Vishāda (persistent sadness, hopelessness) and Chittodvega (restlessness, anxiety) are grouped under Mānasa Vyādhi in Ayurveda. These arise due to disturbance of Rajas and Tamas in the mind, often with Vata-Pitta involvement, affecting Manovaha Srotas, Hridaya, and Indriyas. Ayurveda recognizes mental disorders like Unmāda, Apasmāra, Vishāda as major categories where depression and anxiety overlap.

"विषादः सर्वरोगाणां मूलं प्रोक्तं मनीषिभिः ॥"
(चरक संहिता, सूत्रस्थान २३/४)

Ayurveda views depression and anxiety as complex Mānasa Vyādhi, arising from Pragyāparādha (errors of intellect), unresolved emotions (śoka, bhaya, krodha), Rajas-Tamas vitiation, and doshic imbalance. Vata disturbance leads to anxiety, palpitations, insomnia; Pitta dominance brings irritability, anger, fear; Kapha dominance causes withdrawal, heaviness, dullness. Classical texts like Charaka, Ashtanga Hridaya, Madhava Nidana, and Bhavaprakasha describe overlapping features of Unmāda, Vishāda, and Chittodvega.

Dietary causes (Ahāra Hetu):

• Ati-rūkṣa, ati-śīta, alpa āhāra (dry, cold, insufficient diet)

  "रूक्षशीतललघ्वन्नं वातं मनसि चोद्वेजयेत् ॥"
  (चरक सूत्रस्थान २५/४०)

• Ati-āmla, ati-lavaṇa, ati-katu (excess sour, salty, pungent) — aggravates Pitta leading to irritability, restlessness.
• Mādyapāna (alcohol, intoxicants) — Kapha-tamas aggravation causing depression.
• Viruddha āhāra (incompatible food) — causes āma, obstructing Manovaha Srotas.

Lifestyle causes (Vihāra Hetu):

• Ati-vyāyāma / ati-śrama (over-exertion, fatigue)

  "अतिश्रमाच्च मनो ध्वंसं याति ॥"
  (सुश्रुत संहिता, सूत्रस्थान)

• Diwasvapna (day-sleep) — Kapha-tamas aggravation leading to dullness.
• Rātri-jāgaraṇa (night vigil) — Vata aggravation leading to anxiety.
• Manasika Hetu (psychological causes): Uncontrolled grief (śoka), fear (bhaya), anger (krodha), guilt, chronic stress disturb Manas.
• Vega avarodha (suppression of urges) — obstructs normal Vata leading to psychosomatic illness.

Samprapti (Pathogenesis): Disturbed Rajas and Tamas guṇas obstruct Sattva expression → Vitiated Vata in Manovaha Srotas + Hridaya + Indriyas → manifestation of Vishāda (depression) or Chittodvega (anxiety). Tissue depletion (Ojas-kṣaya) and obstruction (Kapha-tamas) are two parallel modes.

"रजस्तमसोः प्रवृद्ध्या सत्त्वं नश्यति देहिनाम् । ततो मनोविकाराः स्युर्विषादोद्वेगसंयुताः ॥"
(अष्टाङ्गहृदय, निदानस्थान ६)

Diagnosis (Nidāna): Based on clinical presentation: persistent sadness, anxiety, palpitations, sleep disturbance, loss of interest, hopelessness. Nadi Pariksha may show Vata-Pitta predominance. Psychological history and assessment of Satva Bala are crucial. Modern evaluation uses scales (Hamilton, DSM-5) for depression/anxiety.

• Persistent worry, inability to focus
• Loss of enthusiasm
• Sleep disturbances
• Heart palpitations, restlessness

• Vishāda (Persistent sadness, hopelessness)
• Chittodvega (Restlessness, inner turmoil, anxiety)
• Mano-daurbalya (Mental weakness, loss of willpower)
• Atichintā (Excessive worry, overthinking)
• Nidrānāsha / Ati-nidra (Insomnia or excessive sleep)
• Hridaya-udvega (Palpitations, chest uneasiness)
• Anutsāha (Lack of enthusiasm, disinterest in activities)
• Atibhashanam / Mounam (Either excessive talking or silence)
• Anga-laghava / Anga-gourava (Feeling of heaviness or lightness in body)
• Atikruddha / Atibhaya (Excessive anger or fearfulness)
• Arochaka (Loss of appetite, indigestion)
• Dainya (Feeling of worthlessness, guilt)
• Smriti-bhramsha (Poor memory, lack of focus)
• Ashru-pravritti (Tendency to weep without reason)

• Sadness, hopelessness
• Anxiety, tremors, fear
• Withdrawal, lack of speech
• Appetite disturbances
• Crying spells
• Insomnia or hypersomnia

"विषादः शोकजं दुःखं निद्रानाशश्च जायते ॥"
(माधवनिदान)

• Vataja type: Restlessness, insomnia, fear, palpitations
• Pittaja type: Irritability, anger, guilt, burning sensations
• Kaphaja type: Withdrawal, heaviness, excessive sleep

• Suicidal tendency
• Somatic disorders (IBS, headache)
• Memory loss
• Metabolic disturbances

Mild to moderate cases with strong Satva Bala are Sādhya. Chronic, recurrent depression/anxiety with suicidal tendencies or psychosis are Kṛichchra-sādhya or Asādhya.

• सिद्धान्त (Principles): Nidanaparivarjana, Sattvavajaya Chikitsa (counseling, mind training), Medhya Rasayana, Panchakarma for dosha balancing.
• पञ्चकर्म (Panchakarma):
  • Shirodhara with medicated oils (Ksheerabala, Brahmi taila)
  • Nasya with Anu taila
  • Basti (Matra basti with Ashwagandha taila)
  • Abhyanga + Swedana (calming effect)
• औषध योग (Herbal medicines):
  • Brahmi (Bacopa monnieri)
  • Ashwagandha (Withania somnifera)
  • Jatamansi (Nardostachys jatamansi)
  • Shankhapushpi, Mandukaparni, Vacha
  • Medhya Rasayana — Saraswatarishta, Brahmi Vati, Manasmitra Vatakam
• योग एवं जीवनशैली:
  • Āsanas: Shavasana, Sukhasana, Balasana, Setu Bandhasana
  • Prāṇāyāma: Anulom-Vilom, Bhramari, Nadi Shodhana
  • Mudrā: Gyan Mudra, Prana Mudra, Hridaya Mudra
  • Mantra: Om chanting, Gayatri mantra, Mahamrityunjaya mantra
  • Meditation: Mindfulness, dhyana on Hridaya/Anahata chakra

• Satvika ahara — fresh fruits, vegetables, milk, ghee
• Regular yoga & meditation
• Warm, unctuous diet
• Supportive family/social environment

• Alcohol, smoking, intoxicants
• Spicy, sour, salty excess
• Overwork, stress, late nights
• Isolation, excessive screen time

Depression and Anxiety Disorders = mental health conditions characterized by persistent sadness, fear, worry, restlessness. Ayurveda links them with Rajas-Tamas vitiation, Vata-Pitta disturbance, Ojas kṣaya. Holistic management includes diet, lifestyle, Panchakarma, Medhya Rasayana, yoga, pranayama, meditation, and supportive counseling.

• Nadi Pariksha (Vata-Pitta predominance)
• Mental health scales (Hamilton/Beck)
• Thyroid function tests
• Vitamin B12, D3, cortisol levels