|MINI REVIEW ARTICLE
|Year : 2021 | Volume
| Issue : 1 | Page : 38-41
Understanding mental health perspectives of COVID-19 through the lens of Ayurveda
Independent Public Health Researcher, Bhubaneswar, Odisha, India
|Date of Submission||01-Jun-2020|
|Date of Acceptance||26-Nov-2020|
|Date of Web Publication||09-Feb-2021|
Dr. Janmejaya Samal
At-Panasapalli, Po-Bangarada, Via-Gangapur, Dist-Ganjam, PIN-761123, Odisha
Source of Support: None, Conflict of Interest: None
Coronavirus disease-2019 (COVID-19) is a global public health emergency and has affected more than 200 countries in the world. It was declared as a Public Health Emergency of International Concern by the end of January 2020 and a pandemic in March 2020. In addition to the public health challenges, this pandemic has created another parallel pandemic of mental health problems. Furthermore, the existing mental health problems have also been seen to exacerbate owing to this pandemic. The mental health problems are both seen among the community members and the health-care providers those who are in the continuous forefront of service provision in health-care settings. Ayurveda, the ancient medical doctrine of human civilization, delineates some of the tenets that can be understood and are pertinent to the current situation. Some of these tenets could be useful in mitigating the mental health issues that the current world is grappling with owing to COVID-19. Concepts such as Sadvrutta, Achara Rasayana, Adharma, and Prajnaaparadha hold contemporary relevance in the context of COVID-19.
Keywords: Achara Rasayana, Adharma, corona virus, Prajnaaparadha, Sadvrutta
|How to cite this article:|
Samal J. Understanding mental health perspectives of COVID-19 through the lens of Ayurveda. Indian J Health Sci Biomed Res 2021;14:38-41
| Introduction|| |
During the last week of December 2019, several cases of pneumonia with unknown etiology were reported in Wuhan, Hubei Province, China. Soon after this type of pneumonia started spreading to other parts of China and overseas as well. It was observed that most of these cases have a contact history to Huanan Seafood Market and were reported with fever and cough. The Chinese Centre for Disease Control and Prevention identified a novel coronavirus in the throat swab sample of one patient on January 7, 2020, and subsequently, the World Health Organization (WHO) named the virus as 2019 nCoV. When the situation got worsened, the WHO declared the outbreak as the public health emergency of international concern. The virus was later renamed as severe acute respiratory syndrome coronaviruse-2 by the International Committee on Taxonomy of Viruses on February 11, 2020, and the disease was named as coronavirus disease-2019 (COVID-19). By now, many achievements have been accrued, especially in the front of virus identification, understanding clinical manifestations, and diagnosis of the disease; however, no effective treatment has been found out till date.,,
| Impact of Coronavirus Disease-2019 on Mental Health|| |
Public health emergencies and pandemic situations can have severe mental health implications at individual and family levels. These public health emergencies can lead to emotional distress and anxiety among the sufferers and their family members. These feelings of distress and anxiety can also occur to people who are not even at high risk of getting sick in the face of a virus, about which the common man is not familiar with. Previous researches also reveal that public health emergencies and outbreaks can have profound impact on the mental health status of people. At individual and community levels, it can precipitate new mental health problems without preexisting conditions and with preexisting conditions, it can aggravate causing distress to the individual caregivers. Regardless of exposure to infection, people may land up in a panic situation of getting ill, dying, helplessness, blaming, and labeling other people of spreading the infection leading to a mental breakdown. Several types of mental health problems have been reported that range from depression, anxiety, panic attacks, somatic symptoms, posttraumatic stress disorder, delirium, psychosis, and even suicides.,,, A recent study conducted in India among 662 respondents through an online survey reveals that 80% of them were preoccupied with the thoughts of COVID-19, 72% of respondents felt the need of wearing gloves and use of sanitizers. In addition, the study also found that 12.5%, 37.8%, and 36.4% of the respondents reported sleep difficulties, paranoia about acquiring COVID-19 infection, and distress related to social media, respectively. Many countries have reported suicide cases during COVID-19 pandemics including India, Bangladesh, Pakistan, and other countries as well. In addition to the individuals, the health-care workers are also developing mental health problems throughout the globe. This is primarily linked with their protracted working hours in health-care settings caring the COVID-19 cases. These health-care professionals have a higher risk of getting the infection, and in short, they are exposed to a protracted source of distress which exceed their individual coping skills. Health-care professionals have been found to display a heightened level of stress, depression, and anxiety not only because of getting infected themselves but also because of their loved ones and the children. Keeping a balance between professional responsibilities, personal care and altruism may cause conflict and dissonance among many health-care professionals during such emergency situations.
| The Ayurvedic Approach|| |
Ayurveda, the ancient medical doctrine of human civilization, has principles of social and behavioral health that are of contemporary relevance. These principles can be contemplated to provide support to mitigate mental health issues along with the modern principles of psychotherapy and psychiatry. The classical treatises of Ayurveda delineate some of the tenets that can be very much useful in the context of the current COVID-19 pandemic.
| Ayurvedic Approach to Coronavirus Disease-2019 Transmission|| |
Delineations regarding the modes of communicable disease transmission find a place in classical treatises of Ayurveda. Of these delineations, the one made by Acharya Sushrut appears the most apt one in the context of COVID-19 transmission. Acharya Sushrut, the father of Indian surgery, postulated modes of communicable disease transmission in his classical treatise Sushrut Samhita. Acharya says physical contact (Gātrasansparśāt), expired air (Nihśvāsāt), eating with others in the same plate (Saha bhōjanāta), sharing a bed (Sahaśayyāsanāccāpi), and using clothes, garlands, and paste (Vastamālyānulēpanāt) are the prominent modes of infectious disease transmission. Most of these concepts are highly pertinent to the modes of COVID-19 transmission, as COVID-19 is primarily transmitted by physical contact and droplet infection. Acharya Sushrut's idea of communicable disease transmission can thus be bundled into both the categories of COVID-19 transmission, as transmission through expired air (Nihśvāsāt) is the droplet infection and the rest of the modes can be grouped into physical contact transmission directly and indirectly.
The concept of Sadvrutta
Acharya Charak, credited being the father of Indian medicine, in Charak Samhita described about Sadvrutta comprising two words “Sat” meaning good and “Vrtta” meaning regimen. The detailed description about Sadvrutta proposes to mingle with good friends and peer, acquire happiness and aloofness from bad impacts, and avoid an atheist and greed. This tenet is of contemporary relevance and can be understood in the light of modern-day social learning theory or the social cognitive theory proposed by Albert Bandura in 1986. The primary principle of social learning or cognitive theory is the idea of observational learning experiences that occur in the proximal environment. Let us now consider this concept in the context of COVID-19, in which it is evident from several studies that people mostly tried to adhere to activities that they observed from their nearest environment. In this context, the nearest environment could be the e-environment such as social media and Internet, as people were mostly locked down in their houses and could only connect to their near and dear ones virtually. The emotional manifestation, fear, anxiety, depression and panic state is the result of such access. It was also further observed in the context of usage of mask and sanitizers. These usages are the result of the keen observation of people and the information they received from different sources. Given this context, people having the above-mentioned mental health problems could ward off the same if they follow the principles of Sadvrutta meaning following the good regimen. Following a good regimen could also help them avoiding exhibition of stigmatizing behavior in the community. People should follow the right information from appropriate sources and should also get in touch with people who are the health experts who could guide them and allay their anxiety through psychosocial support and counseling. This is all about Sadvrutta, the good regimen, linking with “good” helps develop good behavior. This concept has been applied to many different settings to understand health behavior and the same can also be applied as an intervention measure to ward off mental health problems originating from COVID-19.
The concept of Achara Rasayana
Acharya Charak has described about the concept of Achara Rasayana which means codes of conduct and emphasizes on individual behavior in social settings. It reiterates the individual behavior and conduct in a social network. The idea of social network lies in understanding relationships between individuals, groups, organizations, and sometimes, the entire society. Social networks can influence health outcomes both in direct and indirect ways through social influence, social engagement and participation, prevalence of disease and network member mixing, access to material goods and informational resources and social support. It is very significant in the context of social networks as the disease has the greatest potential to spread through social networks and gatherings. There are many such examples in which COVID-19 has spread through social networks. The most prominent among these is the religious congregation of Tablighi Jamaat in New Delhi, whereby April 6, 2020, 1445 of 4067 tested positive representing 17 Indian states and union territories. Around 22,000 people including Tablighi Jamaat members and their contacts have been quarantined across the country.
The concept of Adharma and Prajnaaparadha
The concept of Adharma and Prajnaaparadha has got strong relevance to the current pandemic of COVID-19. Both these concepts have been delineated by Acharya Charaka in his classical treatise, Charaka Samhita. The concept of Adharma is related to the improper behavior and the concept of Prajnaaparadha refers to intellectual errors leading to improper action that results in bodily ailments. It is said that the cause of improper decisions and actions is deeply ingrained in one's own intellectual error; thus, intellectual error has been considered as one of the significant causes of disease. Prajnaaparadha is the primary cause of misconduct and wrong deeds described as intellectual error and is related to improper understanding of the object, lack of self-control despite knowing the facts, and inability to assess the potential dangers of planned actions. Furthermore, Dhi (intellect) that refers to acquisition of information, Dhriti (retention) which refers to regulation and processing of new information, and Smriti (memory) that refers to stabilization of memory are the three important constituents of Prajnaa. Hence, in the context of COVID-19, the intellectual error may be primarily due to improper knowledge and inaccurate information. This leads to stigma and discrimination in the society which may lead to other social problems such as racism, xenophobia, discrimination, and ostracization in communities. Thus, it becomes imperative to avoid intellectual errors and be mindful in making choices which would prevent mental health problems at an individual level and social stigma at a community level.
| Psychoneuroimmunology and Meaning Response in Relation to Coronavirus Disease-2019|| |
Furthermore, the concept of “psychoneuroimmunology” and “meaning response” holds significant value in fighting the mental and organic problems due to COVID-19. Psychoneuroimmunology talks about an intimate relationship between the nervous, endocrine, and immune systems and explains the mechanism of an immune response to infection through stress and emotional disorders. Similarly, the concept of “meaning response” contrary to “placebo response” describes that an individual's response does not only depend on the pharmacological properties of a drug but on the meaning they ascribe to this treatment. Thus, the advisory on the usage of Ayurvedic preparations to boost immunity could be a combination of the effect of “meaning response” and the interactions of nervous, endocrine, and immune systems in human body.
| Role of Pranayam and Mediation|| |
Understanding of mind has different ways of interpretation in Ayurveda and Yoga. Yoga offers some of the principles that can help in mental well-being of Individuals. Meditation and Pranayam could offer some solution for COVID-19. Studies reveal that regular Yoga practice can improve the pulmonary functions of individuals. In the context of acute conditions which requires intensive care or ventilatory care, this may not help however in case of very mild-to-mild cases which even does not requires oxygen therapy in COVID-19 management, adherence to regular Yoga practice can improve pulmonary functions. Meditation is found to be useful in improving virus-specific immune response.
| Conclusion|| |
Pandemics and public health crises can have a severe impact on mental health. The current COVID-19 pandemic has resulted in several forms of impacts on mental health both at individual level and at the level of health-care providers who work tirelessly to provide medical care at health-care settings. The classical treatises of Ayurveda have delineated concepts that are relevant at the present day and such concepts are strongly relevant to the mental health considerations of COVID-19 as well. Although the Adharaniya vegas should not be held as per the descriptions of Ayurveda while releasing the Vegas, proper care must be taken to avoid the transmission of the disease. Similarly, the concepts of Sadvrutta, Achara Rasayana, Adharma, and Prajnaaparadha hold significant relevance to avoid mental health problems at the individual level and help to prevent social stigma at the community level. Pranayama and Yoga could be useful to eliminate stress by the health-care workers that are engaged in COVID care at health-care settings and the same can also help in improving pulmonary function among COVID cases as well.
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Conflicts of interest
There are no conflicts of interest.
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