Exploring the potential benefits of Shirodhara as an add-on therapy for alleviating post-COVID anxiety and depression: A case study

In this case study, we present a 31-year-old female, a homemaker, who developed persistent symptoms of anxiousness, fatigue, weakness, irritation, anger issues, and difficulty concentrating for nearly 12 months following recovery from COVID-19. She was diagnosed by a consulting psychiatrist with post-COVID anxiety with depression, and had been on anxiolytic and antidepressant medications for the past ten months. She underwent Shirodhara (dripping of medicated oil on the forehead) using Balashwagandhadi taila for 14 days as an add-on therapy, while continuing her conventional medications. Assessments at baseline, 8th day, 15th day, and 30th day showed progressive improvements: Hamilton Anxiety Rating Scale (HAM-A) scores reduced from 42 to 10, Hamilton Depression Rating Scale (HDRS) from 23 to 6, Patient Health Questionnaire-9 (PHQ-9) from 24 to 1, and Flanagan Quality of Life Scale (QOLS) improved from 59 to 79 by the 30th day. Serum cortisol was 3.09 μg/dL at baseline, below the normal range, and returned to the normal physiological range (11.76 μg/dL) on the 15th day, reflecting improved stress adaptation. C-Reactive Protein remained stable, while Systemic Immune-Inflammation Index showed a transient, non-pathological rise within normal limits. Also, based on the evaluation and recommendation of the psychiatrist, the dosage of conventional medications was reduced: Propranolol was tapered from 20 mg twice daily to once daily, Clonazepam 0.5 mg at bedtime was shifted to as-needed use, and Omeprazole was discontinued. This case highlights the potential role of Shirodhara as an adjunctive therapy in post-COVID anxiety, along with depression. These findings require validation through larger studies with long-term follow-up.