Shirodhara is one of the most effective panchkarma therapy used since ancient times . It is used for treating sleep disorders and mental disorders .

1. Submitted by -
Payal Sindel
BAMS Final Year
Batch 2017-18
Role of Shirodhara on
Mental Health
Pt Khushilal Sharma govt.(auto.) Ayurved College
and institute ,Bhopal (M.P.)

2. Introduction
The Human being has to face various challenges in day to day life because of a different kind of occupational
environmental and social conditions. Such frustration and very lead to stress which adversely affects our
physical, social, mental and spiritual health too.
Mental health : A state of well being
Mental health is defined as a state of well-being where every individual realizes his or her own potential ,
can cope with the normal stresses of life , can work productively and fruitfully and is able to make a
contribution to her or his community .
WHO on mental Health : A need for the change
Mental health conditions are increasing worldwide. Mainly because of demographic changes, there has been
a 13% rise in mental health conditions and substance use disorders in the last decade (to 2017). Mental
health conditions now cause 1 in 5 years lived with disability. Around 20% of the world’s children and
adolescents have a mental health condition, with suicide the second leading cause of death among 15-29-
year-olds. Approximately one in five people in post-conflict settings have a mental health condition.
Mental health conditions can have a substantial effect on all areas of life, such as
school or work performance, relationships with family and friends and ability to participate in the
community. Two of the most common mental health conditions, depression and anxiety, cost the global
economy US$ 1 trillion each year.
Despite these figures, the global median of government health expenditure that
goes to mental health is less than 2%.

3. Ayurveda About Mental health
Ayurveda consider prassanna atma (pleasant soul) indriya (senses) and mana (mind) beside equilibrium of
Dosha, dhatu and mala as Swastha (Healthy ) .
Ayurveda classics have also mentioned about mansik dosas Raja and Tama ,
imbalance of his two mansik doshas lead to various kind of mansik (mental disorders) .
Various kind of treatment have been explained for the mental disorders in the ayurvedic samhitas from
satavajaya chikitsa to panchkarma .
Mental Health matters
Dhi or Buddhi - Intellect , or ability to analyse information
Dhruti - willpower , or the ability to make decisions.
Smruti - Memory
When we are physically unwell we take time to allow the body to recover, so why do we not do the same for
when our stress levels increase and our mood and emotion fluctuates.
According to Ayurveda main aspects of the mind are
Any Disturbance in equilibrium of these three aspects of mind leads to mental disorders .
Anxiety and Ayurveda
Daivavyapashraya chikitsa - Spiritual therapy
Yuktivyapashraya Chikitsa - Physical therapy
Satavajaya chikitsa - Psychotherapy
With long term concentration on the objects of the census one develops attachment to them. When the
memories confused the intellect get destroyed and when the intellect is destroyed, one is destroyed . "Over
thinking is inversely proportional to productivity"
Ayurveda utilises three modalities in treatment of any ailment namely
1.
2.
3.
Application of these three modalites place a vital role in management of anxiety.
समदोषः समाग्निश्च समधातुमलक्रियः । प्रसन्नात्मेन्द्रियमनाः स्वस्थ इत्यभिधीयते ॥(सु.सू.15/41)

4. Depression and Ayurveda
Daivavyapashraya chikitsa - Spiritual therapy - Mantradi Chikitsa creates confidence
Yuktivyapashraya Chikitsa - Physical therapy - treatment according to the inherent factors like Dosha
, dhatu etc - Shirodhara can be used
Satavajaya chikitsa - Psychotherapy - to enhance satva Guna Gyanadi chikitsa
Several conceptual and clinical studies have correlated depression as avasada , vishada , manodhukhaj
unmada and kaphaj unmaada according to the etiology and symptoms exhibited by the disease.
Management of Bipolar Disorders with Ayurveda
Intellect promoting or Medhya drugs such as Mandukparni (Centella asiatica), Yashtimadhu ( Glycrrihiza
glabra ),etc along with Diet recommendation (Aaahar) and Lifestyle changes (Vihar) are recommended.
Case report Depression + OCD vis a vis Vaataj Unmaada
70% improvement was observed after 9 months period of treatment of A woman having OCD and
depression ,along with ashvasan chikitsa proved very much beneficial to normalise her life on right track.
Panchkarma for mental disorders : The Ultimate cure
Abhyanga. This deep herbal oil massage is a well known relaxation therapy that increases blood
circulation in the body.
Shirodhara
Nasya. This process of administering herb-infused oils into the nasal cavity also helps to relieve
headaches etc.
Herbs. Below are some of the herbs administered to manage mental illness. Brahmi Dhanavanatari oil
etc
Panchakarma is a method of cleansing the body of all the unwanted waste after lubricating it. Panchakarma
are 5 (five) in number; hence the term PANCHA (five) – KARMA (procedures). Panchakarma treatment is
unique in the sense that it includes preventive, curative and promotive actions for various diseases.
Therapies for Cure and Prevention of Mental Health Diseases

5. Shirodhara :A Gift for Mental health
This unique gift from the ancient healing system of Ayurveda is one of the most calming relaxation
therapies. In this deeply soothing process, the scalp and forehead receive a gentle, steady stream of
lukewarm medicated herbal oil poured in an ancient pattern stimulating points covering the whole of
the forehead.
Shirodhara
The word shirodhara is derived from Sanskrit language shiro (head) + dhara (to flow).
Shirodhara is a form of independent snehana procedure, wherein involves gently pouring liquids over
the forehead.
The selection of the drug and duration depends upon various factors including characteristics of disease,
chronicity, involvement of dosha, patient’s prakriti and environmental condition.
There are various specialized forms of shirodhara such as Tailadhara, Ksheeradhara, Takradhara,
Jaladhara and Kwathadhara. Shirodhara is classically advised for many diseases like insomnia, attention
deficit hyperactivity disorder, anxiety disorders, phobia, depression, essential hypertension and other
psychosomatic disorders.
Benefits of Tail Dharana
When medicated Ghee or Oil is poured on the forehead, it is called TailaDhara. It improves speech,
stabilizes the mind, increases physical strength, removes anorexia, increases sweetness of voice, and
softness of skin. It is helpful in Timira and Netra Roga, Shukra etc. Dhatus are nourished, increase
virility, excessive body temperature is reduced and patients can get good sleep.
Shirodhara Oils
The Shirodhara dripping oil is standardized as per Ayurvedic pharmacopoeia containing Centella asiatica
(Brahmi), Nardostachys jatamansi (Jatamansi), and Withania somnifera (Ashwagandha) etc drugs along with
an oil.

6. INDICATIONS OF SHIRODHARA
Attention deficit hyperactivity disorder
Apasmar (Epilepsy)
Anxiety disorders
Mental exhaustion
Irritability
Hypertension
Insomnia
Phobia, depression and other neurobehavioral disorders
Ardhavabhedaka, Suryavarta, Ardita, Pakshaghata, Hanugraha, Akshishula, Nidranasha, ShirogataVata,
Shirahkampa
CONTRAINDICATIONS OF SHIRODHARA
Inflamed skin on the forehead
Drugs or Alcohol Intoxication
Pyrexia
KaphajaVikaras

7. Probable Mode of action of Shirodhara
The pressure effect
The frontal bone hollow cyanosis is enhanced by the continuous pressure and vibrations produced by
the shirodhara process and results in decreased CNS activity and induces sleep.
The temperature effect
During the shirodhara procedure lukewarm liquid is repeatedly poured on the forehead. Its temperature
is Just bit higher than that of our bodies . It might warm the POAH which could make you fall asleep.
The posture effect
In shirodhara patients are asked to lie down in supine position as in savaasana. This position itself is
used for relaxation in yogik science.
The chakra effect
Aagaya chakra( the space between the two eyebrows )is the seat of the pituitary and pineal gland. As
we know, the pituitary gland is one of the mainlands of the endocrine system. Its penetrating effect
which decreases the brain cortisone and adrenaline level synchronises the brain wave , strengthen the
mind and spirit and this continues even after the relaxation
The Marma theory
According to Acharya bhel,the sthana of chitta (mana) is bhru Madhya I.e. Sthapani marma .
Shirodhara makes to the patient to concentrate on this area by which the stability arrives in the
functions of mind .
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5.

8. PROCEDURE OF SHIRODHARA
Before starting Shirodhara,Physician should explain about whole procedure to the patient and take
his/her consent for the same.
The patient is made to lie down on Shirodhara table with his palms facing up.
A rolled towel or a small pillow should be placed under the head so that head rests in a comfortable
position.
Precaution should be taken not be hyper flex or hyperextend the neck. Massage is done over head with
prescribed medicated oils.
The medicated oil should be warmed and then should be taken out from hot water bath and temperature
should be tested with a digital thermometer.
It is then poured into the shirodhara patra (Vessel) that is positioned over the patient’s head and adjusted
to the appropriate height.
Classically, dhara patra is made up ofcopper metal. It is a wide mouthed and curved vessel pot having a
hole in central bottom. Through the hole a cloth thread is pushed to allow the oil to flow continuously in
the form of stream.
The pot is hanged four inch above the forehead of the patient with the help of chain.
After proper snehan (massage) on head, patient should be asked to lie on the supine position on the
shirodhara table and keep the head on the extra projection of the table.
Both the eyes of the patient are covered with cotton, gauge piece
The fluid is then poured in dhara patra and the fluid is allowed to flow through the wick of cotton that is
pushed down through the hole of the shirodhara patra.
The movement of oil in the entire forehead is regarded beneficial.
The usual duration of shirodhara lasts for about 30-45 minutes. Jaladhara or takradhara can be given for
more time as per the clinical judgment.
After completion of pradhan karma, head of the patient should be cleaned thoroughly.
Patient should be asked to take rest for few minutes on the shirodhara table.
Advise the patient to take hot water bath after half an hour and not to get direct exposure of sunlight
immediately.
The process of shirodhara is divided into
03 important steps:-
Step 1 – Purva karma(Preoperative procedures)
Step 2 – Pradhan karma (Main procedure)
Step 3 - Pachat Karma (Post operative procedure)
PURVA KARMA
PRADHAN KARMA
PASCHAT KARMA

9. CHANGES DURING SHIRODHARA PROCEDURE BASED ON CLINICAL STUDY
AND CASE REPORT
It was observed that Plasma noradrenaline and urinary serotonin excretion decreased significantly more
after Shirodhara treatment than in the control. Apart from this, Plasma levels of thyrotropin-releasing
hormone, dopamine, and natural killer (NK) cell activity were different between control and Shirodhara
treatment.This shows that shirodhara procedure has an anxiolytic effect.
Physiological changes during shirodhara are found to be similar to those of meditation, including α-
wave dominance in the frontal area and a decrease in heart rate and CO2 excretion. These findings
indicate a change in the function of the frontal lobe, limbic system, brain stem, and autonomic nervous
system after shirodhara
Shirodhara showed significant improvement in serum biomarkers of stress, which are reduced after
Shirodhara. It provided significant relief in the grading of the POMS Score. There was a significant
reduction in systolic and diastolic blood pressure after Shirodhara. It showed appropriate responsiveness
to the stress system. This therapy found effective treatment in the management of stress.
EFFICACY OF SHIRODHARA IN GENERALIZED ANXIETY DISORDER
Study shows that combined therapy of Manasamitra vataka and shirodhara is effective in management of
generalized anxiety disorders. Shirodhara reduces the daytime sleepiness associated with GAD with co
morbid generalized social phobia.
CONCLUSION
Shirodhara is an important therapeutic measure in the Ayurveda system of medicine, which has got
worldwide popularity because of its simple administration and effectiveness in several disorders and lifestyle
diseases. It is a purifying and rejuvenating therapy which eliminates toxins and mental exhaustion as well as
relieves stress and any ill effects on the central nervous system. On the basis of the above description, it is
clear that Shirodhara has both the therapeutic effect of medicament and procedural effect. These can be
understood from the aspect of Ayurveda, mechanical and Marma science. Shirodhara can be used for
treatment of all kinds of mental disorders and mood disorders .

10. References
Impact of Shirodhara on Biological Markers of stress :A case study - Sujata Rajan, Manoj K Shankhwar
and Ankur Kumar Tanwar.
Kaya Chikitsa Volume 1 - Dr Ajay Kumar Pandey
Advances In Ayurvedic Medicine -K.N.Murthy , R.H.Singh
Panchkarma for anxiety ,Depression and chronic stress -Art of living faculty
Therapeutic efficacy and mechanism of action of ayurvedic Shirodhara . An evidence based review —
Harsh mohan Moharana , Arun Kumar Mahapatra ,Laxmi Mahapatra , Santosh Kumar Singh (World
journal of ayurveda science )
Charak Samhita - Vidyotani - Kashinath Pandey
Sushrut Samhita - Ambika Dutt Shastri
Bhavprakash Samhita
Yog Ratnakar Samhita
Shirodhara - A psycho physiological profile in healthy volunteers - Kalpana D Dhuri , Prashant V
Bodhe , Ashok B vaidya .
Journal - Heritage Amruth (Mental Health) Volume 17 issue 2 2021.
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