Formica Rufa – A Case of Anxiety and Insomnia

Kristen, whose name has been changed to protect the innocent, is 37 years old and came to see me in September of 2012. As a matter of fact, she called me nervously, scheduled an appointment, called me back and cancelled it and then called me back again, begging it back. (I gave it to her, of course.) But I mention this to introduce you to her, the way I was introduced to her. High anxiety!

When she arrived, she was a tiny thing, barely 5 feet tall and weighing 100 lbs, tops. While crossing and uncrossing her legs, she said she’d been experiencing a lot of anxiety. She had been prescribed Prozac 10 years prior for PMS symptoms and was angry about that now.

Kristen had recently been married and had started seeing a different gynecologist. She and her husband were looking to start a family and the new doctor had instructed her to go off the Prozac. With little guidance on how to reduce her dosage over time, she started experiencing what she called ‘horrific withdrawals’. These were followed by a miscarriage, then a chemical pregnancy, which was followed by what she described as anxiety-induced insomnia. When I saw Kristen she had been sleeping for two hours a night for the better part of five months. She went back on Prozac under the guidance of an integrative psychiatrist and was currently taking 10mg/day of Prozac, as well as small amounts of Klonopin at night for sleep.

“My period is very irregular, which makes me depressed. I want to have a baby (crying). My periods come every 7 weeks to two months.  I used to love music and dancing and going out. I don’t find joy in a lot of things right now, it’s just very hard. I’m afraid of everything. Always been really sensitive. I get hurt very easily by people. My parents told me I’m fragile, but I don’t feel fragile. I have strength. But when I get into bed, my heart is racing.  I have a lot of regret from this year and last year. I did my wedding very wrong.  Feared I was marrying the wrong person, so drank my way through it. I was now married and freaked out. Felt like a prisoner. Like a prison, and feel like I’m in prison right now. I’m not sleeping, and I don’t know what I did to piss God off. I’m in a living hell.”

I asked her to describe the anxiety. “I’m shaking. I feel like my body is out of whack, like there’s something missing. I misspell things, have trouble thinking of the name of something. Take a vitamin, a second later, wondering, did I just take it?”

What about going to sleep, what’s that like? “My mind is racing, active, completely awake. I should be tired, but I’m not. Thinking about the past, for a while, alternate endings of what could’ve been. I used to have a normal life, now I’m a medicated disaster! I don’t want to be in this medicated mess. It’s a horror show. Not sleeping, shaking all day, feeling so out of balance, and weepy. I cry every day. When am I going to feel normal or right? I’m so afraid of Klonopin, I feel like its poison. When I try to sleep, my heart is beating quicker than a resting person’s should.”

Kristen told me that her dreams are based on interactions with others. I asked her the feeling in the dreams. “I’m very sensitive to interactions with other people, take things to heart. I’m a little bit paranoid, very sensitive. My maid of honor and I haven’t spoken in a year and I’m sad about it. I’m going to write her a letter explaining my part of things. I’m a very spiritual person, religious. I believe in being a good person, I believe in God, pray a lot. I feel like God is punishing me by having everybody else have children but me. I don’t know why I deserve it.”

 

She had been taking Ignatia 30c nightly, prescribed by her doctor. Said it really wasn’t helping. “I just feel dead.”

 

Kristen was so desperate to have some relief that I prescribed Arsenicum 12c nightly for the restlessness and anxiety and paranoid feeling/sensitivity to interactions with others. We were in touch over a week’s time and her symptoms really remained unchanged, so I changed it to Natrum Muriaticum 30c nightly, which helped a bit. She came back on October 19, 2012 for a follow up.

 

“I was feeling better, but started feeling anxious again over last weekend. Not terrible, but present enough to affect my sleep. During this time, however, I’ve been having diarrhea every day at 8:30 am.

I used to be the most energetic person, going out, dancing, running every day. Now my body feels useless to me. Heavy and worn out. I just want to hide away.

It’s the worst thing in the world. This hum that’s in my body, humming behind the scenes, makes me feel I’m gasping for breath. In my throat, pulse pounding in my throat, heartbeat jumping. Not really a choking feeling, but something taking over me.”

Something taking over? “Basically destroying it, taking it, making it its own, taking it prisoner, making it suffer, and enveloping it into its being. I feel like a prisoner to this situation! At this point, feel like I’ve been taken prisoner again. Now feel imprisoned by diarrhea, nausea and exhaustion too. It’s like the beast at the end of my bed, all I want to do is just sleep.”

Describe the beast. “It’s a dragony thing with teeth, ready to pounce on me. I see it myself as this enveloping dark force that is trying to take me over.  It sings this song, this bass-y kind of song, it’s like falling into a pit. Terrible, dark pit. Like what you would hear if you were in hell. Enchanting but haunting. I’m not into creepy things, I get scared a lot.”

At this point I asked her what she experienced with PMS so many years ago that led her doctor to prescribe Prozac in the first place. She told me that she would eat like crazy, a pint of ice cream and chips, go from salty to sweet to salty to sweet, was moody and emotional, would cry a lot and be snappy and fight with people.

 

By now I’d been thinking of the insect family for this restlessness and seemingly tubercular expression of symptoms. Restlessness is a known theme in the insect family of remedies. The salty + sweet alternation are Tuberuclinum and Calcarea phos symptoms, both tubercular remedies. So now I was looking for an insect that covered the imprisoned feeling which I found important because she experienced it in more than one symptom – her marriage, the sleep, the drugs, the nausea, the diarrhea. She used the words ‘prisoner’ and ‘imprisioned’ to describe her experience during all these symptoms.

 

Kristen went on to tell me that she had been struck by the flu on two occasions. “I was overtaken by something beyond me. Powerless, useless, heavy, almost like dead weight. I’m the dead weight. I’m surrendered to the evil that wants to overtake me. To render myself useless is one of the worst things I can think of. I’m used to doing, doing, doing. Taking care of things.”

Since Kristen had said previously that she was scared of many things, I asked her about these fears. “I hate putting on acrylic sweaters after getting out of a steamy shower. Suffocation, so horrible, hot, sweaty, itchy, overwhelming. Its like choking, suffocation or torture. Not being able to breathe.”

I ask her to expand on these words. “I see someone choking me, or squashing me down, someone physically is taking me to the floor, hands on my shoulder, pushing my head down, around my neck. I’m also a bit claustrophobic.

I asked her one more question before setting to my research – can you tell me, what is Torture? “Somebody or something inflicting unbearable pain or discomfort. The worst part of this is music and dancing. Losing my passion for so much, I hope I’m not permanently this empty, vacant person. Like an empty hotel, just full of holes and rooms and nothing to like or enjoy. Nothing.”

At this point, I did a repertorization using her anxiety, delusion of persecution and of being a prisoner, along with some of her food aversions and general symptoms. I limited the graph to look at insect remedies and saw Formica Rufa, the Red Ant; it didn’t come up high, but was represented, so I read further about it. Hering stated the mental picture as “Indisposed, forgetful, morose, fearful and apprehensive.” Allen’s Materia Medica says “”All day very happy and inclined to be jolly. During the day remarkably happy and able to study; everything seemed easy to be accomplished. Same happy state of mind and body, but easily depressed, and by slight causes this happy state was changed for a short time to despondency; sudden, but momentary spells of unhappiness; everything looked dark [mentally]. Diarrhoea worse morning on waking or after eating.”

I then went to do research on Ant behavior and survival strategies, and found the following on Wikipedia:

In order to survive, Polyergus workers raid Formica nests in order to steal the pupae which once hatched, become workers of the mixed nest. This sort of relationship is not unique, of the approximately 8,800 species of ants, at least 200 have evolved some form of symbiotic relationship with one another. What makes Polyergus special is the way a newly mated queen can, all by herself, take over a Formica nest and start a new colony. 

This was enough for me, combined with the feeling of persecution and claustrophobia so associated with the tubercular miasm, so I prescribed the one ant I knew of in our current material medica, Formica Rufa, 1M.

 

Follow up, December 5, 2012

“Sleep is great! Nausea is non-existent as is diarrhea. Now constipation and hemorrhoids are an issue! My libido has come back. Husband and I went on a cruise, I was ovulating and I wasn’t before this! I am much more relaxed in general and was able to enjoy myself on vacation, not just sit and worry. But I would like to take this more often than once every 5 weeks.” (In her case, she had been used to taking something daily for the past 10 years, and I felt it could be more comforting to her to take a daily dose of her remedy. Plus that would help support her as she weaned off the Prozac, and at this point she was no longer using Klonopin.)  I prescribed Formica Rufa LM8.

Right before her next follow up, I received an email from her saying she was 8 weeks pregnant!

 

Follow up, February 12, 2013

I’m pregnant! When I stopped the remedy for a few days, I started to feel the anxiety returning. This remedy is helping me cut down on the Prozac.

She’s continued the remedy daily through her pregnancy with small breaks here and there, and we’ve treated an acute UTI successfully with Pulsatilla in there too. Kristen is currently 3 weeks away from giving birth, and we are all really excited in anticipation of this baby!