To supplement my understanding of Western brain chemistry, I’ve found it extremely useful to draw upon the centuries-old healing system from India known as Ayurveda, “the science of life.” A comprehensive and time-tested approach to health and wellness, Ayurvedic medicine may well be the oldest system of healing in the world. It is still widely practiced in India, as well as among some practitioners in this country, including the famed holistic physician Deepak Chopra, from whom I’ve learned what I know about this Mind-Body medicine.
While I’m not an Ayurvedic practitioner myself, I appreciate Ayurveda’s integration of body, mind, and spirit and its vision of health as balance and harmony. I also find Ayurveda’s system of categorizing different constitutional types very useful in understanding depression, particularly since, as we’ve seen, the imbalances associated with each type resemble the neurotransmitter imbalances I described in Step One. Learning your Ayurvedic type is your first step toward crafting antidepression strategies specifically tailored to suit your own personal body, mind, and spirit.
Ayurveda describes three major mind-body types, or doshas. Each dosha is a specific type of energy, and all of us possess some of each—but in different proportions.
Besides corresponding to Western brain-chemical types, Ayurvedic categories also resemble Western body types: endomorphs (thin, wiry build), mesomorphs (muscular, strong build), and ectomorphs (fleshy, heavy build). In Ayurveda, though, each physical category is linked to mental and psychological patterns, as well as habits and lifestyle.
Find out which Ayurvedic type you are by taking the following questionnaire. For each question, circle the answer that best describes you. If more than one answer seems to fit, circle both, or all three:
1. Normally, my body is:
a. thin and light
b. of medium build and muscular
c. solid and large-boned
2. My skin tends to be:
a. dry, cool, or rough
b. soft, warm, or splotchy
c. thick, smooth, or oily
3. I have the most trouble tolerating weather that is:
a. cold
b. hot
c. cool and damp
4. My hair is best described as:
a. dry, curly, thin
b. fine, straight, may have early balding or graying
c. thick, wavy, oily
5. My appetite tends to be:
a. variable and irregular
b. strong, occasionally excessive
c. steady, and I gain weight easily
6. Skipping meals is:
a. something that happens because of my erratic schedule and appetite
b. hard for me, making me crabby or irritable
c. easy for me
7. My bowel habits are:
a. irregular, often constipated or dry stools
b. regular, frequent, often loose stools
c. regular, often oily stools
8. My physical activity level tends to be:
a. high, often restless
b. medium, often driven
c. low, often lethargic
9. My movements are usually:
a. quick, random
b. strong, purposeful
c. slow, methodical
10. My mind is best described as:
a. quick, active, restless
b. sharp, intelligent, critical
c. calm, slow, thoughtful
11. I tend to learn:
a. quickly
b. determinedly
c. slowly
12. My memory is usually:
a. good for short term, poor for long term
b. strong and detail-oriented
c. slow to develop but with good retention
13. My sleep tends to be:
a. light and easily disrupted
b. sound, needing less than others
c. deep, needing more than others
14. When emotionally balanced, I tend to be:
a. lively, creative, and enthusiastic
b. determined, friendly, and successful
c. calm, sweet-natured, and easygoing
15. When stressed, I easily become:
a. anxious, insecure, or moody
b. irritable, impatient, or critical
c. sluggish, complacent, or overly attached
SCORING: Count the number of answers that were:
a:___ (this corresponds to vata, or Air type)
b:___ (this corresponds to pitta, or Fire type)
c:___ (this corresponds to kapha, or Earth type)
If you scored significantly higher in one category, that’s your type. If you’ve got high scores in two categories, you’re a combination type. If you’ve got relatively equal scores in all three categories, you’re that rare phenomenon, a three-part combination type.
In the rest of this chapter and the following three, you’ll learn more about each of the three Ayurvedic types. I urge you to read about all three types, even if you fit one type very strongly. Although each of us is dominated by the energy associated with our type—Air, Fire, or Earth— we each have elements of all three energies within us. So while you’re most likely to go “out of balance” in your dominant energy, you might experience other kinds of imbalances as well. Reading through all three chapters will give you the best overview of an Ayurvedic perspective so you can apply it to your own situation with more flexibility rather than pigeonholing yourself into a single type.
This perspective, too, corresponds to Western biochemistry. Although people tend to fall into certain patterns, with the same chemicals coming up short each time, we all experience individual variations. A person who is normally sluggish might suddenly become anxious or agitated because of an unexpected shift in brain chemistry that was caused by changes in diet, stress, or some other factor. In Western terms, we’d talk about levels of dopamine and norepinephrine. In Ayurveda, we might talk about imbalances in your Fire energy. So even if you are normally a sluggish Earth type, you will need to know what an angry Fire imbalance looks like.
Knowing about all three types is especially important if you’re a combination type, who scored fairly evenly on two or even three of the categories. If that is the case, you need to follow the recommendations for both or all of your types. If the recommendations conflict, use your intuition and a little experimentation to see which path to follow. An Ayurvedic practitioner can also help you fine-tune your approach.
By the way, I myself am a combination type, both vata/Air and pitta/Fire. When I’m living a life of balance, I enjoy many of the good qualities of both types. When I get stressed or out of balance, I tend to fall into the problematic patterns of both.
Body-Mind Traits
• body tends to be light and thin
• skin and hair are often dry
• hands and feet get cold easily
• movements are quick, and may seem random or scattered
• appetite is quite variable
• craves sweet, sour, and salty tastes
• prefers hot drinks
• bowel habits are irregular
• sleep is light and easily disrupted
• daily routine tends to be inconsistent, as in bedtime, wake-up time, mealtime
Vata in Balance
• mind is active, creative, and full of ideas
• fast learner (although tends to forget quickly)
• tends to be enthusiastic and energetic, often excelling at initiating new things
• often lively, fun, and a good conversational partner
Vata Under Stress
• becomes constipated
• has a restless mind
• allows his/her routine to become scattered and erratic
• grows fearful, nervous, and has trouble sleeping
• is prone to an anxious depression
Robert is a young law student. While still an undergraduate, he’d excelled in school, taking easily to nearly every subject. In fact, he liked so many different courses, he had a hard time deciding what to major in and finally settled on law only because it left open so many possibilities for careers.
Robert had never really been depressed. Nor had he really begun to struggle until he started law school. The demands it made on his time left little room for pursuing his many interests. He became stressed, and he started to doubt both his abilities and his choice of career. Suddenly Robert felt insecure, as if he never quite measured up to others. His digestion was unsteady, as were his bowels. His appetite was poor, and he lost weight. He came to rely on caffeine and sugary foods to keep his energy up, and as a result, he became almost constantly tense and anxious. He seldom found time for exercise, other than walking rapidly whenever he had someplace to be. Every night, he’d lie awake, ruminating about the events of the day. At age thirty-two, he seemed to be aging faster than he should.
Robert’s wife added her voice of concern: “He used to be so full of fun and enthusiasm, always interested in doing something, going out or getting together with friends. Now, even when he’s not working, his mind is somewhere else. I feel like he never even listens to me anymore.” Clearly, their relationship was strained, adding another layer of stress.
Robert illustrates many of both the positive and negative aspects of an Air-based constitution. Normally, his mind is quick and he easily grasps new concepts. He has many interests, and he always wants to keep his options open. He likes to stay active, and others experience him as lively, fun, and enthusiastic.
However, when Robert’s work hours became too long and school standards too exacting, he lost time for his other pursuits and felt stressed and out of balance. Then the less healthy aspects of his constitution emerged: stress, insecurity, changes in bowel habits and appetite, sugar cravings, insomnia, and anxiety. Robert’s case illustrates how a vata constitution is all about movement. And when the movement gets out of control, both the body and mind become restless, tense, and caught up in unproductive overactivity.
Body-Mind Traits
• medium, often muscular build
• hair is fine and thin, skin tends to be reactive
• extremities are usually warm
• movements are strong and purposeful
• appetite is strong and regular
• likes sweet, bitter and astringent tastes
• prefers cold drinks
• bowels are regular or loose
• sleeps soundly, may not need as much sleep as other types
• daily routine tends to be precise
Pitta in Balance
• mind is keen and sharp and often loves a good debate
• insightful, competent, and accomplished
• often athletic
• seen by others as warm, friendly, and engaging
• when coupled with ambition, may like to be leaders
Pitta Under Stress
• mind becomes overly discriminating, critical, or judging
• can develop diarrhea
• easily gets skin flushing or rashes
• may become compulsive in routine
• easily gets angry, irritable, jealous, and judgmental
• may seek power and control
• is prone to an agitated depression
Larry is a middle-aged farmer from rural Minnesota. He is married with two teenage children. Although he’s managed to hold on to his farm, he’s felt the struggle of the small family farmer, and both he and his wife have had to take jobs in town just to make ends meet. Their children, meanwhile, have shown little interest in farming, which has been a big disappointment to Larry.
Larry is strong and broad-shouldered, a man with lots of energy who’s always worked hard without complaint. But his age and hard life were starting to catch up to him, and he developed back problems that both limited his working and kept him up because of the pain. He couldn’t afford to hire help, and with his wife working and his kids busy with school activities, Larry felt that all the pressure of the farm had landed squarely on him. He’d always had a temper; now it seemed as if he was always angry, venting his feelings toward his son in the form of criticism and demands that the son was not willing to meet, while his wife began to worry that Larry and his son would come to blows.
Larry’s doctor was concerned, meanwhile, because his blood pressure had been consistently elevated. They were having some trouble getting it under control, a particular danger for a man with a family history of heart attacks at a relatively early age.
Larry reveals many traits of a pitta imbalance. Emotionally, this imbalance is revealed through the anger and irritability that so concerned his family. He also appears flushed, has had problems with diarrhea and hemorrhoids, and struggles with high blood pressure, muscle tension, and pain.
Body-Mind Traits
• heavier, solid body and large-boned frame
• hair tends to be thicker, with smooth and oily skin
• body temperature remains cool
• movements are slow and methodical
• appetite is steady
• prefers pungent, bitter, and astringent foods
• bowels tend to be regular
• sleeps deeply and longer than others
• tends to be methodical and easygoing in daily routine
Kapha in Balance
• mind is slower but thoughtful and has a good memory
• may be graceful and elegant in movement
• has a calm and easygoing demeanor and people find kapha type easy to be around
• normally tolerant and forgiving
• tends to be very loyal and devoted friends or partners
Kapha Under Stress
• more likely than other types to remain calm under stress
• may become mentally sluggish or plodding
• tends to indulge in emotional eating and may become obese
• can develop feelings of attachment, greed, or envy
• is prone to a lethargic depression
Gretchen’s biggest concern was her energy. Never ambitious or high achieving, she had nonetheless felt pretty content with her life. She had found happiness in her second marriage, which had produced one daughter who was about to leave home. She and her husband lived in a pleasant suburb, where she worked as an executive secretary for a company she’d been with for more than fifteen years.
Suddenly Gretchen was feeling lethargic and miserable, a condition she didn’t understand. She had felt this way once before, in her early twenties, after her first marriage had collapsed. She’d gradually emerged from that low point with the help of some therapy and gone on to create a good life for herself. Now in her forties, she was mired in depression once again, but this time, nothing had gone wrong to explain it.
When she first came to my office, Gretchen acknowledged that she hadn’t taken the best care of herself. She had always struggled a bit with her weight, but in the past year she had gained twenty pounds. She used to walk to help keep her weight stable, but now she felt so sluggish and unmotivated that exercise seemed impossible. Worse, she could hardly drag herself out of bed in the morning, and she never felt as if she fully woke up. As a result, she wasn’t always able to get to work on time, and when she was at work, she felt inefficient and always behind. She felt mentally dull and generally depressed, unable to muster up the motivation to do anything about her increasingly severe problems. Normally a reliable worker, she had started making silly mistakes, which upset her boss.
Gretchen is a kapha type, normally content, loyal, and easygoing. She tends to be a little slow and plodding at times, but usually this comes across as steadiness and stability, and she can muster a great deal of endurance, stamina, and calmness under stress.
Her recent struggles, though, suggest that her constitution has become imbalanced. When a kapha type gets out of balance, everything tends to slow down. Thus, Gretchen’s thinking is dulled, she has gained weight, and she’s sleeping way too much.
What causes our bodies and minds to go out of balance? In my view, imbalance has three sources: physical, mental, and spiritual.
Some illnesses begin in the body and then spread to the mind. Diet, exposure to toxins, exercise, lifestyle, routine, even the people who surround you—all of these factors affect your body and its balance. Once that balance is disturbed, your body’s imbalance may infect your mind, creating anxiety, anger, or depression.
However, sometimes it’s the mind that unbalances the body. When emotions are repressed—stuffed away in the body and mind rather than felt and expressed—they can easily create an imbalance that manifests as a nervous stomach, a weakened heart, or a number of other stress-related illnesses.
We tend not to link spiritual problems with disease, but clearly they, too, are related to depression. People who have no connection to a higher power, a life of the spirit, or a deeper purpose to life than the daily struggle for existence may be more likely than others to fall into existential despair. If you feel truly alone and alienated, and your life seems devoid of meaning, you’ve got a recipe for depression, usually with a strong component of fear, or vata imbalance.
If you’ve experienced a tragedy or another type of disillusion, you might feel angry, disenchanted, despairing, bitter, or resentful—toward God, another country or religion, or someone who has hurt or betrayed you. Holding on to these negative emotions for too long can inspire a pitta imbalance, resulting in an erosion of physical and emotional resources.
More commonly, a person’s interest in matters of the spirit simply wanes with lack of attention. The individual may not even be aware of the loss, but he or she gradually realizes that there’s no longer an animating or creative force in his or her life, bringing on a state of apathy or darkness, like living within a cloud. A person with a kapha disturbance like this may not feel despairing so much as lifeless—another form of depression.
I consider spiritual problems to be the result not only of your relationship with the divine but also of your relationship with yourself. Depression can result when we don’t truly know ourselves or when we fail to honor the deepest dictates of our own heart. The soul has its own language and its own designs upon our lives. When we fail to listen to it, or fail to heed what we hear, we set up the conditions for unhappiness. We’ll return to these matters of the soul in Step Three.
Even healthy people can get out of balance and show signs of illness, sometimes for no apparent reason. But if you’re aware of your loss of balance, you take the symptoms as early-warning signals and seek a return to inner balance and to health. I personally believe that the most important factor in maintaining health is this inner state. Of course we interact with our environment, encountering viruses, bacteria, toxins, and other stressors. But two people might be exposed to the same cold virus and yet only one develops a cold, just as two people can undergo identical stresses while only one becomes depressed. When you agree that your inner state determines how the environment affects you, you’re assuming responsibility for maintaining your own health—and taking on the power to do so.
From this point of view, your goal is not so much to relieve specific symptoms, or even to treat a certain disease, but rather to restore your natural state of inner harmony and balance. Chapters 8, 9, and 10 will offer you more information on how balance can be achieved and maintained for each type of energy so that you can begin to create an approach that is specifically tooled to your physical, mental, and spiritual needs. Many tools are available to help create balance, but we’ll focus on those that are particularly effective in treating depression:
• removing the cause of the imbalance
• detoxification
• diet
• exercise
• breathing
• lifestyle and daily routine
• climate and seasonal patterns
• herbal therapies
• emotional release
• meditation and spiritual practice