19/04/2021
Depression:
Depression is a common, debilitating, life threatening and serious
mood disorder with an increasing morbidity and mortality that
affects more than 300 million individual worldwide. It interferes with an individual’s thoughts, behaviour and feelings and affects a person’s ability to work and form relationships and destroy their quality of life. It is the fourth leading cause of disability, which contributes a major role in increasing the overall global burden of disease. It can lead to su***de if left untreated and is responsible for 850,000 deaths every year. Depression is characterized by change in mood, lack of interest in surroundings and enjoyment, feeling of sadness, gloominess or melancholy . Many depressed individual experience anxiety symptoms, disturbed sleep, poor concentration, feelings of guilt or low self-worth and increased or decreased appetite, and may have even medically unexplained symptoms. Mental depression is classified into unipolar and bipolar depression. Unipolar depression is more common and account nearly 75% of cases, in which mood swings are always in the same direction. It is accompanied by symptoms of anxiety and agitation, shows a nonfamilial pattern and closely related to stressful life events. Bipolar depression is less common (about 25% of cases) which shows a familial pattern, appears in early adulthood and usually have no relation with external stress. In this type, mood swings are bidirectional and results in swinging depression and mania over a period of a few weeks. The exact aetiology of depression is still remains obscure, but the most popular theory is the decrease in the neurotransmitter levels in the brain, such as noradrenaline, 5-hydroxytriptamine (5-HT) and dopamine.
However, recent studies have also shown the involvement of oxidative stress in the phenomenon.
Depression in unani perspective:
Psychiatric diseases were well recognized in the ancient Unani
world. Melancholy and hysteria were well known to Egyptian and Sumarian physician as early as 2600 BC. The psychiatric nosology is
discussed comprehensively in Unani classical texts under the title of
“Amraaz-e-Nafsani” (psychiatric disorders) where all the diseases are classified as syndrome rather than an individual disease entity
In the similar fashion, depression is not mentioned in Unani classical texts as an individual disease entity rather it is mentioned as a symptom or group of symptoms of Malankholia (Melancholia) in which the mental functions of the individual are deranged leading to constant grief, fear and dubious aggression. The patient find himself/herself deserted and occupied by loneliness and some patients experience delusion and hallucination. . Unani scholars consider Ghair Tabayi Sauda (Abnormal black bile) as the main cause and basis of psychological and psychiatric disorders e.g. anxiety, depression, melancholia etc. whether it is associated with the Ehteraq (combustion) of Dam (blood), Balgham(Phlegm), Safra (bile) or Sauda (black bile) itself.Ibn-e-Sina has stated in his renowned book Al-Qanoon fit-Tibb, that the Mizaj (temperament) of Khilt-e-Saudawi (Black bile) is Barid Yabis (cold and
dry) which is contrary to the Mizaj of Rooh-e-Dimagi (temperament
of mental/vital spirit) thus resulting in derangement of Rooh-eDimaghi and leading to Khauf (Fear).
Though effective medications are available in conventional system
adverse effects produced by their use may not be ignored. Unani system of medicine is replete with the treatment of depression and other psychological disorders. Use of Mufarrehat is the integral part in treatingpatients with psychological disorders such as anxiety, depression and malankholia. Many Mufarrehat and other drugs, being used sinceages for psychological disorders, have already been reported for their various neuropharmacological activities. Aforesaid preclinical/clinical studies attest that Mufarrehat modulate the physiology of CNS and have a potential clinical value for use in the management of psychological disorders, thus validating the age old theory of Unani scholars.