A Case of Depression

The patient is a 68 year old man, visiting from India. His daughter, who is also a patient of mine, has brought him in. She told me over the phone that the reason she wants him to see me, is that he is very depressed. She drops him off for the appointment.

 

The Interview

Mr. M is pleasant and soft-spoken. When I ask him what brings him in, he mentions a problem with his right knee. He says he used to be a ‘health freak’, a sportsman, and used to exercise every day. A couple of years ago, he went on a bicycling trip, and fell off his bicycle. He used an ointment and painkillers for a couple of months, but since that incident, he continues to have a nagging pain in that knee. On another trip a couple of months ago, the knee buckled again, and the same issues were repeated. He had an MRI and was diagnosed with a ‘Grade 1 injury’. He said he felt better after another round of pain medication.

When I asked about other health problems, he mentioned problems with his teeth that started 4 years ago. He said all his upper teeth were extracted, and now he is wearing a set of dentures in place of his upper teeth. He doesn’t like the taste of his food any more. He says he is hungry but doesn’t feel like eating. He eats ‘just for subsistence, with no relish’. He used to love certain foods, but now eats them without tasting them.

When I ask about other health issues, he also mentions problems in the past with acidity, and flatulence.

When I ask him to tell me what he is like as a person, he says he loves company, and likes meeting people, he has many friends. He says he has no worries, no anxiety. I ask him what he would like homeopathy to do for him. He says he would like to have his knee pain go away. He does not mention his depression at all.

At the end of the interview, his daughter comes to pick him up. I ask him if it’s okay to ask her a few questions in his presence. He agrees, and I ask her to tell me why she wanted him to see me. She paints a completely different picture. She says that he is a great dad, completely invested in his family. He used to be a very social person, had lots of friends. He was always smiling and cheerful. However, now he doesn’t eat, and is down to half his previous weight (literally). He has become very quiet. He doesn’t spend time with his beloved grandchildren. He just goes up to his room and sits alone, or even if he is in the room, he sits gazing out of the window, and doesn’t respond even when spoken to. She is so upset while narrating this that she has tears in her eyes. Her father is quite touched by this, and looks embarrassed, but when I ask him if he has anything to add, he says “No, no I’m fine.”

 

Analysis

To my mind, this was a ‘Never been well since’ case, and since the etiology involved injuries to the teeth, as well as to his knee, I decided to open the case with Arnica. I also thought it was significant that he chose to say he was ‘fine’ when he was clearly suffering from depression.

Margaret Tyler quotes Hahnemann on Arnica, “Hence it is very beneficial…in the pains and other ailments consequent on extracting the teeth…” She adds, “Of course a few doses of Arnica internally, after tooth extraction, is the common practice of us all.”

She also lists among the Black Letter Symptoms for Arnica

Says there is nothing the matter with him

Hopelessness, indifference

Falls, mechanical injuries

 

In the Synthesis Repertory, under

GENERALS, INJURIES, Ailments from, chronic, only Arnica is listed in bold type. It is also listed in

MIND – AILMENTS FROM – injuries, accidents, mental symptoms from

 

I therefore gave him Arnica 200C as a ‘Never been well since’ remedy. To support it, I also gave him two tissue salts:

 

Calc Phos 6X: This remedy is known for its affinity to teeth and bones. It’s also known for its “restorative power after acute diseases…”, and is often used as a ‘tonic’.

Kali Phos 6X: Mental symptoms – Gloomy moods…great despondency. Indisposition to mix with people. Disinclined to converse…

 

Follow ups

First follow-up at 3 weeks: Feeling better. Interacting more with family. Appetite has improved, but still concerned about weight.

Second follow-up at 7 weeks: “Dramatically improved in the last week”. More energy. Eating more than before. Appetite increased. Psychologically feeling better.

After this we had a follow-up 6 months after the first visit, before his return to India.

Final follow-up: “I feel a huge change, my mind is completely cleared”. Appetite is normal, I have gained 5-6 lbs, need to gain more.”

How is your knee pain? “I can do a 45 minute walk daily. Once or twice a month, if I overstrain, I sense some lingering pain, not as bad as before.”

His daughter also confirmed that the family was thrilled to see the change in their dad/granddad; he was back to being the person he used to be, cooking for the family, playing cards with his grandchildren etc.

 

Rx: I asked him to repeat Arnica 200 once more before he left.

 

References:

Margaret Tyler: Tyler’s Homeopathic Drug pictures

Beoricke & Dewey: The Twelve Tissue Remedies