Long-term Persistent alcohol misuse increases your risk of serious health conditions, including:

heart disease stroke liver disease liver cancer and bowel cancer mouth cancer pancreatitis

As well as causing serious health problems, long-term alcohol misuse can lead to social problems, such as unemployment, divorce, domestic abuse and homelessness.

Dependent drinking / alcoholism


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If someone loses control over their drinking and has an excessive desire to drink, it's known as dependent drinking (alcoholism). Severely dependent drinkers are often able to tolerate very high levels of alcohol in amounts that would dangerously affect or even kill some people. A dependent drinker usually experiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including:

hand tremors – "the shakes" sweating seeing things that aren't real (visual hallucinations) depression anxiety difficulty sleeping (insomnia)

This often leads to "relief drinking" to avoid withdrawal symptoms. Am I drinking too much alcohol? You could be misusing alcohol if:

you feel you should cut down on your drinking other people have been criticising your drinking you feel guilty or bad about your drinking you need a drink first thing in the morning to steady your nerves or get rid of a hangover you are sometimes unable to remember what happened the night before because of drinking you fail to do what was expected of you as a result of drinking – for example, missing an

appointment or work Getting help If you're concerned about your drinking or someone else's, a good first step is to visit your GP. They'll be able to discuss the services and treatments available. Your alcohol intake may be assessed using tests, such as the:

Alcohol Use Disorders Identification Test (PDF, 224kb) – a widely used screening test that can help determine whether you need to change your drinking habits

Fast Alcohol Screening Test – a simpler test to check whether your drinking has reached dangerous levels

Severity of Alcohol Dependence Questionnaire – this helps identify how severely dependent on alcohol you may be As well as the NHS, there are a number of charities and support groups across the UK that provide support and advice for people with an alcohol misuse problem. For example, you may want to contact:

Alcohol Concern – runs the national drink helpline, Drinkline on 0300 123 1110 Alcoholics Anonymous – helpline 0845 769 7555 Al-Anon Family Groups – helpline 020 7403 0888

Treating alcohol misuse How alcohol misuse is treated depends on how much alcohol a person is drinking. Treatment options include:

counselling – including self-help groups and talking therapies, such as cognitive behavioural therapy (CBT)

medication


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detoxification – this involves a nurse or doctor supporting you to safely stop drinking; this can be done by helping you slowly cut down over time or by giving you medicines to prevent withdrawal symptoms There are two main types of medicines to help people stop drinking. The first is to help stop withdrawal symptoms, and is given in reducing doses over a short period of time. The most common of these medicines is chlordiazapoxide (Librium). The second is a medication to reduce any urge you may have to drink. The most common medications used for this are acamprosate and naltrexone. These are both given at a fixed dose, and you'll usually be on them for 6 to 12 months. Risks Alcohol is a powerful chemical that can have a wide range of adverse effects on almost every part of your body, including your brain, bones and heart. Alcohol and its associated risks can have both short-term and long-term effects. Short-term effects of alcohol consumption 1-2 units After drinking 1-2 units of alcohol, your heart rate speeds up and your blood vessels expand, giving you the warm, sociable and talkative feeling associated with moderate drinking. 4-6 units After drinking 4-6 units of alcohol, your brain and nervous system starts to be affected. It begins to affect the part of your brain associated with judgement and decision making, causing you to be more reckless and uninhibited. The alcohol also impairs the cells in your nervous system, making you feel light-headed and adversely affecting your reaction time and co-ordination. 8-9 units After drinking 8-9 units of alcohol, your reaction times will be much slower, your speech will begin to slur and your vision will begin to lose focus. Your liver, which filters alcohol out of your body, will be unable to remove all of the alcohol overnight, so it's likely you'll wake with a hangover. 10-12 units After drinking 10-12 units of alcohol, your co-ordination will be highly impaired, placing you at serious risk of having an accident. The high level of alcohol has a depressant effect on both your mind and body, which makes you drowsy. This amount of alcohol will begin to reach toxic (poisonous) levels. Your body attempts to quickly pass out the alcohol in your urine. This will leave you feeling badly dehydrated in the morning, which may cause a severe headache. The excess amount of alcohol in your system can also upset your digestion, leading to symptoms of nausea, vomiting, diarrhoea and indigestion. More than 12 units If you drink more than 12 units of alcohol, you're at considerable risk of developing alcohol poisoning, particularly if you're drinking many units over a short period of time. It usually takes the liver about an hour to remove one unit of alcohol from the body. Alcohol poisoning occurs when excessive amounts of alcohol start to interfere with the body's automatic functions, such as:

breathing


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heart rate gag reflex, which prevents you choking

Alcohol poisoning can cause a person to fall into a coma and could lead to their death. Long-term effects of alcohol misuse Drinking large amounts of alcohol for many years will take its toll on many of the body's organs and may cause organ damage. Organs known to be damaged by long-term alcohol misuse include the brain and nervous system, heart, liver and pancreas. Heavy drinking can also increase your blood pressure and blood cholesterol levels, both of which are major risk factors for heart attacks and strokes. Long-term alcohol misuse can weaken your immune system, making you more vulnerable to serious infections. It can also weaken your bones, placing you at greater risk of fracturing or breaking them. There are many long-term health risks associated with alcohol misuse. They include:

high blood pressure stroke pancreatitis liver disease liver cancer mouth cancer head and neck cancer breast cancer bowel cancer depression dementia sexual problems, such as impotence or premature ejaculation infertility

Treatment The treatment options for alcohol misuse depend on the extent of your drinking and whether you're trying to drink less (moderation) or give up drinking completely (abstinence). Treatment can be:

brief intervention moderation vs abstinence detox and withdrawal symptoms medication for alcohol dependency therapy for alcohol dependency

Brief intervention A short counselling session which lasts about 5 to 10 minutes, and covers risks associated with your pattern of drinking, advice about reducing the amount you drink, alcohol support networks available to you, and any emotional issues around your drinking. Keeping a "drinking diary" may be recommended. Moderation vs abstinence Moderation or abstinence are treatment options if you're:

regularly drinking more than the lower-risk daily levels of alcohol – 14 units a week experiencing health problems directly related to alcohol


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unable to function without alcohol (alcohol dependency) Cutting alcohol out completely will have a greater health benefit. However, moderation is often a more realistic goal, or at least a first step on the way to abstinence. Detox and withdrawal symptoms Some people may be prescribed medication to help achieve abstinence. You may also choose to attend self-help groups, receive extended counselling, or use a talking therapy such as cognitive behavioural therapy (CBT). You may be able to detox at home with medication to help ease withdrawal symptoms. A tranquiliser called chlordiazepoxide is usually used for this purpose. If your dependency is severe, you may need to go to a hospital or clinic to detox. Medication for alcohol dependency A number of medications are recommended by the National Institute for Health and Care Excellence (NICE) to treat alcohol misuse. These include:

acamprosate disulfiram naltrexone nalmefene

These medications are discussed in more detail below. Acamprosate Acamprosate (brand name Campral) is used to help prevent a relapse in people who have successfully achieved abstinence from alcohol. It's usually used in combination with counselling to reduce alcohol craving. Acamprosate works by affecting levels of a chemical in the brain called gamma-amino-butyric acid (GABA). GABA is thought to be partly responsible for inducing a craving for alcohol. If you're prescribed acamprosate, the course usually starts as soon as you begin withdrawal from alcohol and can last for up to six months. Disulfiram Disulfiram (brand name Antabuse) can be used if you're trying to achieve abstinence but are concerned you may relapse, or if you've had previous relapses. Disulfiram works by deterring you from drinking by causing unpleasant physical reactions if you drink alcohol. These can include:

nausea chest pain vomiting dizziness

Naltrexone Naltrexone can be used to prevent a relapse or limit the amount of alcohol someone drinks. It works by blocking opioid receptors in the body, stopping the effects of alcohol. It's usually used in combination with other medicine or counselling. Nalmefene Nalmefene (brand name Selincro) may be used to prevent a relapse or limit the amount of alcohol someone drinks. It works by blocking opioid receptors in the brain, which reduces cravings for alcohol. Therapy for alcohol dependency Many people who have alcohol dependency problems find it useful to attend self-help groups, such as Alcoholics Anonymous (AA).


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One of the main beliefs behind AA is that alcoholic dependence is a long-term, progressive illness and total abstinence is the only solution. The treatment plan promoted by AA is based on a 12-step programme designed to help you overcome your addiction. Cognitive behavioural therapy (CBT) Cognitive behavioural therapy (CBT) is a talking therapy that uses a problem-solving approach to alcohol dependence.


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Madathya (alcoholism) – the Ayurvedic perspective

Stages of alcohol consumption:

Panatya (excessive)

Paramadha (hangover)

Panajeerna (adverse effect)

Pana vibhram (loss of consciousness)

Why people drink alcohol – ‘Nidhana’

If a person feels a need to drink, it can indicate an undernourished mental or physical

capability. If a person is content and happy, then they generally don’t feel any need to drink.

Emotions experienced when alcohol is consumed:

1. Sadness

2. Happiness (alcohol is consumed to gain more happiness)

3. Anxiety

4. Anger

5. Frustration

6. Loss / gain

7. Guilt

8. Strength

9. Silly / mad

10. Celebrate love (alcohol is consumed to enhance the feeling of love)

Attributes (guna) of alcohol

Alcohol has 10 gunas in common with poison and at the same time, it has the opposite gunas

of ojas.


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Gunas of alcohol:

1. Laghu – light

2. Ushna – hot

3. Tikshna – sharp

4. Sukshma – subtle

5. Amla – astringent (acidic)

6. Vishadha – dry

7. Ashukara – penetrating

8. Ruksha – rough

9. Vikashi - spreading

10. Vishra – acidic / foul

Gunas of ojas:

1. Guru – heavy

2. Sheeta – cool

3. Mrudu – soft

4. Slakshna - gentle

5. Bahala - not penetrating / dense

6. Madura – sweet

7. Stira – static

8. Prasanna – pleasant

9. Pichchila – oily / soft / alkaline

10. Snigdha – oily

Effects of alcohol on dosha

Vata


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Pitta

Kapha

Nothing else in the world can equally aggravate all three dosha simultaneously:

- Light, penetrating (chalu), rough and subtle qualities of alcohol aggravate vata

- Hot, sharp, liquid, oily qualities of alcohol aggravate pitta

- The sharp, penetrating and liquid quality of alcohol has an effect on the binding quality

of earth and water elements and begins to loosen it. As a result, kapha is also

aggravated

When every dosha is aggravated in the body at the same time, it gives an immediate feeling

of uplift. The feeling of uplift mirrors the individual constitution:

Vata - - seeking virya (strength / courage)

Pitta - - seeking shakti (control / energy)

Kapha - seeking soma (love / connection)

We might ask, if alcohol gives strength, power and connection / affection, why is it considered

to be bad? In the Charaka Samhita, it is explained that in the process of evolution, God gifted

to human beings glimpses of divine satisfaction so that they may feel a touch of heaven.

These are:

Alcohol – nectar or ambrosia

Orgasm – mythyna

This is the reason why alcohol and sexual connection are often experienced together. Their

co-dependency is needed to create the maximum satisfaction, to feel heaven or feel like God.

However, just as with other divine gifts, humans are able to misuse and mistake the good will


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given to us and cross the line. Once misused, it drags the person straight to hell. Most people

manage to get a touch of feeling heaven and then they feel their descent into hell!

The correct dose of alcohol uplifts the tridosha and hence the person feels uplifted or light or

as if they are flying. However, with kapha dosha, alcohol dismantles its bhutas (elements of

earth and water). This results in a feeling of heaviness or tamasic qualities. In this way, the

person feels heavy and gravitates towards the earth more. It makes the body weight feel

heavier and unable to function normally.

Samprapti

Because alcohol has the opposite quality (gunas) of ojas, when it is consumed, it immediately

affects the heart and stimulates the ojas and its pathway. This includes the heart and 10

vessels (rasa and rakta dhatu and prana vaha srotas and buddhi indriya).

Alcohol

OJAS

HEART

+ 10 vessels PRANA

BUDDHI

(consciousness)


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The first stage of consuming alcohol is represented in this diagram

The effect of excess alcohol is to arrest the ojas (overcome)

Signs / symptoms of the first stage (pratama madha)

- Happiness

- Satisfaction

Signs / symptoms of the second stage (madya madha)

- The stimulated ojas begins to lose its strength

- The toxic qualities of alcohol begin to appear with below qualities

o Intoxication

o Loss of intelligence

o Loss of memory

o Loss of speech

o Behaviour beginning to change

o Restlessness

o Talking nonsense

Rasa Dhatu (Preenana /

Satisfaction)

Stimulate

Life

Stimulate Wisdom &

creativity

Rakta Dhatu

Jeevan (Life)


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o Lunatic behaviour

o Induces sleep / laziness and feeling floppy

Many people stop at this stage feeling ok and relaxed.

Signs / symptoms of the third and fourth stages

The third stage is the stage in which pitta in induced. Rajas guna is provoked and results in

the person becoming more agitated and angry. There is a tendency towards arguments or

fights in this stage.

In the fourth stage the person is unable to stand upright because the tamas guna is

aggravated, making the person lose balance hence he wanting to lie down. In this stage the

person can lose consciousness completely. In this stage they are capable of doing bad or

immoral things, lose their sense of right or wrong in the mind.

Panatya – chronic alcoholism

When a person is addicted to alcohol some symptoms remain apparent whether they are

consuming alcohol or not at a particular time.

Vata

Hiccups

Dyspnea

Tremors of the head

Shakiness

Pain

Insomnia

Severe delirium


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Illusions

Anxiety

Pitta

Thirst

Burning sensation

Feeling extremely hot

Fever

Sweating

Fainting

Diarrhoea

Vertigo

Red / greenish colour of the body

Red eyes

Anger

Frustration

Kapha

Vomiting

Anorexia (loss of appetite)

Nausea

Drowsiness

Sensation of body covered with a wet cloth

Depression

Madathya is a result of all three dosha imbalanced. Hence any of those symptoms can appear

according to the constitution of the person.


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Poor prognosis

When a person displays the signs and symptoms below, the prognosis is poor and the disorder

is difficult to cure

Drooping upper lip

Body has become very cold

Facial skin has oily / radiant / red colouring

Tongue, lips and teeth are blackened

Eyes are yellow

Complications of alcoholism

Fever

Hiccups

Trembling

Pain and cough

Congestion

Cirrhosis

Chest pain

Advantages of alcohol

It is considered to be rejuvenating and detoxifying for the body

If alcohol is consumed according to the individual constitution, in the correct

dosage, with the correct food and in the correct company it can have a positive

effect on the body

The beneficial effects of alcohol consumed in the correct way

Balances the digestive fire (agni deepana)


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Encourage expression of emotions

Enhances the voice

Enhances the colour and texture of the skin

Pleasant appearance

Rejuvenative

Eliminate fear, anxiety, shyness

Eliminate sadness, guilt and create happiness

Induce good sleep

Eliminates toxins

Increases libido and sexual health

Jarahara (rejuvenates and virility and removes old age)

Considerations when drinking alcohol

Constitution

Strength (bala) – youth, middle age, old age

Health – mrudu - weak, madya - medium, daruna - strong

Kala - season – sheeta - cold, ushna - heat, varsha - rainy

Manas dosha – sattva, rajas, tamas

Before administering alcohol the considerations above are to be taken into account.

Chikitsa

- Alcohol aggravates tri-dosha

- How a person feels when consuming alcohol is related to the individual constitution

- As a treatment use the opposite type of alcohol to their preference


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o For example – a kapha person might like whisky or beer, which aggravates

kapha (earth or water quality). When asked to drink wine instead over a period

of time, it aggravates the pitta and counteracts the dosha.

o Generally kapha person is uncomfortable with feeling aggravated pitta and

eventually gives up alcohol because the dosha is also becoming balanced

- Detoxifying

- Rejuvenative

Medicated wine

Ashwagandha arishta

Bala arishta

Arjuna arishta

Modaka

Formulated cannabis supplement

Madana modaka

Medicated ghee

Saraswata grita

Phala grita

Brahmi grita

Agni deepana

Hinguwashtaka

Paaka choorna

Vamana


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Maduka decoction (liquorice)

Rock salt with honey

Madana pala water (emetic nut)

Virechana

Cumin cube / dhatri

Oil enema

Rejuvanative

Chayawanaprash

Kushmanda avaleha

Brahmi grita

Unmadha (mental disorder) – the Ayurvedic perspective

“Sarve prutag jana ēva unmataka” Every human being on the planet suffers from some kind of mental disorder


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In Ayurveda, people are categorised into three constitutions (vata, pitta, kapha). The mental

constitutions are categorised as sattwa, rajas, tamas which are the three guna.

Sattwa

The quality of sattwa means all the positive qualities of the mind such as love, compassion,

kindness, calmness and meditative qualities. When the mind is in a state of Samadhi (bliss)

one can experience these qualities of the mind. Due to the demands of general life we

wouldn’t be able to sustain or gain this state of mind even for a few moments. General life

tends to make other qualities of the mind, rajas and tamas to arise and creates mental

disorders in people.

Rajas

Rajas means to control and gaining power. Gaining power or control, the mind can endlessly

create thoughts, create speed of thoughts and content of thoughts. This makes the person

restless, agitated and feeling undernourished of achievements. The person will tend to dwell

on negative thoughts and self judgement and creates anger, frustration, self judgement,

rudeness, and selfishness. When there is an overload in the mental faculty or consciousness

it creates mano ama (unprocessed thoughts and negative emotions). When such ama

obstructs the mano vaha srotas (the channels that carry thoughts) it appears as a mental

disorder.

Tamas

Tamas means the darkness of the mind. The tamasic quality of the mind is created by

attachment and laziness of the mind. This might be attachment to negative thoughts or

mental states. This creates mental qualities such as fear, guilt and sadness. Due to the laziness

of the mind, it tends to hold onto and become attached to the negative continuously. Like

the rajas qualities it can also block the mano vaha srotas and create mental problems.


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Main hindrances of the mind

Moha – delusion / illusion

Raga – attachment / greed

Dvesha – hatred

Nidhana

1. Incompatible food

2. Contaminated food

3. Unwholesome food

4. Horrible taste and smelly food

5. Insulting God, gurus, parents or arahats

6. Generally insulting others

7. Being broken hearted

8. Fighting with mentally or physically strong people

These causes can affect the body and the mind. After consuming contaminated or wrong

food, there can be an affect on the ojas level in the body, as well as contaminating the ojas. It

renders the person incapable of dealing with a negative situation. Mentally, if the person

comes into association with situations that stimulate the rajas and tamas gunas, it can

manifest mental disorder.

Samprapti

As a result of the causative factors, the level of ojas in the body can be depleted or the ojas

become contaminated in the body and mind. A low level of ojas gives rise to a weak quality

of sattwa. In this way, rajas and tamas are stimulated and aggravated.

Seat of ojas in the heart and 10 vessels. When it is all contaminated or has low level of ojas it

obstructs the mano vaha srotas.


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Hence the mind begins to lose the qualities of calmness, love, compassion and kindness and

instead fills up with rajasic and tamasic qualities. The result is a restless, angry, frustrated,

judgemental, greedy and lazy mind.

Neither the Charaka Samhita nor other texts dedicate a great deal to the explanation or

identification of mental disorders. This may be due to environmental factors, in that mental

disorders were not as prevalent as they seem to be in modern society.

We need to address mental disorders in today’s society and how we can help people who are

suffering.

Nidhana for the present day

Lack of physical connection

Lack of mental connection

Over-exposure to electronic devices

Desire or greed for materialistic life

Loss of connection to intuitive faculties (gut feeling)

Lack of understanding and consequent lack of respect for the way in which the

mind and body function

Being misled by society

Excess of choice

Failure to identify changes in the body or mind or ignorance of the feelings and

sensations

Loss of spiritual connection

Impatience / looking for a quick fix

Embracing any food without reference to how the body feels

Unnecessary supplements


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Inability to express emotions or lack of opportunity, time, space and person to

express emotions

Diploma Ayurvedic Practitioners Course Module 7 30 st& 31 ...€¦ · high blood pressure stroke...

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