Unmada (Psychosis) Written by Richa Mohan

Unmada  (Psychosis)

Several historical writings describe mentally unsound state. The term “Unmada” denoting insanity first appeared in atharvaveda, believed to be wrirren around 1500 B.C. A Thounsand year later, Samhitas documented the clinical subtypes of Unmada.

In Ayurveda, conditions such as Vataja Unmada, Pittaja Unmada, Kaphaja Unmada, corresponding to psychosis and depressive states have been described.
Unmada in Ayurveda is described as : Due to dushti of vatadi doshas these doshas cause mansik aaghat leading to psychosis like state.

CAUSES

• Dushta aahar vihara
• Disrespect of God, teacher and Brahmin.

TYPES

• Vataja Unmada
• Pittaja Unmada
• Kaphaja Unmada
• Sannipataja Unmada
• Bhuta Unmada

PSYCHOSIS

A Mental disorder in which there is severe loss of contact with reality evidenced by delusions, hallucinations, disorganized speech patterns and bizarre and catatonic behaviors. Psychotic disorders are common features of schizophrenia, mania, and some affective disorders.

MANIA OR BIPOLAR DISORDRES

Bipolar disorder is a relapsing disturbance with periods of both depression and elevated mood, known as hypomania or mania, when severe.

In few cases, depressive and maniac symptoms occur simultaneously or in rapid succession.

CRITERIA OFR MANIC EPISODE

1. Distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week.
2. During period of mood disturbance
   - Inflated self esteem
   - Decreased need for sleep
   - More talkative than usual
   - Flight of ideas or subjective experience that thought are racing
   - Distractibility
   - Increase in goal directed activity, at work or school either socially or sexually
3. Patient may experience delusions and paranoid thinking indistinguishable from schizophrenia.

CLINICAL TYPES

1. Euphoric mania
2. Mixed / Disphoric mania
3. Mania with psychosis
4. Hypomania
5. Severe mania with psychosis
6. Severe depression with psychosis
   

SCHIZOPHRENIA

A Common thought disorder marked by delusions, hallucinations, and disorganized speech and behavior (Positive symptoms) and by flat effect, social withdrawal and absence of volition (like negative symptoms).

Associated features include appropriate affect, anhedonia, dysphoric mood, abnormal psychomotor activity, cognitive dysfunction, confusion, lack of insight and depersonalization.
Onset typically occurs between late teens and mid 30’s.

TYPES

• Catatonic Schizophrenia
• Paranoid Schizophrenia
• Residual Schizophrenia

AYURVEDIC TREATEMENT OF UNMADA

1. DEVAVYAPASHRAYA
2. YUKTIVYAPASHARYA

• SANSHODHAN
• SANSHAMAN

• • BAHAYA
  • ABHAYANTRA

3. SATVAVAJAY

1. DEVAVYAPASHRAYA CHIKITSA

1. Worship of lord Shankara, ruler of the world.
2. Bali, mangala, path, manglikachhatara, siddhaarthaka etc. agada satya bolna, sadachara palana, tapasaya, adhyatama gyana, respect of devta brahmina and gurus.
3. Tadana adi varjita in bhootunmada :
   Trishna , Anjana ,dhoop, bhaya pradarshana, marna etc. varjita in bhootunmada.

2. YUKTIVYAPASHRAYA CHIKITSA

SANSHODANA

• In Vataj unmad 1st of all snehpan is done then if vayu marg is obstructed by kapha and pitta then mridu shodhan alongwith sneha and after that vamana and virechana is done.
• Panchakarma : Snehan, swedan, vamana, virechana, sansarjana karma.After vamana virechna, niruha Basti, Anuvasana Basti,and shirovirechana is done according to the doshas.
• Dhoomapana with virechana dhooma is done.
• Nasya : Shreesh beej, mulathi, heeng, lashuna, tagar, vacha and kutha- equal parts are mixed with aja mutra.It is used as nasaya and Anjana.
• Anjana : teekshna Anjana and tadana nasaya is useful.

SANSHAMANA

Ghrita

• Kalyanaka ghrita
• Mahakalyanaka ghrita
• Mahapaishachik ghrita
• Lashunngadi ghrita
• Apar ghrita
• Prapurana ghrita

Siddharthaka agada
Siddharthaka ghrita

SATVAVAJAYA

• Ashawasana

OTHER TREATMENTS

1. DRAVYABHUTA CHIKITSA
2. ADRAVYABHUTA CHIKITSA

ADRAVYABHUTA CHIKITSA

One who is unsubmissive should be bond with firm and soft cotton bandage and isolated in dark room free from iron rods wooden pieces etc. threatening, terrorizing, frightening and astonishing restore the mind to normalcy by diverting it. ointment anointing massaging, smoking and intake of ghee should be administered to arouse mind,intellect and memory.in case after evacuation thaere is abnormal behaviour, application of irritant snuffing , collyrium, beating which are agitating to mind , intellect and body are beneficial.

PATHAYA

1. Hitkara bhojana
2. Pavitra vihara
3. Jivaniya ghritas
4. Mishraka sneha, madhur mridu annapana

APATHAYA

1. Mansa, madira, jal and vriksha