Case Discussion: Case of Depression

Case discussed by Dr  Mamata Kumar, Dr. Nupur Sharma, Dr. Hira Aggarwal, Dr. Kavitha kukunoor, Dr. Shweta Singh

Female, Age 55, Height and Weight 5’”3″. 120 lbs

Occupation: Teacher

Presenting Symptoms

Thyroid, BP, Anxiety, Depression, Hemorroids, Peri menopause.

Taking medication for Thyroid, BP, Depression.

Depression whenever there is sad news in family / I hear

Don’t feel like doing anything

Feeling like helplessness, no one is caring for me

Don’t like superficial conversation. Can’t cry

Interact with few people

Tightness in chest and it is holding not relaxing

Total insomnia

I can’t enjoy happy things

>Consolation

Sometimes I feel dizzy & headache and don’t feel like eating

and other times feel like eating more

When there is no pains I feel good

Pressing Pain in Back , left knee, left big toe

Rheumatoid arthritis –

Rheumatoid Factor 28 iu

<Extreme cold, worse initial movement

> Hot water pack, better with continuous movement

Headache after waking in lawn especially grass cut

Right side sinus headache when it is cloudy weather. Pressing pain over temple radiating to back of the head

>sleeping<light, straining eye

Don’t like fall as winter is coming feels gloomy

Don’t like too much noise,

Scared narrow & high places

Past History

13yrs back identified as Thyroid later diagnosed as high BP 160/90 after 10yrs

Identified as small aneurysm 3.5mm in head behind Right eye 8yrs back.

Dizzy and feel like falling down backwards syncope like…but never fell down

Got scared & went to hospital they identified as aneurisym.

Didn’t get surgery.

3 yrs back Initially Left toe started to hurt, constant dull pain, then right thumb & index finger then pain shifted to left knee. Later no pain on right thumb or index finger. Alternating & shifting pain.

Hemorrhoids since 6 months (had 18yrs back)..can feel some internal hemorrhoids, needle like pain and bleeding (seen with stool) which is with little pain & seen occasionally.

For past 5-6 months can’t cover until stomach as I get night sweats. (before cover until neck),

underarms foul perspiration with out stain

No perspiration of feet or soles

18yrs back diagnosed as PCOS, fertility treatment, Clomid, IV when they didn’t had children later she conceived.

Family History

Patient mother died last year at age of 74yrs from Covid now don’t want to go to India. It was sudden and bed ridden. It was a shock, her daughter 17yrs broke down as she was attached.

Mental Generals

Patient feels guilty not able to attend

Since then sleeplessness, lot of palpitations, panic attacks with anxiety, with restlessness

<morning, 9-10am, between 5:30-7pm sunset

worry about the future, fall asleep for 3 hrs 12:30-4am then wake up around 4am with palpitations & anxiety and can’t go to sleep feels very tired.

Dreams: Not much & don’t remember

Fear of something going to happen and who is going to take care of her.

What if something happens to my husband

Feeling of insecurity, not much family to take care

Scared of poisonous snakes, water

Love music but when depressed I don’t like to listen to it.

Physical Generals

Can’t bear extreme heat, feels suffocated

From neck to stomach it is full of sweat in summer

Desires rice can’t live without rice, Goat meat (during periods)

Can’t take spicy food, pine apple causes acidity with flatulence more

Craves sweets and sometimes salts things…keeps changing

recently eating more bananas

No allergies to food

Desires hot food, hot drinks tea

Thirsty: Varies sometimes too thirsty sometimes no thirst

Bowels: regular twice daily. Sometimes diarrhoea sometimes constipation

Urination: Frequent urge, no pain when I am stressed I feel like going

Over sensitive when my daughter or husband is rude to me

Body in general is warm, except feet and toes which are cold. Still like to cover.

Likes open air.

Still Menstruating, irregular, one month heavy for 3-5 days followed by scanty flow on alternate months.

Lot of back pain during periods first 2 days

Leucorrhoea before & after menses for 2 days…white & transparent

(7- 8yrs back leucorrhoea had an onion smell but not now).

Current levels are normal

TSH- 0.49 2021 and in 2020 it was 0.67

BP- 130-140/90-100mg

BP becomes normal with Yoga & meditation & when there is no expectation

Rubric choosen for Analysis

  1. Despair
  2. Claustrophobia
  3. Ailments from death from parents
  4. Anxiety future about sadness with
  5. Anxiety palpitations with
  6. Anxiety frightened easily
  7. Guilt
  8. Anxiety conscience with
  9. Insecurity

Possible remedies through different repertorization are:

Arsenicum, Lycopodium, Pulsatilla and Calcarea Carb etc

Repertorization done by Zomeo Software

Calc 200 as patient is insecure and calcarea is marked in insecurity…

Patient is suffering from lot of fears and anxieties as well as feeling lonely ,helpless , going through pre menopausal symptoms

Tightness in chest

Fear of narrow places, height , misfortune , snakes , water 

Insomnia due to panic attacks

 Rheumatoid arthritis agg cold amel hot and continued motion 

Alternating and shifting pain in joints 

Giddiness falling back 

Desire sweets , hot drinks 

Frequent urination 

Repertorization by Mac Repertory-Complete Repertory

Remedy given after case discussion is Calcarea Carb

Rx

Calcyarea Carb 200 weekly once for 2months

Pulsatilla sos

Guiding symptoms calc carb are:,

In calc carb there is tightness of chest because of that patient can’t bear tight clothing, <eye strain ,cold ,wet weather and morning.. and patient can’t bear heat aa well. Patient is too muchsensitive , restlessness ,insecurity, patient cannot relax physically and mentally, lack of confidence, anxiety about health and anxiety about future, fear that people will notice her mental confusion and person will loose her Reason , worry about small things, despair recovery about, fear of narrow places , desire sweets or sugar, longing for fresh air.

Guiding symptoms of pulsatilla are ;

Patient Craves and ameliorated by open air, irregular menses,fear to be alone, fear of high places, > Consolation,  forsaken feeling in evening only, pains start suddenly, disappear gradually or vice versa, changing and contradictory symptoms ,lids inflamed,agglutinated, thick yellow discharges, thirstlessness..

Follow up after 3 months

95% improved

More energy levels , able to concentrate,

No anxiety, no tightness of breath

No more depression, Peaceful, happy.

Upper eye lids swollen (both sides) since 2-3 yrs ..seen on & off

seen frequently now

Nails black strips on thumb over a year

Sleep improved (earlier insomnia)

Appetite is good

Thirst has increased

Bowels are regular

Guiding symptoms of Kali carb;

Compulsive Rigidity,adhering to the code of ethics and rules , strong control over his emotions, duty conscious, chilly ,bag like swelling of eyelids esp upper( very marked and prominent symptom), a/f catching cold, overstrained, cold air aggravation..

Conculsion:

Calcarea carb1m(constitutional remedy) once a month

Kali carb 30 as Acute remedy suggested sos.

Testimonial from the client:

I have been suffering from anxiety and depression for the past 18 years.  I took allopathy medicines off and on for all these years and every time I would the doctor either one more medicine would be added or the dosage increased.  I was just living but was not enjoying life.   With just two months of treatment by Dr. Kavitha I am 95% better.  Just being able to enjoy the simple pleasures of life is a blessing. Thank you!

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