Subjective well-being and health: A potential field for scientific enquiry into the foundational concepts of Ayurveda

The Caraka Samhitā defines Ayurveda as the discipline that deals with the salutary and unsalutary life, the happy, and unhappy life, what is beneficial and not beneficial for nurturing life, the life span, and life itself.[1] For this reason, Ayurveda translates as knowledge of life, rather than one medicine. In fact, it makes a lot of sense to translate Ayurveda as life science. On the other hand, the subject matter of Ayurveda does deal in great detail with health and illness. And the common understanding is that Ayurveda is a medical system that defines health and disease even as it explains their determinants, elaborates the symptomatology and outlines approaches to treatment.

Ayurveda has looked at life in a comprehensive way and has defined health as a state of happiness that is derived from a life of fulfillment. On the other hand, disease is defined as a state of sorrow. In many contexts, the classical textbooks of Ayurveda have pointed out the connection between happiness and health, sorrow and disease. Not only does health create happiness, happiness also creates health. Similarly, not only does disease create sorrow, but sorrow also creates disease. In other words, Ayurveda has looked at health and well-being in an integral manner.

It is interesting therefore to see the description of the happy and unhappy life incorporated into the very definition of Ayurveda, because they have a bearing on health and disease. In fact, the Caraka Samhitā distinguishes between the happy and salutary life. The happy life (sukham āyu) leads to personal happiness whereas the salutary life (hitam. āyu) is focused on higher meaning and purpose in life, well-being of the Universe.

Ayurvedic texts have pointed out in several contexts about the connection between the pursuit of a happy life or salutary life with health outcomes. Emotional imbalances such as sorrow, lust, and fear can imbalance Vāta, while anger imbalances Pitta.[2] A state of happiness, on the other hand, has a positive influence on Kapha enhancing immunity and strength. It has also been pointed out that when the mind is favorably disposed, there is a positive impact on the immune system increasing the energy and strength of the individual.[3] These are perhaps early allusions to the psychoneuroimmunological axis in the tradition of Ayurveda. The connection between the mind and the body has been compared with that between ghee and iron. If hot ghee is poured into a cold iron vessel, the latter gets heated. If cold ghee is poured into a hot iron vessel, the former gets heated. Thus, the body and mind influence each other.

We find echoes of this theme in modern researches that have explored the connection between happiness and states of health. Diener and Chan[4] pointed out in a review paper that “Happy People Live Longer” on the basis of seven types of evidence that indicated a positive correlation with high subjective well-being and health. He concludes that the evidence for the influence of subjective well-being on health and all-cause mortality is compelling.

A very interesting study by Fredrickson et al.[5] explored the molecular mechanisms underlying the prospective health advantages associated with psychological well-being. Eighty healthy adults were assessed for hedonic and eudaimonic well-being. People with high levels of hedonic well-being showed up-regulated expression of conserved transcriptional response to adversity (CTRA) involving increased expression of proinflammatory genes. On the other hand, high levels of eudaimonic well-being were associated with CTRA down-regulation and suppression of proinflammatory markers. This paper points out that functional genomic perspective favors eudaimonia although a balance between the two approaches with a predominance of eudaimonia seems to be desirable.

Hedonism and eudaimonism seems to have been the focus of Ayurveda when it discusses about Sukham Āyu and Hitam ĀyuSukham Āyusimply means happy life and Hitam Āyu means salutary life.[6] The former stands for life that pursues personal happiness and the latter for a life that pursues higher meaning and benevolence for others. Ayurveda also describes the unhappy and unsalutary life and recommends that one strikes a balance between these two pursuits. In other words, the balance between hedonism and eudaimonism.

Ryff[7] points out that there is increasing evidence that psychological well seven being has definite health protection effects in reducing risk for disease and promoting the length of life.

Although there is the presence of publication bias, review by Chida et al.[8] suggests that the religiosity/spirituality has a favorable effect on survival. Many 1000 of years ago, the Caraka Samhitā encouraged the development of a religious/spiritual attitude toward life by emphasizing the need to promote what it called the āstikya buddhi.[9]

That brings us to another aspect of well-being. How mental well-being can help people to cope better with physical illness. Wiesmann and Hannich[10] draw our attention to the fact that resilience factors like the sense of coherence and psychological resources enable older people to maintain mental health when confronted with physical health problems.

Psychosocial and cultural factors can also have a profound impact on the biology of ageing. Coe et al.[11] pointed out Japanese have healthier profiles than Americans when it comes to the pro-inflammatory biology. It is suggested that the comparatively homogeneous nature of Japanese society could lessen the impact of social factors that promote inflammatory physiology. In fact, in another study, Miyamoto et al.[12] discovered that “Negative emotions predict elevated interleukin-6(IL-6) in the United States, but not in Japan.” They point out that the link between negative emotions and IL-6 may be specific to Western cultures where negative emotions are considered to be problematic, unlike in Japan.

All these studies point to the connection between mind and physical health, which is conditioned by outlook on life, religiosity, and even socio-cultural beliefs. As a comprehensive approach to life and health, Ayurveda has dealt with these dimensions of well-being in great detail. An exploration of the Ayurvedic understanding of well-being and health seems to be a promising field of scientific enquiry.

P Ram Manohar



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