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CHILDREN TODAY ARE often more stressed than parents and suffering from mental, behavioral, and developmental health conditions that affect a person’s thinking, feeling, behavior, and moods. An estimated 50 percent of all lifetime mental health disorders begin by the age of fourteen. The question on so many parents’ minds today—especially if you have a child yourself diagnosed with a mental health issue—is Why? Why are these diagnoses increasing at such an alarming rate, and why are so many children in distress? There are many underlying factors for disease according to the science of Ayurveda, which we will discuss throughout this chapter, but common denominators of unhealthy behaviors and chronic childhood disorders are lifestyle, environment, and stress.
Whereas modern medicine views most mental health issues in children as entirely brain-related, Ayurveda identifies certain aspects of the mind that work not only with the brain but also independent of the brain. While intellectual, analytical, and factual memory are connected to brain function, Ayurveda correlates emotional aspects of the mind such as unconditional love, empathy, and compassion to the heart. Due to this wide scope and understanding of the mind, the science of Ayurveda adopts multifaceted treatment methodologies that influence the brain as well as the aspects of the mind that are not controlled by the brain. Satvavajaya Chikitsa (Ayurvedic psychotherapy) is a nonpharmacological method aimed at controlling the mind and restraining it from unwholesome objects (ahita artha), or stressors.
Mental disorders in children are usually first identified when parents and caregivers observe major changes in the ways children typically behave, learn, and cope with their emotions, which often lead to greater distress and challenges throughout the day. It’s common, of course, for healthy children to feel irritable, sad, or fearful at times and occasionally experience difficulties staying focused, but severe changes in behavior that persist over time and affect school activities, social life, and behavior at home are indications of a mental disorder.
When your child’s mind is balanced, they reach social-emotional and developmental milestones and acquire meaningful skills that allow them to play happily with friends, cooperate, help others, and effectively cope with feelings and behavior. A healthy mind reflects a happy, enthusiastic child at school, home, and in their community.
Ayurveda’s approach to children’s mental health is not limited to managing a diagnosis but includes treatment therapies aimed at improving and enhancing abilities related to perception, analysis, decision-making, and memory so they can respond to life with a positive attitude and balanced state of mind. The most common mind-related disorders in children are ADHD, autism spectrum disorder, developmental delays, anxiety, bed-wetting, and night terrors. Let’s consider Ayurveda’s perspective on these conditions.
ADHD
ADHD is one of the most diagnosed neurodevelopmental childhood disorders in the modern world. Fundamentally, children are prone to such disorders during this stage of life because of the young, delicate nature of their heart and mind. The possible etiological factors for children diagnosed with ADHD are many and can stem from both genetic and environmental influences before and after birth. These include undernourishment of the fetus, premature delivery, imbalances during pregnancy (dietary, lifestyle, mental and emotional, alcohol or tobacco use), poor nutrition, and exposure to toxic chemicals.
According to Ayurveda, ADHD is a vata disorder of the mind often associated with pitta. Symptoms of ADHD primarily indicate a vata aggravation and express in many different ways including increased restlessness, emotional instability, tics and fidgeting, excessive talking, daydreaming, increased forgetfulness, and carelessness. From the Ayurvedic perspective, there also exists an exaggeration of symptoms during the last phase of digestion and a tendency to have low body weight. In cases with a pitta association there can be increased anger, aggression, and a tendency for self-harm.
In a climate of increasing ADHD assessments and diagnosis rates in children and adolescents, many parents and caregivers have obvious concerns about potential for overdiagnosis and the long-term effects of treatment. Misdiagnosis is a controversial subject in today’s culture. In Dr. J’s experience, children can be diagnosed with ADHD who have tendencies to be only slightly more active than other children in their age group without any major behavioral issues. This is a limitation of the current system that uses incomplete and subjective diagnostic criteria to assess and define mind function. Ayurveda views the mind as profoundly complex in nature, and while it doesn’t have a physical existence, it controls all of the sensory perceptions and responses to stimuli.
Ayurvedic management of ADHD is very comprehensive and considers every aspect of a child’s mind, body, and environment. Since it is a vata-predominant condition with pitta association, the overall treatment principle/protocol is to nourish, stabilize, and strengthen the mind-body systems, especially the brain and mind. While regular psychosocial interventions and behavioral therapies such as speech therapy and occupational therapy are immensely helpful for children to learn tools for managing their day-to-day life, healing and recovery from ADHD also requires dietary, lifestyle, and therapeutic interventions.
In addition to following the basic principles of Ayurvedic nutrition we discussed in chapter 4 such as establishing regular mealtimes and avoiding cold food and beverages, it is especially important to provide your child food and ingredients known to pacify both vata and pitta with the ability to nourish and strengthen the nervous system and mind. Some examples include cultured ghee, winter melon, cultured butter, black raisins, red rice, coconut, Indian gooseberry, and pomegranate.
As you have learned, your child’s lifestyle practices are essential to correcting imbalances and maintaining good health. The best way you can support your child is by helping them follow a regular daily routine that includes a moderate level of physical activity, going to bed early, limiting screen time, and spending time relaxing in a family environment. There’s no need to be overly regimented or strict; life is meant to be enjoyable and carefree—just do your best not to let unhealthy habits creep in too often!
Specific practices Ayurveda recommends for managing ADHD include daily, full-body oil application (abhyanga), or body massage (refer to chapter 16 for oil suggestions), warm showers, and application of sandalwood paste at the center of the forehead between the eyebrows in cases of pitta association. Making time for slow and steady deep breathing sessions as part of a fun family activity and playing calming, stabilizing mantras for your children will create a soothing, grounding home environment.
The basic therapeutic regimen an Ayurvedic physician will undertake includes clearing the mind-body channels, pacifying vata and pitta, undergoing a mild purification if necessary to eliminate aggravated doshas and accumulated toxins from the body, followed by the final stage of rejuvenation therapy (rasayana) that uses traditional herbs and Ayurvedic formulations such as Brahmi Ghrita and Kalyanaka Ghrita to rejuvenate the mind and nervous system. Rasayana, or rejuvenation therapy, deeply nourishes and strengthens the body to prevent recurrences of disorders and provide a sustained clinical outcome to the Ayurvedic healing regimen. Traditional Ayurvedic body therapies such as abhyanga, shirolepa, shashtika lepa, shirovasti, nasya, and pichu can also be highly effective performed under the supervision of an Ayurvedic doctor.
Since the causes of ADHD are commonly linked to genetic factors, derangements that occur during the fetal period, and labor complications, the best thing parents can do when they are planning to have a child is to prepare for a healthy pregnancy.
Traditional Ayurvedic preconception care starts with both parents having a complete Ayurvedic assessment and receiving guidance on lifestyle routines based on constitution and present health status. Many couples and individuals preparing for pregnancy choose to embark on a complete physical and spiritual journey during the preconception period that includes an Ayurvedic cleanse (panchakarma) followed by rejuvenation practices (rasayana) to optimize all aspects of fertility and conception through the Ayurvedic lens. Taking these steps can minimize the possibility of your child developing ADHD and help prevent pregnancy complications.
epigenetics
All too often, the accepted way of thinking cements ideas that there is nothing you can do about genetic tendencies and hereditary disorders. The science of Ayurveda rejects this belief and completely aligns with the emerging principles of epigenetics that recognize we have the outright ability to downregulate our own disease tendencies as well as upregulate epigenetic patterns that can cause changes to affect the way our genes work. Epigenetics is an emerging field, and literally means “above” or “on top of” genetics. The preventive and curative guidelines of Ayurveda rest entirely on our capability to resist disease and degeneration through diet, lifestyle, mind care practices, natural healing ingredients, detoxification, and rejuvenation protocols. Our genes play an important role in our health, but so do our behaviors, environment, and lifestyles. According to the CDC, “While genetic changes can alter which protein is made, epigenetic changes affect gene expression to turn genes ‘on’ and ‘off.’ Since your environment and behaviors, such as diet and exercise, can result in epigenetic changes, it is easy to see the connection between your genes and your behaviors and environment.”[1]
Autism Spectrum Disorder
Autism spectrum disorder (ASD) covers a range of developmental debility causing significant challenges and limitations in behavior, social skills, and communication. A distinctive feature of this condition is that children with ASD present a wide array of behavioral patterns with varying degrees of severity. There are gifted ASD children with superior cognitive skills and various exceptional abilities that exceed what most other children demonstrate. At the same time, some ASD children face severe challenges and need a lot of support in their daily lives. In most cases, growth and physical development of children with ASD are equal to typical norms for children, but differences in the way their brains develop affect the ways they learn, behave, and communicate.
The causative factors are similar to ADHD and include genetic disorders, environmental factors, and maternal lifestyle imbalances and disease during pregnancy (depression, addiction, stress, depression, and emotional trauma). The signs of ASD usually start during early childhood and typically express with unusual and repetitive movements and behaviors. Other common symptoms include unresponsiveness, trouble making eye contact, not showing interest in other people, an inability to recognize emotions or have empathy, reluctance to be touched or to cuddle, repeating or echoing words or phrases, difficulty expressing needs, and becoming easily frustrated. Ayurveda classifies ASD as a vata-predominant condition with the association of other doshas in some cases.
Early systematic psychosocial interventions and behavioral therapies focused on social communication development and reduction of repetitive behavior are essential tools that can help minimize symptoms profoundly and help children transition into the mainstream as they get older. Ayurveda recommends following a balanced Ayurvedic diet guided by the healthy eating principles we have discussed along with increasing foods known to pacify vata and strengthen the mind and nervous system. Modifying your child’s lifestyle habits is key to supporting any Ayurvedic regimen and should include going to bed early, regular physical activity, and a limited amount of screen exposure. Regular full-body oil application and massage also supports vata pacification. Ayurvedic therapeutic protocols need to be customized based on your child’s prakriti, age, and stage of ASD as guided by an Ayurvedic doctor. The overall treatment principle is to pacify vata and provide Ayurvedic herbs that strengthen and rejuvenate the mind and nervous system such as shankhapushpi, brahmi, and madukaparni. Ayurvedic bodywork techniques including abhyanga, shirodhara, shirolepa, and pichu are found to be very effective in calming and stabilizing the unique body-mind systems of affected children. Listening to mantra chanting on a regular basis can be calming and emotionally stabilizing for children with ASD.
As with ADHD, the causes of ASD are mostly related to genetic factors and complications during pregnancy and the perinatal period. As mentioned earlier, Ayurvedic preconception care is a profound traditional protocol guided by an Ayurvedic physician that goes beyond prenatal medical screening tests and offers couples and women planning a pregnancy a comprehensive path to prepare the mind and body for a healthy pregnancy. This unique health care program integrates counseling on conscious conception with a systematic orientation that prepares the womb for balanced fetal development and supports mental and emotional preparedness for this profound journey.
Developmental Delays
Children unable to stand or walk on their own by the age of one indicate developmental delays and conditions known collectively as phakka in Ayurveda. These delays can occur in many areas and may affect cognition, communication, speech, and motor skills as well as social, emotional, and behavioral skills. Cognitive delays interfere with awareness and influence learning abilities, intellectual functions, communication, and interaction with others. Often, children present with delays in more than one area of development, known as global developmental delay.
Etiologies of developmental delays in children range from a variety of prenatal, perinatal, and postnatal factors to socioeconomic and environmental causes that can impact a child’s growth and development. The ancient Ayurvedic texts classify causes of developmental delays in children into three primary types: impairment of intrauterine, embryonic, and fetal nourishment that affects the development of a child, or garbhaja phakka; deficiencies in the quality and quantity of breast milk that can lead to diminished and delayed growth and mental development in children, or ksheeraja phakka; and chronic diseases such as recurrent abdominal and respiratory infections, intestinal parasites, bleeding disorders, and metabolic and endocrine diseases during the neonatal period that decelerate the growth and overall development of a child, or vyadhija phakka.
Ayurvedic management of developmental delays begins with assessing and managing underlying disease such as gut infections or intestinal parasites known to put children at high risk for growth delays. The second step is supporting digestion and absorption of nutrients by correcting agni along with gut dynamics like grahani. The incorporation of simple digestive spices, consuming food at the correct time, and preparing easily digestible and nourishing meals are common guidelines parents can follow. External application of traditional Ayurvedic oils known to enhance nourishment and strength is also recommended at home, and these can be found in chapter 16.
Ayurveda offers many traditional herbs known to enhance digestive strength and nourish all of the body systems along with specific therapeutic formulations to rejuvenate the mind. These can help parents manage speech and cognitive delays. An experienced Ayurvedic physician will create a treatment plan for your child that customizes herbal remedies along with therapies that include shashtika lepa, shirolepa, shiro pichu, and abhyanga for a complete treatment protocol.
Anxiety
Anxiety can be seen across different stages of a child’s development and affects many children of all different ages: toddlers throw tantrums, elementary school children refuse to get dressed on the first day of school, and teenagers experience heart palpitations and other symptoms when studying for an upcoming exam, for example. Since younger children especially aren’t always able to articulate their feelings to their parents, anxiety expresses through temper tantrums, excessive screaming, crying, misbehavior, difficulty sleeping, and nightmares. Although some of these feelings and experiences are part of everyday life and considered typical, generalized anxiety is quite common among children—and on the rise. If your child repeatedly worries about matters before they happen or has constant concerns about school, sports, or friends, it can affect normal childhood activities. Other signs of anxiety include intense fear and phobias and a wide range of physical symptoms such as headaches, nausea, shortness of breath, stomachache, tremors, and digestive issues. Anxiety medications are widely prescribed to children today to help manage their anxiety and day-to-day activities.
Ayurveda understands childhood anxiety as a vata-predominant condition. Known causes of anxiety disorders include hereditary and congenital factors as well as negative exposures and childhood traumas. It is the delicate nature of a child’s mind that makes them vulnerable to anxiety and mental disorders. Traditional Ayurvedic herbs and formulations that support rejuvenation of the mind (medhya rasayana) including shankhapushpi, brahmi, and yashtimadhu combined with herbal adaptogens such as ashwagandha are especially beneficial. These should be prescribed by an Ayurvedic professional.
Lifestyle routines are key in helping children manage anxiety and provide many opportunities to establish a healthy way of living and restore balance to a child’s mind. Ayurveda recommends parents make every effort to follow a warm, unctuous, vata-pacifying diet that favors sweet, sour, and salty tastes and do their best to adhere to regular sleep times. Oleation or abhyanga is very soothing and effective for relieving anxiety and can be incorporated into your child’s daily routine along with other lifestyle therapies such as listening to soothing mantras playing softly in the bedroom and adopting yoga practices that include deep belly breathing, Yoga Nidra, and balancing yoga sequences with plenty of seated postures. You can wind down these practices with a simple guided meditation at bedtime, for example, or whenever you notice your child needs to relax. Remember, keeping these activities light, fun, and part of a regular routine will help achieve the best outcome for your child.
Bed-Wetting
Bed-wetting, or nocturnal enuresis, is the condition of involuntary urination at night after five years of age and can be due to both physiological and psychological etiologies. Causes include small bladder capacity, lack of bladder control, and hormonal issues along with anxiety, stress, and developmental disorders issues like ASD. Bed-wetting can have emotional impacts on both the affected children and their family members. The most important thing for parents to be aware of is that bed-wetting is neither their child’s fault nor under their control. Some common management techniques include counseling for parents, bladder training, conditioning therapy, regulation of water intake in the evening, and ensuring a child voids their bladder just before going to bed.
From the Ayurvedic perspective, this is a vitiated vata condition, specific to the aspect of vata that controls downward movements including elimination (apana vata). Ayurveda recommends vata pacifying and strengthening herbs and rejuvenating formulations specific to the mind. Most children overcome bed-wetting with suggested supports, but in cases where there isn’t noted improvement with such modifications, more extensive clinical investigations may be required to identify possible neurological abnormalities.
Night Terrors and Nightmares
Night terrors and nightmares are common childhood conditions that occur in different stages of the sleep cycle. All children cycle through light sleep or rapid eye movement (REM) and deep sleep or non-rapid eye movement (NREM) throughout the night. After falling into a deep stage of sleep, children typically stay in that stage for the first few hours of the night and then alternate between deep and light sleep. Night terrors generally occur prior to midnight when children get “stuck” between the deep and light sleep stages. Their body is “awake” but their mind is not, which causes a sudden onset of screaming with their eyes either open or closed, rapid breathing, and a fast heartbeat. They may look intensely afraid and can even run around shouting and screaming, which can be terrifying for parents. Usually, children won’t remember anything in the morning because they have no awareness of what is happening during these episodes.
Nightmares usually occur after midnight during the dream stage of sleep, and children often wake in the middle of the night with extreme fear. Parents should comfort and hold their children until they feel relaxed and can return to bed. Frequent nightmares associated with symptoms such as recurrent headaches or variation in hunger levels can be an indication of underlying issues like bullying, academic problems, or family issues.
Since night terrors and nightmares occur at distinct times on different conscious levels, management approaches vary. Though it may seem counterintuitive, you should never try to wake or comfort your child during a night terror. This can further aggravate them and wake them completely, leaving the child very confused and making it difficult to go back to sleep. Parents should make sure their child is safe and stay nearby until the night terror subsides.
Fear is considered an expression of vata dosha. The best way to support children suffering from recurrent nightmares or night terrors is to follow a vata-pacifying diet and lifestyle. Daily routines should include a regular pranayama practice of slow and steady Alternate Nostril Breathing, simple meditation sessions, and massage with vata-pacifying oils. Parents can also apply a few drops of soothing, calming Ayurvedic oil to the crown of their child’s head before bedtime to help calm the mind and nervous system and promote a restful night’s sleep. Spending time with your children having positive, reassuring conversations can be very supportive in helping them overcome these tendencies.
Ayurvedic herbs including brahmi, guduchi, shankhapushpi, and mandukaparni are known for their calming and rejuvenating effects on the mind (medhya rasyana) and may be suggested by an Ayurvedic physician along with bodywork techniques and oil therapies.
There are many other mind-related disorders that affect children, and this is by no means a complete list, but rather a sample of common examples of mind-related disorders in children to describe the Ayurvedic approach to healing the mind. You can understand treatment of other mind-related conditions the same way as Ayurveda corrects all possible disorders within one system based on the same management principles. Above all, your dedicated and loving mental and emotional support along with creating and maintaining balanced lifestyle routines for your children can support healing all types of mind-related conditions.