Depression (Chittodwega)

Depression cannot be said to be a disease, because it is not primarily a biological disorder – that is, the root cause of the symptoms are not usually physical.
Depression is a common but serious mood disorder. It causes severe symptoms that affect individual’s feel, think, and handle daily activities, such as sleeping, eating, or working.
Causes
There are a number of factors that may increase the chance of depression, including the following:
• Abuse: Any physical, sexual or emotional abuse especially in the past life can increase the vulnerability to clinical depression later in life.
• Medicine side effect: Some medication especially for the treatment of viral therapy, acne treatment and the use of some corticosteroid for long time can increase the risk of depression.
• Conflict: Personal conflicts or disputes with family members or friends, some times may become the reason for Depression.
• Death or a loss. Sadness or grief from the death or loss of a loved one, though natural, may increase the risk of depression.
• Genetics. A family history of depression may increase the risk.
• Major events. Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring from the service.
• Other personal problems. Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can contribute to the risk of developing clinical depression.
• Serious illnesses. Sometimes depression co-exists with a major illness or may be triggered by another medical condition.

Signs and Symptoms
To be diagnosed with depression, the symptoms must be present for at least two weeks.
If any individual may have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, then may be suffering from depression:
• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
All the symptoms may or may not be experienced at a single time. Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.
Ayurveda mentions Depression as Vishada or chhitodwega. This is also described as “most disease aggravating factor”. Although this disease is categorized under psychological diseases, it can also affect the body; hence it can lead to any physical or psychological disorder.
Depression is an illness that infiltrates your whole body. It affects the way you feel about things and situations, and you feel about yourself, the way you eat and sleep, the way your memory is working. Depression is a mental disease going along with body processes – or vice versa. Depression cannot just be blown away, but have to get treated.
According to ayurveda the cause of depression is the vitiation of the three doshas that leads to the condition. Due to the causative factors three doshas among them especially Tarpaka Kapha, Prana Vata and Sadhaka Pitta ( sub types of the main doshas) get vitiated and does not performs itd normal functions. Otherwise in brief the normal functions of:
Tarpaka Kapha is to governs fluid balance in the brain, healthy brain tissue, and communication between brain cells. When in balance, it contributes to a stable personality.
Prana Vata — which governs energy, creativity, perception, growth of consciousness and self-realization
Sadhaka Pitta- which is responsible for balanced emotions, self-confidence, healthy desires, motivation and a feeling of fulfillment.
Vitiated doshas become unable to perform their normal functions and thus starts producing the symptoms and leads to deseased condition.

Treatment
Treatment aspect from ayurveda consist of :
• Shodhana chikitsa or panchakarma chikitsa
• Shamana chikitsa or oral medication

Shodhana chikitsa or panchakarma chikitsa, includes:
• Abhyanga or generalised body massage, especially with ksheerabala taila, mahamasha taila, or simple tila taila.
• Swedana or steaming or hot fomentation, with herbal decoctions or oil like tub bath etc.
• Shirodhara, pouring some liquid for certain time over the forehead. In different conditions liquid may wary from oils, herbal decoctions, milk, buttermilk etc
• Nasya karma or introducing medicine from nasal route.

Shamana aushadies or oral medication includes:
Ayurvedic herbs for depression:
• Arjuna
• Ashwagandha
• Clove
• Amla
• Shatavari
• Brahmi
• Vacha
• Sankhpushpi
• Jatamamsi
• Mulethi
• Cardamom
Herbal preparations commonly used:
• Brahami vati
• Manasmitra vatakam
• Sarpagandha mishran
• Brahami ghrita
• Mahakalyana ghrita
• Mahapishacha ghrita
• Ashwagandha choorna/ capsules
• Shatavari choorna
• Ksheerabala taila
• Ksheerabala 101

Home remedies
• Crush 3-4 cardamom seeds, make powder of it and mix with 1 glass of water. Consume daily for few days.
• Crush and prepare the juice of 2-3 amla fruit daily and mix with 30-40 ml water. Take daily for few days
• Take 3-4 almonds daily with hot milk, especially in morning empty stomach.
• Consume daily 2-3 gm ashwagandha powder with hot milk for few days.
• Administer 2-2 drops of cow’s ghee or almond oil in each nostril daily at bed time for few days.
• Combine or mix powder of jatamamsi, guduchhi, ashwagandha and brahami in equal quantity and start consuming all the day in 2-3 gm per day with hot milk.

Daily yoga practice
• Janu Sirsasana.
• Ustrasana
• Uttanasana
• Salamba Sirsasana
• Pranayam practise
• Meditation

Risk Factors
Depression is one of the most common mental disorders. It is assumed to be caused by a combination of genetic, biological, environmental, and psychological factors.
Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood.
Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present.
Risk factors include:
• Personal or family history of depression
• Major life changes, trauma, or stress
• Certain physical illnesses and medications
TIPS:
• Keep the patient active
• Give the patient simple tasks to do, so that he or she can experience a sense of achievement
• Sufficient rest and meditation will help rejuvenate the body