Abstract

Background: Anxiety disorders, particularly Generalized Anxiety Disorder (GAD), represent one of the most prevalent psychiatric conditions globally, significantly impacting quality of life and productivity. The neuro-endocrine mechanisms underlying anxiety involve hyper-activation of the hypothalamic–pituitary–adrenal (HPA) axis, cortisol exhaustion, and dysregulation of neurotransmitters such as GABA and serotonin. Ayurveda describes anxiety in terms of Chittodvega, a Manas vyadhi involving Vata-prakopa, Rajas-Tamas aggravation, and Oja-kshaya. Shirodhara is traditionally indicated for disorders of mind and stress-related psychic disturbances. Aim/Objectives: To evaluate Shirodhara through modern neuro-hormonal mechanisms and classical Ayurvedic principles in the management of anxiety disorders and GAD. Methods: A narrative review of Ayurvedic treatises (Bruhatrayee, Laghutrayee, Nighantu, Rasashastra texts) and modern biomedical literature was conducted. Data were extracted from PubMed, Scopus, Cochrane, and Google Scholar using keywords: Anxiety, GAD, Shirodhara, neuroendocrine, cortisol, GABA, melatonin, HPA axis. Key Review Findings: Shirodhara modulates HPA axis activity, decreases cortisol, enhances GABA and serotonin levels, increases parasympathetic tone, and improves sleep architecture. Ayurvedically, it pacifies Vata, balances Rajas-Tamas, nourishes Ojas, and stabilizes PranaVyana-Sadhaka Pitta. Conclusion: Shirodhara offers a promising integrative therapy for GAD through a dual framework neurohormonal regulation and Ayurvedic mind–body balancing. Further randomized, neurobiochemical studies are required for stronger clinical validation.