Post-Traumatic Generalised Anxiety Disorder induced Secondary Insomnia managed with Multimodal Holistic Ayurveda approach: A case report

Background: Generalised Anxiety Disorder (GAD) is a condition which commonly associated with Insomnia particularly when precipitated by significant psychosocial stress. Persistent worry and hyperarousal interfere with normal sleep-wake cycle and impairs emotional resilience. Ayurveda correlates this clinical condition with Chittodvega (mental agitation), Vishada (low mood) and Nidranasha (insomnia) mostly attributed to aggravated Vata dosha and Rajo guna. Present report is unique as it exhibits quick and sustained recovery from trauma associated GAD-induced secondary insomnia through multimodal holistic protocol. Methodology: A single case report of 22-year-old male presented with chief complaints of difficulty in falling and maintaining sleep for last six months along with lack of interest in daily activities and continuous feeling of worry. These manifestations were noted especially after major psychosocial life events, namely road traffic accident, parental separation and grandfather’s demise. Baseline assessment revealed marked distress. Intervention: Intervention consists of comprehensive 56-days staged protocol which include Shirodhara (pouring of medicated liquid over forehead), Padabhyanga (therapeutic foot massage), Shirotalam (therapeutic application of medicated paste over scalp), Shiroabhyanga (therapeutic head massage), Medhya Rasayana (nootropic and neurocognitive medicines) (Brahmi Vati, Saraswatarishta, Brahmi Ghrita), Ashwagandha, Sarpagandha churna, Satwawajaya Chikitsa (psychotherapy), therapeutic Yoga, Marma therapy (therapeutic stimulation of vital points) and Music-Supported Therapy, administered in inpatient and home-base treatment sequentially. Outcomes: Significant improvement was reported by day 7. At day 56 insomnia, anxiety and mood scores were nearly normal when assessed on standardised scale. No ADEs were reported and adherence to treatment was excellent. Conclusion: Post-traumatic GAD-induced secondary insomnia was effectively managed with integrative multimodal holistic Ayurvedic approach compromising oral formulations, external therapies and mind–body practices given over a period of 56-days. Intervention resulted in marked improvement across sleep, anxiety and overall functioning