Changes

=== Introduction ===

=== Introduction ===

The unmada covers a wide range of major mental disorders and is considered synonymous with  madness and mental derangement, in which a person loses his/her contact from reality and loses the ability to regulate his/her actions & conduct according to norms of the society. In unmada there is upward movement of doshas leading to disturbance in the functions of manas causing mada ( delusional/ intoxicated state ) in an individual. The factual clinical picture of the mental status of psychotic patients is vividly described. This description suggests that a patient of unmada develops derangement of all the activities of manas (mind), buddhi(intellect), ahamkara (conceit of self-individuality) and indriyas (senses). He develops thought disturbances in the form of abnormalities of chintana (thinking), vichara(discrimination) and uhya (analysis), derangement of memory in the form of smriti nasha (loss of memory) and smriti bramsha (impairement of memory), behavioral, social and emotional disturbances in the form of abnormalities of achar (behaviour), dharma (eternal duties) and bhavas (mental factors) along with functional derangement of indriyas which is manifested clinically as disturbed speech and its various presentations like incoherence (abaddha vakyam), thought blocking (hridaya shunyata ), loosening of associations, neologism, echolalia etc. and various psychomotor disturbances .

The ''unmada'' covers a wide range of major mental disorders and is considered synonymous with  madness and mental derangement, in which a person loses his/her contact from reality and loses the ability to regulate his/her actions and conduct according to norms of the society. In ''unmada'' there is upward movement of ''doshas'' leading to disturbance in the functions of ''manas'' causing ''mada'' ( delusional/ intoxicated state ) in an individual. The factual clinical picture of the mental status of psychotic patients is vividly described. This description suggests that a patient of ''unmada'' develops derangement of all the activities of ''manas'' (mind), ''buddhi''(intellect), ''ahamkara'' (conceit of self-individuality) and ''indriyas'' (senses). He develops thought disturbances in the form of abnormalities of ''chintana'' (thinking), ''vichara''(discrimination) and ''uhya'' (analysis), derangement of memory in the form of ''smriti nasha'' (loss of memory) and ''smriti bramsha'' (impairment of memory), behavioral, social and emotional disturbances in the form of abnormalities of ''achara'' (behaviour), ''dharma'' (eternal duties) and ''bhavas'' (mental factors) along with functional derangement of ''indriyas'' which is manifested clinically as disturbed speech and its various presentations like incoherence (''abaddha vakyama''), thought blocking (''hridaya shunyata'' ), loosening of associations, neologism, echolalia etc. and various psycho-motor disturbances .

Thus, unmada is not a lone clinical entity comparable to a single modern diagnostic category, rather it is a syndrome describing a group of psychotic disorders. It is a common and broader entity, which provides guidance to the line of management for almost all psychiatric disorders in Ayurveda. In this ailment, the intellect, mind and memory get perverted. Unmada can be described as the disordered state of mind, in which an individual loses the ability of regulating his/her actions and conduct according to the rules of society.  As the psychotic disorders  cover  almost all the major mental illnesses, the different types & sub types 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 / major depressive disorder. Unmada is divided into two broad categories – (1) Nija- those caused by internal imbalance of body humors i.e. vata, pitta, kapha & the sannipataj and the (2) Agantunimitta- those caused by  exogenous factors.  

 

Thus, ''unmada'' is not a lone clinical entity comparable to a single modern diagnostic category, rather it is a syndrome describing a group of psychotic disorders. It is a common and broader entity, which provides guidance to the line of management for almost all psychiatric disorders in Ayurveda. In this ailment, the intellect, mind and memory get perverted. ''Unmada'' can be described as the disordered state of mind, in which an individual loses the ability of regulating his/her actions and conduct according to the rules of society.  As the psychotic disorders  cover  almost all the major mental illnesses, the different types and sub-types 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 / major depressive disorder. ''Unmada'' is divided into two broad categories – (1) ''Nija''- those caused by internal imbalance of body humors i.e. ''vata, pitta, kapha'' & the sannipataj and the (2) Agantunimitta- those caused by  exogenous factors.  

The medicated ghrita, the most preferred dosage form for the management, enhances intellect, memory and plays an important role in the treatment of unmada. Hence many ghrita formulations have been described for the management. Anjana & nasya are other treatment modalities indicated in unmada. Acharya Vagbhata emphasises their importance by saying that if all medications for unmada like vamana, virechana etc. fail, one should do teekshna anjana & nasya karma.

The medicated ghrita, the most preferred dosage form for the management, enhances intellect, memory and plays an important role in the treatment of unmada. Hence many ghrita formulations have been described for the management. Anjana & nasya are other treatment modalities indicated in unmada. Acharya Vagbhata emphasises their importance by saying that if all medications for unmada like vamana, virechana etc. fail, one should do teekshna anjana & nasya karma.