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Mental disorders, particularly depression and anxiety, are among the leading causes of disability worldwide, and the National Mental Health Survey of India documented a large treatment gap. Ayurveda views mental health through the concepts of Manas, the three Gunas (Sattva, Rajas, Tamas), and the Doshas, and describes Manasika Vikara with a threefold therapeutic strategy comprising Daivavyapashraya, Yuktivyapashraya and Sattvavajaya. Panchakarma procedures such as Shirodhara, Shiroabhyanga, Nasya, Takradhara and Basti are used for stress-related conditions, together with Medhya Rasayana drugs. This article reviews classical concepts, the physiology of stress, therapeutic procedures, evidence from physiological and clinical studies, and safety considerations. Evidence indicates short-term relaxation and subjective benefit, whereas robust trials in clinical anxiety and depression are lacking. Panchakarma should be integrated with, and not substitute for, evidence-based psychiatric care in moderate to severe illness.