By Alakananda Ma
As vata season comes into its own, Ayurvedic practitioners may see large numbers of individuals complaining of nervousness, anxiety, panic and sleepless nights. In this article we will take a look at some examples of anxiety disorder and panic disorder and see how Ayurvedic lifestyle and herbs benefited these patients.
A fifty year old social worker suffers from pervasive fear and anxiety which started during her menopause and is always worst in fall and winter. A twenty six year old technician developed weakness, fatigue, back tension and panic attacks after a four month cross country bicycle ride. His symptoms too are worst in fall and winter. A fifty three year old former dancer, now a home-maker, complains of anxiety and insomnia since menopause, with symptoms worse in fall and winter. A thirty two year old mother suffers from panic attacks and irritable bowel syndrome. Her symptoms began on the day of her marriage and worsened when her child was born. In all these individuals, with their responses to life changes and seasonal changes, we can see the rough, dry, cold and above all mobile properties of vata.
Generalized anxiety disorder is characterized by excessive anxiety and worry. As our young mother stated, "I was born to worry." Symptoms of anxiety are typically accompanied by restlessness, being easily fatigued--as in the case of our cross country bicyclist, difficulty concentrating, muscle tension--as reported by the bicyclist, and sleep disturbance--as in the case of the former dancer (1). Other vata conditions such as irritable bowel syndrome frequently accompany anxiety disorder, as illustrated by the young mother, who had a recent onset of IBS (2, 3).
Our young mother vividly described her first panic attack, which occurred shortly after the stress of her big wedding with hundreds of guests. As she was driving down a mountain road, she developed a tremendous feeling of shortness of breath, "I was unable to breathe", severe fear of losing control of her body, depersonalization and a devastating fear of dying .This is a classic panic attack, which involves a cluster of symptoms such as pounding heart, sweating, trembling or shaking, shortness of breath, choking, chest pain, nausea or abdominal distress, dizziness, depersonalization, fear of losing control or going crazy and fear of dying (1).
Although all the patients we have discussed were seeing an MD and taking medications such as Lexapro, many had not addressed basic lifestyle issues clearly contributing to their condition. Our young mother was regularly taking Lexapro to manage her panic disorder but concomitantly was drinking three Diet Pepsis a day, down from a high of twelve a day before the onset of her psychiatric disorder. Our social worker was also on Lexapro and was a daily coffee drinker. Our former dancer, whose symptoms included insomnia , drank one to two cups of coffee as well as a daily glass of wine--a form of lifestyle that we as medical students referred to as 'titrating caffeine and alcohol.' As students we noticed that we drank coffee to stay awake and then hung out in the bar at bedtime to balance the stimulant effect of coffee with the sedative effect of alcohol. Our bicyclist noted coffee consumption up to the time of onset of his disorder. Studies showing that those who suffer from panic disorder or anxiety disorder have a greater sensitivity to the anxiogenic effects of caffeine than those who do not have panic or anxiety disorders were carried out a long as twenty five years ago (4, 5). The DSMV even carries four caffeine-caused psychiatric disorders: caffeine intoxication, caffeine-induced anxiety disorder, caffeine-induced sleep disorder, and 'caffeine-related disorder not otherwise specified' (6). Nevertheless, our patients were quite unaware that their caffeine consumption was almost certainly exacerbating if not causing their symptoms.
Vatagenic diets were of course endemic among the patients cited. One 'daily diet list' ran
· Breakfast--Cold cereal with cold milk
· Lunch--apple, cold yoghurt, cheese and crackers
· Dinner--salad with chicken and quinoa
- Breakfast--skips or raisin bran
- Lunch--salad bar
- Dinner--meat and potatoes
The social worker, who was dedicated to healthy eating, was on a low fat diet because of raised cholesterol. The bicyclist, who had also put effort into his diet, regularly snacked on Clif bars, a dry, rough, dense, cold food, and drank cold soymilk daily.
Suggestions for vata soothing diet, lifestyle and herbs were welcomed by these patients. The social worker, who had a vata prakruti, began eating hot oatmeal porridge with cinnamon at breakfast and taking Ayurvedic cooking classes. She soon became aware of the effect of food on her anxiety. She also came to the realization that adequate amounts of healthy oils were essential for her wellbeing and that her choice of a low fat diet had majorly contributed to her anxiety. Now she consumed butter, ghee and heavy cream freely while taking Yogaraj Guggulu regularly as a vata balancing formula that simultaneously lowered her cholesterol and helped combat anxiety symptoms. She stopped using coffee and began drinking warm goat milk at bedtime with Ashwagandha. She found regular use of Stress Ease to be extremely helpful. She drank Brahmi tea two or three times daily and was able to get off Lexapro for a while.
The bicyclist, who also had vata prakruti, took a formula which included Ashwagandha and Vidari and drank tea made from a blend of Tulsi and Brahmi. He adjusted his diet in favor of warm, soupy, smooth foods such as kitcheri and dals and began daily self-abhyanga with Vata Massage Oil. These treatment and self-care strategies helped ease his anxiety.
The former dancer, who had vata-pitta dual prakruti, embraced a vata and pitta soothing diet and stopped her rough, cold and dry breakfasts and snacks. She chose to manage her elevated cholesterol by including sources of soluble fibre in her diet, including stewed apples and Sat Isabgol, which she took at bed time with warm water; thus lowering cholesterol while pacifying vata. Her formula included Vidari as dosha pratyanika for vata and Shatavari as dosha pratyanika for pitta. She was also encouraged to receive abhyanga with pitta massage oil and shirodhara with Shirodhara Oil to help reduce her anxiety level and calm vata without disturbing pitta.
The young mother had kapha prakruti and vata vikruti. The biggest improvement she noticed came from cutting out the Diet Pepsi and drinking Bacopa tea instead. This was so dramatically effective that she was able to get off Lexapro and remain free from panic attacks.
Anxiety and panic can be disabling conditions that affect every aspect of personal, social and professional life. Yet as we have seen in the examples we have cited, the lifestyle and dietary adjustments and Ayurvedic herbs can dramatically improve quality of life for these patients.
- The role of anxiety and depression in the irritable bowel syndrome. Blanchard, Edward B.; Scharff, Lisa; Schwarz, Shirley P.; Suls, Jerry M.; et al Behaviour Research and Therapy. Vol 28(5),1990, 401-405.
- Systematic review of the comorbidity of irritable bowel syndrome with other disorders: What are the causes and implications?Gastroenterology, Volume 122, Issue 4, Pages 1140-1156 W. Whitehead, O. Palsson, K. Jones
- Increased anxiogenic effects of caffeine in panic disorders. Charney, Dennis S.; Heninger, George R.; Jatlow, Peter I.Archives of General Psychiatry. Vol 42(3), Mar 1985, 233-243.
- Anxiogenic effects of caffeine in patients with anxiety disorders. Bruce, Malcolm; Scott, Nigel; Shine, Philip; Lader, Malcolm Archives of General Psychiatry. Vol 49(11), Nov 1992, 867-869.