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=== Introduction ===

=== Introduction ===

Unmada, a major mental disorder, has been known to Ayurvedic practitioners since ancient times in India. In the Vedic period, the disease was thought to be caused due to grahas or demons, but in Ayurveda, it is considered a major mental illness. Unmada as such does not describe a lone clinical entity comparable to a modern diagnostic category, rather it is a group of psychotic disorders. As the psychotic disorders cover almost all the major mental illnesses, the different types and subtypes of unmada can be separately correlated with different psychotic disorders. The clinical features of the different types of unmada resemble various types of schizophrenia, manic psychosis, psychotic depression, and depressive disorders.

''Unmada'', a major mental disorder, has been known to Ayurvedic practitioners since ancient times in India. In the Vedic period, the disease was thought to be caused due to ''grahas'' or demons, but in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], it is considered a major mental illness. ''Unmada'' as such does not describe a lone clinical entity comparable to a modern diagnostic category, rather it is a group of psychotic disorders. As the psychotic disorders cover almost all the major mental illnesses, the different types and subtypes of ''unmada'' can be separately correlated with different psychotic disorders. The clinical features of the different types of ''unmada'' resemble various types of schizophrenia, manic psychosis, psychotic depression, and depressive disorders.

Thus, unmada covers a wide range of major mental disorders and is considered synonymous with madness and mental derangement, in which a person loses contact with reality and loses the ability to regulate his actions & conduct according to the norms of the society. When doshas move upwards in the body into the head, they could cause aberrations in the functioning of manas(mind) while producing mada (delusional/ intoxicated state) in an individual. The mental status of psychotic patients is vividly described while explaining the clinical aspect of the disease. The description suggests that a patient of unmada develops derangement of all the activities of manas(mind), buddhi(intellect), ahamkara(ego) and indriyas (sense organs). The patient develops thought disturbances in the form of abnormalities of chintana(thinking), vichara(discriminating) and uha(analyzing), derangement of memory in the form of smruti nasa (memory loss.) and smruti bhramsha (memory impairment), behavioural, social and emotional disturbances in the form of abnormalities of achara, dharma and bhavas along with functional derangement of indriyas which is manifested clinically as disturbed speech  and other variants such as  incoherence (abaddha vakyam), thought blocking ( hrudaya shunyata ), loosening of associations, neologism, echolalia etc. and various psychomotor disturbances .

 

Thus, ''unmada'' covers a wide range of major mental disorders and is considered synonymous with madness and mental derangement, in which a person loses contact with reality and loses the ability to regulate his actions & conduct according to the norms of the society. When ''doshas'' move upwards in the body into the head, they could cause aberrations in the functioning of ''manas''(mind) while producing mada (delusional/ intoxicated state) in an individual. The mental status of psychotic patients is vividly described while explaining the clinical aspect of the disease. The description suggests that a patient of unmada develops derangement of all the activities of manas(mind), buddhi(intellect), ahamkara(ego) and indriyas (sense organs). The patient develops thought disturbances in the form of abnormalities of chintana(thinking), vichara(discriminating) and uha(analyzing), derangement of memory in the form of smruti nasa (memory loss.) and smruti bhramsha (memory impairment), behavioural, social and emotional disturbances in the form of abnormalities of achara, dharma and bhavas along with functional derangement of indriyas which is manifested clinically as disturbed speech  and other variants such as  incoherence (abaddha vakyam), thought blocking ( hrudaya shunyata ), loosening of associations, neologism, echolalia etc. and various psychomotor disturbances .

Unmada is classified into two broad categories: Nija(endogenous), or those caused by internal imbalance of dosha i.e. vata, pitta, kapha and sannipataja, and Agantu nimitta, i.e., those caused by exogenous factors. Sushruta (S. ut.62/4-5) and Vagbhatta - both are of the opinion that  unmada is of six types, of which four are due to doshas, the fifth is madyaja (like intoxications) and sixth is vishaja (poison-based or poison-like) . Both have described the agantuja unmada separately as the condition of amanushopasarga (due to affliction of supra-human power) and bhuta badha (due to affliction of demons), under the heading amanusopasarga pratishedha (treatment of affliction of supra-human power) and bhuta badha pratisedha (treatment of affliction of demons) respectively. The body of knowledge within Ayurveda dedicated to psychiatry underscores the advancement in scientific knowledge on this subject that existed thousands of years ago.

Unmada is classified into two broad categories: Nija(endogenous), or those caused by internal imbalance of dosha i.e. vata, pitta, kapha and sannipataja, and Agantu nimitta, i.e., those caused by exogenous factors. Sushruta (S. ut.62/4-5) and Vagbhatta - both are of the opinion that  unmada is of six types, of which four are due to doshas, the fifth is madyaja (like intoxications) and sixth is vishaja (poison-based or poison-like) . Both have described the agantuja unmada separately as the condition of amanushopasarga (due to affliction of supra-human power) and bhuta badha (due to affliction of demons), under the heading amanusopasarga pratishedha (treatment of affliction of supra-human power) and bhuta badha pratisedha (treatment of affliction of demons) respectively. The body of knowledge within Ayurveda dedicated to psychiatry underscores the advancement in scientific knowledge on this subject that existed thousands of years ago.