Ayurvedic Management of Persistent Depressive Disorder (PDD) with Special Reference to Kaphaja Unmada with Vatanubandha

Abstract

Persistent Depressive Disorder (PDD), also known as dysthymia, is a chronic and recurrent mood disorder characterized by a persistent low mood lasting for at least two years. Although the symptoms are less severe than major depressive disorder, their long-standing nature significantly impairs quality of life and may lead to disability and substance abuse. Epidemiological data suggest a significant lifetime prevalence of approximately 2.5 to 6 % in India, emphasizing the need for effective management strategies. This case report illustrates the Ayurvedic management of a 36-year-old male patient presents with low depressed mood, reduced energy, sleep disturbances, fatigue, and social withdrawal with a duration of 20 years and can be correlated with Kaphaja Unmada with Vatanubandha, considering the chronicity of the condition. Symptoms including Rahapreethi, Alpavak, Alpachesta, Alpaahara, and Sauchavidwesha reflect classical Kaphaja Unmada Lakshanas, with Vata involvement contributing to disease persistence and management in Ayurveda focuses on Kapha Shamana, Srotoshodhana, and the restoration of mental faculties through internal medications and therapeutic procedures such as Snehapana, Vamana, Virechana, and Vasti. Assessment using Hamilton Depression Rating Scale showed a reduction in score from 12 at baseline to 04 after intervention. Clinically, the patient exhibited improved social smile, mood and social interaction.