Management of Chittodwega a Case Report

Introduction

Generalized anxiety disorder is one of the most common mental disorders. Up to 20% of adults are affected by anxiety disorders each year. Generalized anxiety disorder produces fear, worry, and a constant feeling of being overwhelmed. Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things. This worry could be multifocal such as finance, family, health, and the future. It is excessive, difficult to control, and is often accompanied by many non-specific psychological and physical symptoms. Excessive worry is the central feature of generalized anxiety disorder. Ayurveda understands these disorders under the umbrella of chittodwega. The word chittodwega [1] is mentioned by Caraka in Vimanasthana while explaining the Manovikara (Minor psychritric disorders). The word meaning of chittodwega refers to anxious state of the mind which is produced due to vitiation of Raja and Tama. In addition to Prana, Udana, Vyana Vayu;

Sadhaka Pitta; and Tarpaka Kapha are also aggravated factors in it.

Case Study-Pradhana Vedana

Palpitation since 3months which is associated with tremors in the both upper limb, electric shock like sensation in both the upper and lower limb, burning sensation in the chest, sour belching and reduced sleep.

Brief History

A 30 years male patient not a K/C/O DM/HTN was apparently normal 3months back. When he came to our hospital Kayachikitsa OPD(OPD No.2010444) on 14th September 2020 with the complaints of palpitation since 3months which is associated with tremors in the both upper limb, electric shock like sensation in both the upper and lower limb, burning sensation in the chest, sour belching and reduced sleep, for all these complaints he consulted nearby doctor they advised ECG and Echocardiogram all are within normal limit given Tab. Petrilbeta 10mg 0-0-1after food, Tab. Metoprolol 25mg 1-0-0 after food, by these medication pt. did not get complete relief later consulted to Kayachikitsa O.P.D Of S.S. Ayurvedic Medical College & Hospital, Haveri.

Discussion

To ayurveda understanding of vyadhi is mainly based on Laxana, Udbhavasthana and Adhisthana considering this acc. To Sushruta [2] vyadhi is mainly classified into two types i.e. Shareera and Manoadhisthana. At present because of stress and changes in lifestyle many people suffering from minor to major psychatric disorder. For disorders like Chittodwega (Anxiety disorder) many herbomineral preparations are explained in the classics, among these many preparations are used based on the involvement of Dosha and Dushya, here an case presented with Dushti of Pitta-vata and Manas hence the selection of the drugs as mentioned above. Rationality behind these drugs Kamadugharasa [3] is mainly having Mukta bhasma, muktasukti bhasma, shanka, pravala and varatika bhasma which mainly acts on manovikara and pittahara, Medhya vati is Shankapushpi, Bramhi, Guduchi, Jatamamsi which are having medhya, Sanjyaprabhodana and Nidrajana properities which are very much useful to calm the mind of the individual. Saraswatharista is mainly having Bramhi panchanga as main ingredient which is having the property of Rasayana and chittasantosha. Aviphattikara choorna [4] is the herbal preparation mainly used in annavaha srotovikara here patient even presented with disturbance of annavaha srotas which mainly reduces the pittadosha, vatanulomana and rechana. Hence patient needs the combination of different formulations in cases of Chittodwega and even other psychiatric disorder too.

Conclusion

In this case study justifies the successful management of Chittodwega through simple, cost effective and easily available. By this case study, we can conclude that in all cases of chittodwega (Generalised anxiety disorder) if patient seeks Ayurveda treatment as early as possible the percentage of recovery is more. And we can prevent the drug dependency and adverse effect of anxiolytics and sedatives. As this is a single case study so it’s very difficult to conclude the effect of Ayurvedic treatment, but along with shamana medicine it’s very essential to plan panchakarma as the main treatment. To treat more effectively the combination of Shodana and shamana is very much essential; hence considering the dosha avastha one can adopt the suitable treatment for the better result. But this case study might be considered as base for future research protocol on the management of chittodwega through Shamanoushadi.