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 Table of Contents  
REVIEW ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 140-147

Relevance of Charaka's principles for psychological well-being during the COVID pandemic


Central Ayurveda Research Institute, Bengaluru, Karnataka, India

Date of Submission17-Jan-2022
Date of Acceptance16-Jun-2022
Date of Web Publication10-Nov-2022

Correspondence Address:
Ms. Sonam Chandhok
Central Ayurveda Research Institute, No. 12, Uttarahalli Manavarthekaval, Talaghattapura Post, Bengaluru - 560 109, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoyppp.ijoyppp_12_22

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  Abstract 


The coronavirus pandemic has created a psychological havoc across nations. Researchers and mental health practitioners have put in their efforts to use contemporary forms of psychological interventions and therapies for the management of mental health concerns that have arisen in the current pandemic. However, only rare attention has been paid to the principles of Ayurveda for psychological issues. Hence, the present paper aims to bring forth the forgotten but treasured principles of Ayurveda explicated in Charaka Samhita for psychological well-being and to outline some of the indigenous strategies for COVID-related psychosocial management.

Keywords: Ayurveda, COVID, indigenous interventions, psychological well-being


How to cite this article:
Chandhok S, Shubhashree M N, Chandrasekharan C. Relevance of Charaka's principles for psychological well-being during the COVID pandemic. J Appl Conscious Stud 2022;10:140-7

How to cite this URL:
Chandhok S, Shubhashree M N, Chandrasekharan C. Relevance of Charaka's principles for psychological well-being during the COVID pandemic. J Appl Conscious Stud [serial online] 2022 [cited 2023 Feb 8];10:140-7. Available from: http://www.jacsonline.in/text.asp?2022/10/2/140/360860




  Introduction Top


Ayurveda is one of the most ancient traditional systems of medicine. The classical texts of Ayurveda advocate certain principles to be followed in life for ensuring good physical and mental health, overall well-being, and optimum quality of life. Ayurveda is considered “The Science of Life” and it views health as holistic with emphasis on the mind-body relationship. Charaka Samhita (Sharma and Dash, 2002a, p. 32-33) has stated in verse 46–47 that:

“Mind, Soul and the Body - these three constitute a tripod, upon the meaningful combination of which the world is sustained. They constitute the substratum for everything, which is endowed with life. This is Purusha who is sentient and who is the subject matter for this science. It is for this that Ayurveda has been brought to light.”

Verse 55 (Sharma and Dash, 2002b, p. 40) also states:

“The body and the mind are the abodes of diseases as well as health. Proper body-mind interaction is the cause for happiness.”

In Ayurveda, psychological and mental well-being is considered equally important as any other physical ailment.

It is also stated that to maintain good mental health, one should strive for discarding the harmful or unwholesome regimens and adopt the wholesome ones in regard to virtue (dharma), wealth (artha) and desire (kaama), because happiness or unhappiness can occur in this world because of these three elements (Sharma and Dash, 2002c).

The field of psychology is highly dominated by western theories and concepts. However, many concepts and theories related to the psyche of an individual have been explored and stated in the ancient Ayurveda texts. The principles of Ayurveda suggest the regime that individuals should follow to maintain optimum psychological well-being.

Western theories of psychology are not relevant to all cultures; however, Ayurveda captures the basic facets of human personality in terms of TrigunasSattva, Rajas, and Tamas and TridoshaVata, Pitta, and Kapha that can be applied to all human beings irrespective of race and culture (Shilpa and Venkatesha Murthy, 2011). The Ayurvedic philosophy suggests that the entire world is made up of 5 elements or “Mahabhutas” namely Akasa (Ether), Vayu (Air), Tejas/Agni (Fire), Ap (Water), and Prithvi (Earth), that synergize together to form three basic humors of Vata, Pitta, and Kapha that are called as the Tridoshas. The Triguna theory purports that all individuals have varied levels of Sattva, Rajas, and Tamas that are manifested as “Prakriti” of the individual. Each individual has a unique “Prakriti” that defines their personality and state of being. Of these Trigunas, Sattva represents knowledge and happiness; Rajas represents activity and passion; and Tamas represents resistance, inertia, or confusion (Shilpa and Venkatesha Murthy, 2011). Several biological factors and socio-environmental circumstances can create an imbalance in the Tridoshas. The principles of Ayurveda aim to help individuals balance out Rajas and Tamasik states with Sattvik states and strike a healthy equilibrium for overall well-being.

The indigenous knowledge of Ayurveda is increasingly gaining momentum across the globe in contemporary time. Especially during the COVID-19 pandemic, people from different parts of the world turned their heads to the lifestyle, diet and herbs suggested in the Ayurveda system to boost their bodies' immunity levels (“Ayurveda Goes Global,” 2020). Moreover, the pandemic has brought about a “psychological turbulence” around the world with a massive loss of lives and arising health concerns. It thus becomes important to explore the relevance of the principles of Ayurveda for prevention and management of the psychological problems arising during the coronavirus pandemic.


  Psychological Turbulence Caused by the COVID-19 Pandemic Top


COVID-19 has brought an immense amount of physical and psychological suffering to the entire human race and across all age groups. Many people lost their loved ones and some lost their jobs and livelihood, so many children became orphans and many families got wiped off by the COVID waves. The devastation caused by the pandemic has had a huge impact on people's mental health and psychological state.

Impact on adults

Young- and middle-aged adults are the responsibility bearers in families who have to take care of their children and parents. Studies done on the adult population suggest that they experienced feelings of helplessness, hopelessness, grief, fear, anxiety, trauma, and depression during the pandemic (Serafini, et al., 2020; Grover, et al. 2020 and Shaw, 2020). A lack of social interactions and tangible communications due to lockdown and social distancing instilled a feeling of loneliness among many people (Field et al., 2020; Pesonen, et al., 2020). People experienced sleepless nights, disturbed dreams, and poor appetite as a result of their psychological state (Pesonen, et al., 2020; Banerjee and Rai, 2020). Mental fatigue, tiredness, and a reduction in work productivity were some other major concerns (Hamouche, 2020). The impact on mental health has been so profound that there has been an increasing number of incidences of suicide during the pandemic (Dsouza et al., 2020).

Researchers have also found a multifold increase in the cases of domestic violence and abuse against women during the pandemic that has had an adverse impact on the mental health state of women in abusive relationships (Sharma and Borah, 2022; Suraj et al., 2020; Pattojoshi et al., 2021).

Impact on children and adolescents

Children and adolescents also had to deal with several concerns. Disruption in normal lives and social distancing norms affected the socialization of children with their peers, relatives, and teachers that are crucial elements of socio-emotional development of a child (Singh and Suri, 2021). Even physical activities were restricted and parents had to look for indoor alternatives to engage children in play (Olive et al., 2022). Children also experienced symptoms of anxiety and disturbance in the sleep cycle due to misinformation and uncertainties associated with the novel virus (Dondi et al., 2021).

As the situations necessitated the use of online platforms for education, it also led to increase in cases of cyber harassment, threat, and victimization adding to the psychological impact (Jain et al., 2020). A rise in the cases of child abuse and violence was also reported during the lockdown when India's children's helpline received enormous numbers of calls reporting abuse.

Impact on elderly individuals

Factors such as existing health conditions, physical mobility, staying alone, financial instability, and limited ability to use digital platforms made the elderly population a vulnerable group during the pandemic. Some individuals experienced fear of death, fear of losing loved ones, and health anxiety during lockdown (Uvais, 2020).

Uncertainty of being able to meet children who stay away amid travel restrictions was another stressor reported in studies which further led to symptoms of depression and panic disorder (Olive et al., 2022). Moreover, there were several cases of suicide by older adults reported in India where the reasons were attributed to coronavirus (Rana, 2020).

COVID-19 waves brought with it a set of uncertainties and apprehensions and hence adapting to the “new normal” became a requisite challenge. The pandemic has iterated the essentiality of a good immune system for survival. Our mind and body are related and therefore, psychological well-being is also crucial for our body's immune system (Abdurachman and Herawati, 2018; Kiecolt-Glaser et al., 2002). The field of “psychoneuroimmunology” exclusively looks at the impact of psychological and neurological factors on our immune system. Hence, it is important to work towards psychological and mental health enhancement for boosting our immune system and fighting the pandemic.


  Viewing COVID-Related Psychological Concerns from the Lens of Ayurveda Top


To deal with the psychological concerns arising during the pandemic, mental health practitioners have put in their efforts to use western theories for assessment and contemporary forms of psychotherapies and interventions for the management of psychological symptoms. However, only rare attention has been paid to the indigenous knowledge and principles for psychological concerns. The negative feelings and manifestations discussed in section 2 have been mentioned in the texts of Ayurveda as chittodwega (anxiety), chinta (stress and overthinking), bhaya (fear), shoka (grief and sorrow), chittavasada (depression), krodha (anger), and anidra (disturbed sleep and dreams). Charaka Samhita elaborates upon the techniques to assess the mental state of an individual under Vimanasthana.

Vimanasthana-examination and assessment of mental state using Charaka's principles

Vimanashtana is the third of the eight sections of Charaka Samhita that explicates the principles to be followed to examine the patient (Sharma and Dash, 2002d). In Ayurveda philosophy, there are three ways of examining the patient, namely Prateyksha (direct observation), Anumana (inference), and Aptopadesha (from the informant or guardian of the patient). Pratyeksha refers to the examination done by the practitioner using his/her senses, i.e., by seeing, listening, touching, or smelling. For instance, by listening to a gurgling sound from the stomach, seeing the paleness of the skin, abnormal body smell or touching to ascertain swelling in case of injury. Sense of taste was also used in older times in indirect ways for inference, such as by keeping urine sample for ants to taste, the level of sugar could be ascertained. Anumana refers to examination by inference. In the context of this paper, Anumana is the most relevant technique as latent psychological concerns are understood by covert observation or observation by inference. As we know various psychological concerns emerged during the pandemic, their impact can be assessed by drawing inference on the certain dimension as described in Charaka Samhita.

For instance, there were instances of decline in cognitive functioning among the elderly during COVID (De Pue et al., 2021). For assessing cognitive functioning the following techniques can be employed:







  1. Manoarthavyabhicharena: Presence of mind – can be assessed by observing whether the patient can concentrate on specific objects in the presence of many other objects. In modern-day assessment, this aspect is called “selective attention”
  2. Vijnaanamvyavasaayena: Awareness and knowledge of the purposeful nature of basic things – by presenting the person with a common daily life object (e.g., drinking water) and observing if they use it properly or not
  3. Mohamavijnaanena: State of consciousness or unconsciousness – by observing the presence or lack of understanding and comprehension abilities
  4. Samjnam naamgrahanena: Recognition – by their ability to recollect names of people and things. In western psychology, inability to recall names or recognize objects is referred as anomia or agnosia, respectively
  5. Smriti smaranena: Memory – by their ability to remember recent and old instances. This is what we call “remote memory” and “recent memory” in the modern psychology
  6. Medhaam grahanena: Intelligence – by their capacity to comprehend and grasp.

    As discussed in section 2, studies reported an increase in aggression and frustration among people during the lockdown that also impacted their interpersonal relationships. Such emotions can be inferred by:
  7. Krodham abhidrohena: Level of anger and aggression – by their disposition to take revenge from others and engage in violent behaviors
  8. Upadhimanubhandhena: Deceptive nature – by subsequent occurrences of pretence with hidden evil intentions which can be inferred by the person's actions with friends and relatives
  9. Dvesham pratishedhena: Aversion or Dislike – by their refusal or disinclination towards the things
  10. Rajosanghena: Attachment – by understanding the quality of their relationship with significant other

    Fear, sadness, and grief were prevalent as people lost their loved ones. According to Charaka, the presence of such feelings must be assessed to understand the mental state of the person:
  11. Shokam Dainyena: Grief – by observing whether they are in a sorrowful and gloomy state
  12. Bhayam Vishadena: Fear – by understand their apprehensions.

    It is noteworthy that Charaka's principles to assess mental health do not only focus on the deficits in an individual's functioning. It also suggests techniques to assess the strengths of an individual that serve as coping resources during adverse situations. These ancient principles are consonant with the modern-day' “positive psychology” approach. In the context of COVID, the assessment of such factors can serve as the basis of interventions to enhance coping:
  13. Harshamamodena: Joy – by their level of excitement and exhilaration
  14. Pritimtoshena: Pleasure – by inferring satisfaction level reflecting from their joyous appearance
  15. Dhairyamavishadena: Courage – by the strength of their mind in adverse or dangerous situation. The concept is closely related to resilience
  16. Veeryamuthaanena: Vitality or energy – by their ability to take initiative in challenging situations
  17. Avasthaanamavibhramena: Stability and resolution of the mind-by avoidance of indecisiveness and mistakes
  18. Shradhamabhipraayena: Faith – by their outlook and opinions
  19. Seelamanuseelanena: Liking of something – by their habitual acceptance of things
  20. Dhritimalaulyena: Courage-by their ability to stay firm and assertive
  21. Vashyantaamvidheyatayaa: Docility or obedience – by compliance. In the context of the pandemic, compliance with preventive norms can be observed
  22. Upasthitashreyastvamkalyaanabhinivesena: Approaching recovery and prosperity-by initiation of useful work and healthy inclinations
  23. Amalam sattvamvikaaren: Sattvika qualities or clarity of mind – by absence of maladaptive emotions, thoughts, and attachments.


Assessing and inferring all these aspects can help a practitioner capture the mental health profile of an individual. Understanding difficulties and strengths can pave way for interventions to enhance mental well-being.


  Indigenous Strategies Emerging from Charaka's Principles to Manage COVID Related Psychological Concerns Top


The following sections explain some of the indigenous strategies based on the principles of Ayurveda for the management of psychological issues and overall mental well-being.

Dinacharya

As discussed in the earlier sections of the paper, Ayurvedic philosophy aims to create a homeostatic balance between the three gunas of Tamas, Rajas, and Sattva. Enhancement of Sattva and lessening of Rajas and Tamas advances the resilience, efficacy, and optimism level of an individual that are crucial for coping with the pandemic In order to achieve the same, Ayurveda texts suggest individuals to follow a daily regime called “Dinacharya” that consists two daily cycles: the sun cycle and the moon cycle. During these two cycles, the intensity of Vata Dosha, Pitta Dosha, and Kapha Dosha varies. To maintain a balance among them, an individual should follow certain daily activities that involve (Sharma and Dash, 2002e).







  1. Waking up before the sunrise to feel fresh, calm, and peaceful
  2. Rinsing face with cold water and performing “Jalneti” to cleanse the oral and nasal passage
  3. Awakening of all senses by washing eyes, massaging oil on ears, brushing teeth, and scraping the tongue
  4. Drinking warm water to prepare the body for evacuation of wastes and flushing out of toxins
  5. Application of essential oils on the body to keep the skin nourished and to enhance blood circulation. This also helps to relax tense muscles
  6. Performing physical activities such as Yoga, Surya Namaskara, or walking
  7. Bathing to cleanse the body of oil and dirt. It helps to refresh and energize one's mind and body
  8. Meditating to enhance concentration and focus. It also helps to calm down the nervous system
  9. Relaxing and sleeping adequately after completing the day's work.


Adopting Dinacharya in our lifestyle is the best way to promote health, prevent lifestyle diseases, and strengthen our immune system (Shubhashree et al., 2020). It encourages personal hygiene which is an important preventive measure against COVID. It helps us to stay conscious of our body and mind and allows us to stay in touch with nature. Following dinacharya enhances coping with stress and anxiety as it encourages relaxation and self-care. It is known to promote longevity and happiness. Evidence shows that self-care activities help enhance mental state of people experiencing psychological issues (Bible et al., 2017). As our mind and body are related, the psychological benefits associated with self-care and following daily regime can enhance our immune system to fight against adverse situations like the COVID pandemic.

Sattvavajaya Chikitsa-mental therapy

Counseling is used in both indigenous and contemporary medicine for dealing with psychological issues. In Ayurveda, counseling comes under the purview of “Sattvavajaya Chikitsa.” Sattvavajaya Chikitsa is called the “Ayurvedic Psychotherapy.” It is an intervention discussed in Ayurveda for treating psychological symptoms. It aims to cultivate self-control to restrain from stressors and unwholesome objects. It entails assurance therapy (ashwasana) and substitution of negative emotions. These concepts are also used in the modern-day psychotherapies, such as in the Rational emotive Behavior Therapy and Grief Therapy. Charaka Samhita enlists the stages of Sattvavajaya chikitsa as (Sharma and Dash, 2002f; Roshni, 2020):





  • Jnana - Knowledge about self and fostering of self-awareness
  • Vijnana - Understanding the scientific reasoning
  • Dhairya - cultivating determination and patience
  • Smrithi - Enhancement of memory
  • Samadhi - Attaining a stable state of mind.


Sattvavajaya chikitsa promotes integrity and consonance of thoughts and actions to prevent psychological problems. It encourages “Sadavartan” or good behavior and compassion for psychological and social well-being of people. It can thus be used as a preventive strategy by encouraging people to follow COVID protocols and a healthy routine to boost their immune system. Counseling can help enhance the health-seeking behavior of people (Chandhok and Chandhok, 2020). It can be used to motivate people to enhance lifestyle patterns, developing self-control, taking care of eating habits, and managing anxiety (chittodvega) and depressive symptoms.

In the current pandemic context where hospitals are brimming with patients, many people restrain from taking the help of mental health professionals in hospitals because of the fear of getting infected. Thus, it becomes relevant to address their concerns through virtual platforms by arranging tele-counseling or online counseling sessions. The pandemic has made it necessary to explore virtual alternatives of traditional physical modalities. The concepts under Sattvavajaya Chikitsa involving Jnana, Vijnana, Dhairya, Smirti, and Samadhi can be implied and practiced using digital platforms. Tele-counseling and online counseling prove to be useful and practical media for dealing with COVID patients, their caregivers and the general population experiencing psychological concerns (Amulya, 2020; Szlamka, et al., 2021).

Daivavyapasraya Chikitsa-spiritual therapy

Daivavyapasraya Chikitsa is another form of therapy described in Ayurveda that is relevant for managing psychological symptoms. It is also known as “spiritual therapy.” The techniques used in this form of therapy are chanting mantras (japa) and engaging in religious activities (Sharma and Dash, 2002g).

During the coronavirus pandemic, people felt helpless and hopeless and heavily relied on faith and spirituality. Studies have shown the importance of faith and spirituality in coping with crisis situations. Faith and spirituality are known to boost coping and resilience as it acts as a protective factor again anxiety and stress (Ozcan et al., 2021; Roberto et al., 2020).

Other activities suggested under Daivavyapasraya Chikitsa include auspicious offerings to religious places or gifting the needy (Sharma, and Dash, 2002g). During the pandemic, the world came across worst and best face of human species when everyone was fighting for survival. On one hand, people were hoarding groceries, medicines and even oxygen cylinders, on the other hand, many individuals came forward to help people in need by their philanthropist and prosocial acts. Moreover, studies have shown the psychological benefits of charitable and prosocial giving across cultures. Humans experience greater happiness and emotional benefits when they engage in prosocial spending and giving (Aknin, et al., 2013; Geng, et al., 2022).

Yuktivyapasraya chikitsa-physical therapy

Yuktivyapasraya Chikitsa is the physical or rational therapy that involves “Samshodhana” or cleansing (Panchakarma) and “Shaman” or pacification therapy. In this form of therapy, channels of body are cleansed followed by palliative care with the help of lifestyle counseling, diet, and herbs. In a study, the impact of a 5-day Ayurvedic cleansing retreat program using Panchakarma was reported wherein, there were significant improvements in level of stress, anxiety, self-efficacy, and positive health behaviors after the intervention (Conboy et al., 2009).

Yoga and meditation

The Health benefits of Yoga and Meditation are known all over the world in the recent times. Ayurveda has always advocated the importance of Yoga and Meditation for psychological and physical well-being. Charaka Samhita focuses on “Niyama” which is one of the eight branches of Yoga (Sharma and Dash, 2002h). Niyama refers to the practice of positive duties, rituals, or observances for healthy living that facilitates self-actualization and enlightenment. In the context of meditation, Charaka's principles shed light on the concept of “Samadhi” which is the ultimate meditative state to attain consciousness (Sharma and Dash, 2002f). Although there is limited reference to the practice of yoga and meditation in Charaka Samhita, principles from other classical texts that elaborate on other branches of Yoga can be eclectically incorporated to enhance psychological well-being.

Recent studies have proved the efficacy of practicing yoga and meditation for fighting the psychological consequences of the COVID-19 pandemic (Priyanka and Rasania, 2021; Kulkarni et al., 2021). The practice of yoga and meditation enhances focus and consciousness that can help an individual in the tamasik state to attain alertness. Meditating regularly makes a person more mindful and aware. It is known to enhance the overall psychological capital of an individual that includes resilience, efficacy, hope, and optimism (Li and Li, 2020). Thus, it is of vital relevance in the pandemic times as it is a wholesome practice for coping with crisis.

Mind stimulation by Rasayana (rejuvenation) therapy

Studies have shown that many people experienced mental fatigue, reduced productivity, and lowered work efficiency during the lockdown period (Hamouche, 2020). People complained of a lack of motivation and engaging in procrastinating behavior during the pandemic (Wang et al., 2021). Such state of drowsiness, brain fog, and mental fatigue is referred to as “Tandra” state in Charaka Samhita. The classic text extensively elaborates on the Rasayana Therapy also known as the Rejuvenation therapy. Rasayana Therapy promises the enhancement of an individual's vitality and potentiality. It is known to help people overcome the Tandra and Tamasik state of mind to become more alert and active. The text describes certain recipes with natural ingredients such as Amalaki, Ghee, Pippali, Bhallataka, Brahmi, Ashwagandha, and Honey. The accurate proportion of each of the ingredients and the method of administration of all the recipes is meticulously enlisted in the Charaka Samhita. Studies have also shown the efficacy of such ingredients in enhancing memory and cognitive functioning. For example, a study has shown Ashwagandha to be effective in improving memory and cognitive functions in people with Mild Cognitive Impairment (Choudhary et al., 2017). Similarly, work has been done on proving the efficacy of Brahmi for enhancing cognition (Stough et al., 2015). Brahma Rasayana is one such effective Ayurvedic formulation which consists of 45 ingredients that help reduce lethargy, tiredness and enhances memory, and immunity (Dash et al., 2018).


  Discussion Top


The objective of the paper was to highlight the principles of Charaka Samhita that are useful in coping with the psychological disturbances caused due to the pandemic. These principles were written in ancient times but still hold relevance in the current scenario. However, only rare attention is paid to the indigenous texts as hegemony over-diagnosis and treatment is held by the western theories and therapies.

Techniques enlisted in Charaka Samhita's Vimanasthana for assessment and examination provide a holistic modality to look at the deficits as well as strengths of an individual's mental repertoire. In the context of COVID, understanding deficits in the normal functioning can ascertain the impact of pandemic on mental health, and estimating strengths can form the basis of expanding the individual's coping resources to enhance resilience in the uncertain and disturbing contexts arising due to the pandemic.

Intervention strategies can be designed from the principles of Ayurveda to cope with psychological concerns that can include following Dinacharya for maintaining personal hygiene and self-care which are essential preventive measures against COVID; counseling or tele-counseling based on the facets of Sattvavajaya Chikitsa to deal with anxiety, depression, grief, trauma and disorientation happening due to pandemic; Daivavyapasraya Chikitsa that involves chanting (japa), religious rites and helping the needy by prosocial acts for mental harmony and happiness during the pandemic; Yuktivaprashya Chikista for psychological benefits arising due to cleansing of body channels; practicing yoga and meditation; and Rejuvenation Therapy for stimulating the mind and enhancing efficacy and productivity that was reduced due to the pandemic.


  Conclusion Top


Mental health concerns have increased manifold during the coronavirus pandemic. Therefore, it calls for an integrative and eclectic approach to enhance psychological well-being. For optimum, significant, and long-term outcomes, we must combine the knowledge and principles of Ayurveda and indigenous literature with modern-day psychotherapy to expand our reservoir of coping resources.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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