Management of depression in patient with CHD in light of classical Unani medicine

Coronary heart disease (CHD) and Depression are the two leading cause of death and disability worldwide. Depression is especially common in cardiac patient, and there is recently, growing evidence that depression is a risk factor for fatal and non fatal events in CHD patients. The global public health implications of a causal association between the two most common morbidities- coronary heart disease (CHD) and depression- are well immense now. Depression is an independent risk factor for coronary heart disease (CHD). Depression is approximately 3 times more common in patients after an acute myocardial infarction (AMI) than in the general community and depressed patients had a fourfold likelihood of dying after an acute MI. Both biological and behavioral mechanisms have been proposed to explain the link between depression and CHD.It is not a new concept in Unani system of medicine to give importance to the mental health of an individual. The potential mechanisms responsible for Depression-CHD relationship by Unani physicians have discussed it in detail under the heading of Quwat-e-Nafsaniya (psychic faculty) whose seat is in the brain. Depression was first described by Hippocrates under the heading of Melancholia meaning black bile or khilt-e- siyah. It is a condition where there is excessive accumulation of yabusat inside the brain. Unani scholars have successfully established the association of excess in infiyalate nafsaniya and abnormal cardio- vascular events such as hypertension, CHD etc. According to them, ifraat (excess) in infaalate nafsaniya such as ranj- wa- gham, gussa wa gazb or fikr wa taraddud are considered as the asbaab-e- waasla for coronary heart disease (CHD) in any human being. The treatment of depression in modern medicine has certain limitations because of adverse effects for example: except a few drugs most of the antidepressants have been reported to have cardio toxic effect. Since depression is a Life style disorder it can be prevented as by maintaining the six essential factors of body i.e. Asbaab-e-Sitta- Zaruriya. In Unani system of medicine the great Unani physicians like Hippocrates, Galen, Razes, Avicenna and Abulcassis have described four fundamental therapeutic principles of treatment i.e. Ilaj-bil-ghiza (Dietotherapy), Ilaj-bil-tadbeer (Regeminal therapy), Ilaj-bil-dawa (Pharmacotherapy), Ilaj-bil-yad (Surgery).As Unani scholars have clearly described the association of depression with heart and heart diseases. Therefore this Article reviews Depression as a risk factor for CHD along with pharmacologic and non pharmacologic treatments for depression in cardiac patient in light of Classical Unani Medicine which are safe and efficacious effects both on brain and heart as well.