Potential Application of Yoga & Ayurveda for Preventing Psychological...

[Full title: Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis.]

[Find the meaning and references behind the names: Art, Singh, Priyanka, Joshi, Soma, Hindu, Banaras]

Review Article This work is licensed under a CC BY 4.0 License International Research Journal of Ayurveda & Yoga Vol. 6 (5),84-89, May,2023 ISSN: 2581-785 X : https://irjay.com/ DOI: 10.47223/IRJAY.2023.6513 Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis. Priyanka Joshi 1 , O.P. Singh 2 1-PhD research Scholar Yoga, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 2-Professor, Former HoD & Research Supervisor Department of Kayachikitsa, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh INTRODUCTION Psoriasis is a chronic, immune mediated inflammatory skin disease and the prevalence rate of Psoriasis is 0.44-2.8% in India 1 The worldwide prevalence 2 is about 2%, but varies according to regions. The contribution of psychological disorders to the burden of skin disease has been poorly explored, 3 and the association of psychiatric morbidity 4 like depression, anxiety, and suicidal ideation with various dermatological diagnoses has been increasing. A large number of skin diseases, including eczema and Psoriasis, appear to be exacerbated by psychological stress. The Study have shown that chronic stress diminishes hypothalamic-pituitary-adrenal axis and regulates sympathetic-adrenal-medullary responses, stimulating proinflammatory cytokines. Then, it exacerbates Psoriasis along with psychological disorders. High levels of proinflammatory cytokines connect Psoriasis, psychiatric conditions 5 Another study 6 have shown that Psoriasis occurs as a result of inflammatory and immunological reactions. Article Info Article history: Received on: 10-04-2023 Accepted on: 17-05-2023 Available online: 31-05-2023 Corresponding author- Priyanka Joshi, PhD research Scholar Yoga, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh Emailpriyankaj 755@bhu.ac.in ABSTRACT: Yoga is a traditional art and subtle science of body, mind and soul. Yoga deals with psychosomatic as well as soma-psychotic aspect of the disease, which connects body and mind. The psychosomatic aspect of treatment helps to know the relationship between body and mind. In considering the skin health and disease condition, the first point is to realize that the skin is a different body organ. Covering entire body which helps internal body organ from extreme temperature, attack of the pathogens, and other infections. An organ is defined as a group of cells bundled together in order to fulfil a specific physiological function. Secondly, the health of the skin cannot be neglect from the rest of the body organs. There are many reasons of skin problems but mostly it occurs due to undisciplined lifestyle, lack of sleep, unhealthy food habits, medication, environment and some extent due to genetic factors in some cases. Study have shown, Yoga helps to reduce psychosocial stress and allostatic load through the regular practice of Asana, Pranayama, Shatkarmas and Mudras , these techniques of Yoga work as a panacea in many chronic skin diseases like Psoriasis and related co-morbid conditions like stress, anxiety, depression and improve the quality of life of psoriatic patient. Keywords –Yoga, therapy, Psoriasis, Psychological burden, skin disease.

[Find the meaning and references behind the names: Tamas, Sun, Eva]

Priyanka et.al , “Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis.” : 2023; 6 (5):84-89 85 Ayurvedic prospective of psychosomatic disorders The mind and body are not distinct entity although there is a tendency to think, to govern, to do and to act as though they are. The grosser part of the mind is the body and the subtler part of the body is the mind 7 Psychological disorders are very common condition in skin diseases especially in Psoriasis. Many studies have shown anxiety and depression is more in Psoriasis as compared to other chronic diseases. All the fluctuation of the mind is due to the tendency of mind. Mind and body is the two pathway as Ayurveda considers which manifests diseases. Śarīraṃ Satvasaṃjñaṃ Ca Vyādhīnāmāśrayomataḥ Caraka Sūtra Sthāna 1/55 Mind has its three tendencies in Sattva, (light) Rajas (action) and Tamas (indolence) . 8 Apart from the Sattva other two are the responsible for the responsive tendencies, which vitiate the mind leading to an emotional and mental imbalance, culminating in a psychological disturbance. Similarly the three Dosas of the body also called Tridosha in Ayurveda, Vata, Pitta, Kapha, excess of these three in the body, leading to a metabolic disturbance and can cause of many chronic disease. Vāayuḥ Pittaṃkaphacoktaḥ Śārīro Doṣasaṃgrahaḥ Mānasaḥ Punaruddhiṣṭo Rajaścatama Eva Ca Caraka Sūtra 1/57 Although body and mind are considered as the two different entities nevertheless these two are interrelated as mind is the subtle form of the gross body and body is extension of the mind and if the mind gets disturb then body will automatically be disturbed. Disease related the body and mind respectively somatic and psychological. But both of the entity interrelated to each other. Both influences jointly hence mental health as important as physical health. Cause of kustha (skin diseases) according to Ayurveda Psoriasis is considered as Kitibha in Ayurveda which comes under broad heading Kustha (skin diseases). All the skin disease comes under in Kustha . There are two types of Kustha (skin diseases) mentioned in Ayurveda 1. Mahakushtha (Major Kustha) 2. Kshudrakushta (Minor Kustha) Psoriasis is described in Ayurveda as kitibha , it is type of Kshudrakushta (Minor Kustha). Kustha is describes in Charak Samhita & Shusurut Samhita as a correlation with skin diseases In classical text of Ayurveda, Charak Samhita describes the cause of kustha (skin disease) are as follows 1 Contraindicated mix diet, excessive intake of oily and heavy meal. 2 Restraining natural urges like vomiting, 3 Exercising or coming in contact of excessive heat, 4 Haphazard intake of foods with hot and cold properties and fasting. 5 Use of cold water immediately after exposure to scorching sun heat, exertion or exposure to frightening situation. 6 Intake of excess food, uncooked food and intake of food before the previous meal is digested. 7 Excessive intake of foods of freshly harvested grains, curd, fish, salt and sour substances. 8 Excessive intake of Masha (Black gram), Mulaka (radish), Tila (Sesame seeds) and Jaggery. 9 Performance of sexual act while suffering with indigestion. 10 Sleep during day time. 11 Insult to Brahmans, and preceptors, and other sinful acts. Psychological disorders WHO defined ‘Health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity 9 Although somatic disturbance may appear easily and one can understand to see the common symptoms but the psychological disturbance cannot understand easily hence psychological problem as important as the somatic. Both in the initiation and continuation of the disease it is of course possible that any emotional upset, which go along with physical diseases, is merely secondary to the physical disability, this condition is not applicable all the situation that psychological disorders lead to somatic problem, psychological leads to somatic. Sometime things happen in different way. Study have shown that depression can cause vitamin D 3 deficiency 10 Less secretion melatonin could be the reason. Exact cause cannot find easily but some sort of deficiency may occur psychological and somatic disturbance. However, the Chronic emotional problems, such as Anxiety, unresolved conflict, suppressed desire and anger may be contributory etiological factors in the Psycho Somatic conditions 11 These include Bronchial Asthma, Ulcerative colitis, certain skin diseases, peptic ulcer, migraine etc. Physiology of stress Hypothalamus control and integrates activities of autonomic nervous system. It regulates emotional and behavioral patterns. When the stress comes activity of neuron gets disturbed, due to the stress biological clock gets disturb. Stress diminishes hypothalamic pituitary

[Find the meaning and references behind the names: Beat, Gita, Santosh, Satya, Deep, Ishwar, Don]

Priyanka et.al , “Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis.” : 2023; 6 (5):84-89 86 adrenal (HPA) axis and due to stress Allostatic load has increased. By these changes all the chemical reaction and the mechanism inside the body gets disturbed. Stress directly affects the immune system result manifestation as autoimmune disease including Psoriasis, Hypothyroidism, Rheumatoid arthritis, psoriatic arthritis. When the cerebral cortex interprets the deep emotion which one can get from the outer world it directly sends impulses along the tracts that connect the cortex with the hypothalamus. The hypothalamus then directs impulses via the autonomic nervous system (ANS) and also release chemicals that stimulate the anterior pituitary gland 12 The result can be a huge change in the body activities. When one is in stress, through the ANS sympathetic nervous system activates which is responsible for the fight and flight response it stimulates blood pressure, heat beat. Likewise, persistent and prolonged period sadness, worry, fear and trauma convert into psychological disorders it can culminate longterm abnormalities in body function and can cause serious illness. These are known as Psycho Somatic disorders. Yogic counselling in psychological disorder Yuktahara viharacha yukta chestsya karmshu 13 Bhagwat Gita 6.17 That means Yoga, which destroys all kind of problems etc. is proved only for those who eat the diet properly, who do the write deeds, and those who sleep and wake up at the appropriate time. Samtavam Yoga Uchyate 14 Bhagwat Gita 2.48 As per the Bhagwad-Gita, an individual has to be in the state of Equanimity of the mind, whether any condition like instability comes in mind, it is Yoga. Yoga therapy work as a Panacea Most diseases are psychosomatic in nature. Drug treatment of these ailments is only symptomatic and fails to touch the roots of the disease 15 Stress plays a key role in many chronic disease including Psoriasis, cancer, bronchial asthma, diabetes mellitus etc. Yoga therapy provides a great option to cope up with these problem. It is well defined that stress plays an important role in the pathophysiology of numerous skin disorders 16 Yoga is being practiced thousands year ago for the salvation and purification of the Nadis for the proper flow of Prana (Vital energy). Now a days Yoga practices has become necessity for the people to keep body mind healthy. People are adopting Yoga for their wellbeing. Mental health has become a serious concern for the society. Yoga is the only way to keeping mind relax and healthy, by the regular practice of Asana, Pranayama, Pratyhara, Mudra And Shatkriyas (Six Purification Technique) which helps to clean the Nadis to the proper flow of the Prana (vital energy). Yoga philosophy In Yoga Darshana , psychological disorders considers as Chitta Vikshepa 17 These are the obstacles it create hindrance of the path of Samadhi. It is occure due to disturbance of the Vrittis of mind. Why mind gets fluctuate? It fluctuates because the fluctuation in the tendencies of the mind Rajas and Tamas . These are the quality of mind. Rajas is responsible for action, activity and Tamas for the indolence, darkness but when it gets excess in our Chitta (mind) then psychological disorders manifest likewise depression, anxiety and suicidal ideation. Sattva is also considered in three qualities of mind hence Sattva is the manifestation of light, wisdom. Through the learning and understanding the philosophy of Yoga, one can eliminate all the vitiation on the mind as well as body and free from all the psychosomatic disorders. Ashtanga Yoga (eight limbs of Yoga) the pathway to remove obstacles of the mind are as follows Yama, Niyama, Asana, Pranayama, Pratyahar, Dharana, Dhyana, Samadhi Yama - It is for social ethics, it teaches how to deal with others and how to behave like a human. It is considers as do’s & don’ts for the external world. Non-violence ( Ahimsa ), Truthfulness ( Satya ), Non-stealing ( Asteya ), Celibacy ( Brahamacharya ), Minimalism ( Aparigraha ), these five steps comes under the Yama. 18 Niyama - It is for personal ethics, everyone should do for everyday including external and internal cleaning ( Sounch ), satisfaction ( Santosh ), austerity ( Tapa ), selfstudy ( Swadhayaya ), surrendering to higher self ( Ishwar Pranidhana ). These things comes under the Niyama Asana - It means a state of being in which Yoga practitioner remains steady, calm, quiet and comfortable in physically and mentally. In the Patanjali Yoga Sutras , 19 there is a precise definition of Asanas: "Sthirsam sukham aasanam" , meaning that position which is comfortable and steady Pranayama (breath control) - Practice of Pranayama stimulate pranic flow. Skin disease occurs due to accumulation of toxin in our body. By the practice of Yogic breathing, it helps to eliminate toxin through the lungs.

[Find the meaning and references behind the names: Danger, Main, Chakra, Heart, Med]

Priyanka et.al , “Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis.” : 2023; 6 (5):84-89 87 Pratyahara (withdrawal of senses) - To understand the Pratyahara to understand the tortoise, when tortoise find some danger, it pulls all the limbs inside for the protection similarly when the outer world disturbs, then try and go inward for the peace. It helps to understand to own state of mind, it is the journey to become gross to subtle. Pratyahara is the link between external and internal, when ones go internal all the external pain and suffering go away. Despite of many symptoms of the disease’s manifestation Pranic flow is the most important factor in illness. Where there pranic flow does not pass in that area of the body gets blocked and disease manifest. By the practice of Yoga one can get the disease-free body. Relation between Chakra and Asana Chakras are considered as the energy centres of the body. These are the circular vortex of energy lying across the six different point of spinal column 20 A chakra is like a centrally positioned electricity pole from which electrical wires are run to different places, houses and street lights in the locality 21 The chakras are arrange is the same way in the spine. There is upward and downward pranic motion in the Nadis (Energy Channels). Which carry Prana (vital energy) in both directions equivalent to the flow of alternating current in electrical wires. There are six chakras in the human body are as follows 1 Ajna (Third eye Chakra) 2 Vishuddhi (Throat Chakra) 3 Anahata (Heart Chakra) 4 Manipur (Solar Plexus Chakra) 5 Swadhisthana (Sacral Chakra) 6 Mooladahara (Root Chakra) According to Yogic prospective skin disease manifest as a result of disturbance of Chakras (energy centres). The energy flow depleted, degenerated the body manifest physical and mental imbalance. Chakra meditation is the best tool to energize and channelize the weak area of the body and provide pranic flow on that area. As the study have shown skin diseases exacerbate due to psychological stress and some sort of underline weakness in internal organs like liver kidney and lungs. These organs helps to eliminates toxin from the body. By the focusing on Chakras along with the asana practice its gives double benefit. There are seven Chakras being mention in Yogic text among of them these three Chakras associated with the Immune system, Nervous system and Digestive system. Psoriasis is the autoimmune disease. It is occurring due to deregulate immune system. Main cause of any disturbance in the harmony between body and mind is psychological stress. Persistent and prolong period of stress turns into psychological disorders including depression, anxiety and can cause of the many chronic diseases etc. This types of imbalances in the body leads to many chronic diseases. Chakras and their association along with the asana are as follows MATERIALS & METHOD This review paper aims to review, to know the skin diseases induced psychological manifestation, cause and its management through to Yoga and Ayurveda. These two discipline not only find out the root cause of diseases but it has a potential to eradicate the disease from the root. Literature is reviewed from the classical text of Yoga and Ayurveda- Charak Samhita, Susurta Smhita, Madhava- Nidana and also review from some electronic database – Google scholar, Pub-Med, Research Gate. RESULT This study shows that only practicing Asana superficially is not sufficient for healthy body and mind because body and mind are connected to each other if individual wants holistic health and wellbeing, one should practice all the aspects of Yoga including Yama & Niyama , these are the first step of the path of Yoga. Everyone should follow this ethical code and conduct first then only one can get deeper essence of happiness from within. DISCUSSION Many studies have done in the field of Yoga and Ayurveda, after evaluating many text and research journals, we find that the Yoga and Ayurveda works every dimension of human life where Ayurveda explain about lifestyle modification for health, longevity, and diseases prevention as well as detoxification of body on the other hand the term Yoga means to unite, harmonize. One can get complete benefits of Yoga by follow Yama & Niyama (Yogic lifestyle) first, then yogic philosophy, principles and practice of Asana, pranayam, Pratyahara, dharana, dhyana. Mingling Yoga and Ayurveda with the greater context of the Vedic science offers a complete system of well-being for body and mind. CONCLUSION Yoga is the way of life. There are many ways to treat psychological disorders but Yoga is beyond from the all techniques. Usually it happens during stress, negative

[Find the meaning and references behind the names: Malik, Darshan, Masood, Khan, Murthy, Rishikesh, Nil]

Priyanka et.al , “Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis.” : 2023; 6 (5):84-89 88 thoughts comes in mind, through the practice of Yoga it starts bringing positive hormone in body and all the negative thoughts converts into great positive thoughts, divine thought, pure thoughts and the mind gets purified. By the regular Yoga practice one can change the lifestyle doing some set of asana pranayama along with focusing on Chakras helps to channelize the particular weak area, remove toxins and starts all the secretion properly. Skin diseases directly connected with the weak metabolism (poor digestive fire) along with psychosomatic imbalance. From a Yogic outlook one has to change their prospective towards life and including Asana, pranayama , proper diet and proper sleep as part of life. Which helps to correct all the system of the body especially nervous system, immune system and digestive system. Psychological disorders of skin disease reduce efficiently through the Yogic management. Acknowledgment - Nil Conflicts Of Interest- Nil Source of finance & support – Nil ORCID Priyanka , https://orcid.org/ 0000-0003-2681-9033 REFERENCES 1 Cited from https://www.psoriasis.org/psoriasis-statistics/ accessed on 07.05.2022 2 Cited from https://www.psoriasis.org/psoriasis-statistics/ accessed on 07.05.2022 3 Garg A, Chren M, Sands LP, et al. Psychological Stress Perturbs Epidermal Permeability Barrier Homeostasis: Implications for the Pathogenesis of Stress- Associated Skin Disorders. Arch Dermatol. 2001;137 (1):53–59. doi:10.1001/archderm.137.1.53 4 Russo, P. A., Ilchef, R., & Cooper, A. J. (2004). Psychiatric morbidity in psoriasis: a review. Australasian journal of dermatology, 45(3), 155-161. 5 BFERREIRA, BIRC, Abreu JLPDC et al. Psoriasis and Associated Psychiatric Disorders A Systematic Review on Etiopathogenesis and Clinical Correlation. Journal of Clinical Aesthetic Dermatology . 2016; 9(6), 36-43 6 Lowes, M. A., Suárez-Fariñas, M., & Krueger, J. G. (2014). Immunology of psoriasis. Annual review of immunology , 32 , 227–255. 7 Krishnananda.S. The Yoga System . The Divine Life Society Sivananda Ashram, Rishikesh, India 8 Murthy, A.R.V. Rationale of Ayurvedic Psychiatry. Chaukhamba Orientalia, Varanasi, U.P 2009 9 Citedfrom https://www.who.int/about/governance/constitu tion accessed on 04.05.2022 10 Sahi, F. M., Masood, A., Danawar, N. A., Mekaiel, A., & Malik, B. H. (2020). Association Between Psoriasis and Depression: A Traditional Review. Cureus , 12 (8), e 9708. https://doi.org/10.7759/cureus.9708 11 Murthy, A.R.V. Rationale of Ayurvedic Psychiatry. Chaukhamba Orientalia, Varanasi, U.P 2009 12 Ramsukhdas, S. Shrimad Bhagwat Gita (Sadhak Sanjeevani, Parishishtha). Gorakhpur Gita Press 2013 13 Ramsukhdas, S. Shrimad Bhagwat Gita (Sadhak Sanjeevani, Parishishtha). Gorakhpur Gita Press 2013 14 Saraswati, S.S. Asana Pranayama Mudra Bandha . Yoga Publications Trust, Munger, Bihar, India 2002 15 Dalgard, FJ, Gieler U, et al. The Psychological Burden of Skin Diseases: A Cross-Sectional Multicentre Study among Dermatological Out-Patients in 13 European Countries. Journal of Investigative Dermatology . 2015; 135, 984-991; doi:10.1038/jid.2014.530; 16. Niranjanananda Saraswati, S. Yoga Darshan . Yoga Publication trust, Munger, Bihar.1993 17 Khan, Y., Choudhari, V. Role of Manipur Chakra in treating Diabetes Mellitus. International Journal of Research in Indian Medicine; 5(1), 1-5 18 Niranjanananda S, S. Yoga Darshan . Yoga Publication trust, Munger, Bihar 1993 19 1 Khan, Y., Choudhari, V. Role of Manipur Chakra in treating Diabetes Mellitus. International Journal of Research in Indian Medicine; 5(1), 1-5 20 Saraswati S, S. Kundalini Tantra . Yoga Publication trust, Munger, Bihar 2002 How to cite this article: Joshi P, Singh O.P “Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases W.S.R. Psoriasis” IRJAY. [online]2023;6(5);84-89. Available from: https://irjay.com. DOI linkhttps://doi.org/ 10.47223/IRJAY.2023.6513

[Find the meaning and references behind the names: Ram, Asa, Lam, Master, Red, Green, Yam]

Priyanka et.al , “Potential Application of Yoga & Ayurveda for Preventing Psychological Burden of Skin Diseases w.s.r. Psoriasis.” : 2023; 6 (5):84-89 89 Table 1 Represents Different Chakras Cha kra s Co lo ur E lement Seed M a ntr a Asa na Ass o cia te d O rg a ns E ff ec t Mool adhar (Root Chakras) Red Earth Lam Veerasana, Vrikshaasna Tadasana Reproductive, Immune System, Bone Marrow, Endocrine Gland, Adrenal Medulla Feel Stable, Confident, Balanced, Energetic, Independent And Strong. Manipur ( Solar Plaxus) Yellow Fire Ram Paschimottan asana, Bhujang Asana Liver, Stomach, Pancreas, Gallbladder, Intestinal Tract Feel Energetic, Confident, Productive And Focused Anahat ( Heart Chakra) Green Air Yam Ustrasana, Shavasana Thymus Gland, Heart, Lungs Feel Compassionate, Optimistic, Friendly, Motivated, Understanding And Caring Ajna Third-Eye Indigo Blue Om Headstand Pituitary Gland, Eyes, Head, Lower Brain One Of His Own Master Without Fear Of Death And Free Of Attachment To Material Things CHAKRAS

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