Ayurvedic management of Bipolar affective disorder: A case report

Abstract

Abstract: Bipolar Affective Disorder (BPAD) is a recurrent and chronic disorder that is characterized by episodes of depression and elevated mood with intervening periods of normal mood. This disorder is associated with severely debilitating symptoms that hamper the quality of life of both patients and their caregivers as well. Bipolar disorder typically begins in adolescence or early adulthood and can have life-long adverse effects on the patient’s mental and physical health, educational and occupational functioning, and also on interpersonal relationships. A 25-year-old female presented with primary concerns of frequent speech which was occasionally incoherent, elevated mood, wandering nature, increased social mingling, increased thoughts, increased anger, irritable nature and feeling that her mother is the “devil,” and thoughts of killing her repeatedly coming to her mind for six months. A detailed interview with her parents revealed the presence of similar symptoms and irritable nature most of the time. The observations were made in the level of affective and behavioral domains of BPAD I. In Ayurveda, the condition was diagnosed as Vatikonmada (~Vata predominant insanity) with Pittanubandha (~association of Pitta) based on the clinical symptoms. Shodhana (~purificatory therapies)-based treatment protocols including Virechana (~therapeutic purgation), Snehapana (~internal oleation), Vamana (~therapeutic emesis), Basti (~enema), and Nasya (~medication through nose) followed by Shamana (~palliative procedure) were planned and administered. Psychological supportive measures such as Satvavajaya (~psychotherapy) and Yoga therapy were also sought under the supervision of Manasa roga (~psychiatric disorder) experts and qualified yoga therapists, and the mental status of the patient was assessed using the Young Mania Rating Scale. The case showed considerable relief after the treatment with Shodhana and Shamana based therapies and the psychological supportive measures.