Psychiatric Disorders and Homoeopathy

ABSTRACT:

Psychiatric disorders refers to a wide range of mental health conditions that affect  mood, thinking and behaviour. People often have mental health concerns but a mental health concern becomes a psychiatric Disorders when ongoing signs and symptoms causes stress easily and affect your ability to function in daily life, such as at school or work or in relationships.

In most cases, symptoms can be managed with a combination of medications and psychotherapy. But the most effective mode of treatment is homoeopathy. In homoeopathy, physicians emphasize the mind of the patient and find the medicine that suite best for the patient. The mental symptoms are of special importance in homoeopathic prescribing.

KEYWORD:-

psychiatric disorder, Homoeopathy, Psychosomatic diseases, Repertory.

INTRODUCTION:-

Psychiatric disorders are associated with abnormal aspects of mind. Psychiatry is the study and treatment of disorders of the mind and behaviour. The mind, or psyche is usually defined as the part of the person consisting of the thoughts, feelings and the function of willing.

Psychiatric disorders, therefore, can be viewed to occur whenever there is an impairment of thinking (cognition), feeling (affect) or willing (volition). In a paranoid reaction, for instance, the patient wrongly thinks he or she is being persecuted by an ill intentioned acquaintance.

In depressive psychoses the patient is incapacitated by a persistent feeling of intense gloom and in schizophrenia some patients are inactive, ineffectual and lacking in volition.

As a basis for understanding what is abnormal, doctors must know what constitutes mental as well as physical health. So here the history of the patient is very important. Before diagnosing the disease it is necessary to consider the development of personality and the mechanisms of psychological defence.

It follows that the priority is to ensure that psychiatric knowledge and skills and professional attitudes adequate to provision of psychiatric care are the part of clinical equipment of all doctors.

They must know the symptoms, signs and syndromes in psychiatry and they should be aware of the psychological, pharmacological and physical treatments that are effective in psychiatric illness. The basic skills are the ability to take a psychiatric history to elicit the clinical features of psychiatric disorder presented by the patient.

Hahnemannian View Of Mental Diseases:-

Mental diseases come under the mixed miasma. The mental diseases are well defined in Sec. 210 to 230 in Hahnemann’s Organon.

Definition:

Mental diseases are part of the whole psycho-somatic entity where the symptoms of derangement of mind and disposition are increased while the corporeal symptoms decline. Like all other one-sided diseases, they are psoric in origin.

Master Hahnemann stated, ” All the so called mental and emotional diseases are nothing more than corporeal disease in which the symptoms of derangement of the mind and disposition peculiar to each of them is increased, while the corporeal symptoms decline (more or less rapidly) till it at length it attains the most striking one sidedness ” (Sec. 215)

Classification of Mental Diseases:

Hahnemann has arranged mental diseases into following four types (Sec. 216, 221, 224, 225):

(A) Mental diseases appearing with the decline of corporeal diseases which threatens to be fatal-somato-psychic. (Sec. 216):-

In this type of mental diseases, the so-called corporeal disease declines with a rapid increase of the psychic symptoms.  Finally the corporeal symptoms lose all their dangerous aspects and improve almost to perfect health, or decreased to such degree that their obscure presence can only be detected by the observation of a physician gifted with perseverance and penetration. In this manner they become transformed into a one-sided disease with prominent mental symptoms.

In short, the affections of the grosser-corporeal organs become transferred and conducted to the almost, spiritual, mental and emotional organs, which the anatomist has never yet and never will reach with his scalpel.

 (B) Mental disease appearing suddenly as an acute disease in the patient’s ordinary calm state, caused by some exiting factor. (sec. 221).

These diseases may be considered as the sudden flaring of latent psora. The exciting factors are fright, vexation or abuse of spirituous liquors etc. (Sec. 221).

(C) Mental disease of doubtful origin (sec. 224). There are certain mental diseases (not quite developed) where it is difficult to ascertain whether they really arise from a corporeal affection of from psychological factors.

 (D) Mental disease arising from prolonged emotional causes, psycho-somatic (sec. 225). There are few emotional diseases which originate and are kept up by some emotional causes, such as continued anxiety, worry, vexation and fright. In contrast to the first type, they are primarily psychological in origin. Here the body is slightly affected in the beginning, but in course of time they “destroy the corporeal health often to a great degree”.

The Place Of Mental Symptoms In Repertory or Reportorial Aspect: –

“The moral state and mental condition of the patient often determines the choice of the homoeopathic remedy” (Organon). “Mental symptoms almost, always, define a case absolutely when the doctor exercises the art and patience to extract them from a carefully taken case-history and to understand them.”

In homeopathy as well as in repertory, Kent laid greater emphasis on the mental symptoms, especially the “causative emotional modalities” which were given the highest importance in the whole field of symptomatalogy. According to Kent the various symptoms of the mind were classified into the following three groups in their order of importance:

(A) WILL & AFFECTIONS

Love, hate and emotions (suicidal, loathing of life), lasciviousness, revulsion to sex, sexual perversions, fears, greed. smoking, drinking, drugs, dreams, homicidal tendencies, desire or aversion to company, family, friends, jealousy, suspicion obstinacy, contrariness, depression, loquacity, weeping, laughing, impatience.

(B) Understanding (Logic)

Delusions, delirium, hallucinations, mental confusions, loss of time senses.

(C) INTELLECT

Memory, concentration, mistakes in writing and speaking.

In Kent’s repertory, the plan followed throughout is from general to particular. It starts with the mind chapter which has been given prime importance. It deals various rubrics, sub-rubrics and symptoms and also contains in the mind chapter qualified symptoms which are very helpful in repertorisation.

Boenninghausen

Boenninghausen gave a very small place to mentals with a certain justification.  He was of the opinion that in actual practice it is difficult to extract reliable mentals. Very often the psychic state has to be ignored as it is only a mask for the true mental symptoms which are exhibited through the physical expressions.

Boenninghausen did not under rate the mental but he felt that it was not practically possible. Therefore, he did not give the priority to the mental which Kent later did. For Kent it is the mental symptom around which other symptoms revolve because mental symptoms express the innermost of the man and hence are most characteristics of a sick individual. The mind is a subjective as well as objective index which reveals the bias and rules of the whole case.

BBCR :-

In BBCR it is the modified and detailed worked over Boenninghusen’s therapeutic pocket book in which basic principles have remained unchanged by Boger. Boger especially stresses the pathological general while Boenninghusen gave more importance to physical generals, concomitants, and modalities. Characteristics and repertory not found in Kent’s repertory under mind include:

1. Alcoholism
2. Automatisms
3. Beseeching
4. Carefree
5. Collar, Pulls at
6. Death Agony
7. Duality, Sense of
8. Execrations
9. Imitation Mimicking
10. Over active
11. Paranoia
12. Rivalry
13. Satyriasis
14. Taciturm
15. Untidy etc. & so on.

Mental symptoms are truly “Generals” of the patient, but can be common as well as characteristic. It is not always that mentals are given precedence, because in certain mental diseases the apparently characteristic mental symptoms are merely common symptoms of the disease. Here other physical generals are much more important.

Usually the earliest mental manifestations are decidedly the most important of all the symptoms. If we have the acumen to detect this very early, we will discover that the later mental phenomena are simply variations and that either will lend to the same remedy which will, however be found with increasing difficulty as the case progresses. The mental symptoms pertaining to the will and emotions are more important than these concerning the intellect.

Actually, strong physical generals may be more important from the point of view of remedy selection than symptoms of intellect, like forgetfulness poor memory etc.  There are many books regarding mental disorders from the repertorial and  homeopathic point of view.

1. Quick Reference guide to Repertory of Mind Symptoms – by CHITAKARA H.L.
2. Probing the Mind and Other Guiding symptoms by GUNAVANTE S.M.
3. Mental Disease in Homeopathy -by – TALCOTT S.H.
4. Analytical Repertory of the Symptoms of Mind. By – C. HERING.
5. Synthetic Rep. mental Symptoms Vol. I
6. Repertory of Psychic Medicines with Materia Medica -by – GALLAVARDIN J.P. etc. & so on.

Classification Of Psychiatric Disorders According To The Modern System Of Medicine: 

Disorders which are associated with abnormal aspects of mind.

2. Major Disorders —–> Organic                    Acute (Delirium)

(Psychoses)          ** (Brain Diseases)                  Chronic (Dementia)

Functional

Major Depressive illness                             Schizophrenia

2. ‘Minor’ disorders: –       Are

(a)     Psychoneuroses: – Anxiety, Hysterical.

Obsession, Depressive & Phobic Neurosis.

(b)     Personality Disorders: –          Are

• –        Obsession
• –        Schizoid
• –        Hysterical & Sociopathic
• –        Alcoholism and drug dependency
• –        Psychosexual disorders
• –        Psychosomatic disorders

(c)      Mental Handicap:   Mental Retardation

AETIOLOGY

Collective and generalised aetiology of the psychiatric disorders. There are many causes of mental disorders and no single factor is responsible for the types of mental disorders. Certain common factors are enumerated as follows:

1. Constitutional factors and physical abnormalities e.g. –

• –        Deaf, Dumb, Mute,
• –        Limbless or crippled
• –        Blind, Lame
• –        Stammering, Babbling
• –        Dwarfism of undersize etc.

2. Hereditary Disorders
3. Physiological changes in body. at the time of:

• –        Puberty
• –        Menarche
• –        Involution
• –        Menopausal
• –        Senile age
• –        Adolescence

4. Any serious Head injury.
5. Deficient status
6. Social & cultural environment are disturbed.
7. Heavy work load and occupational hazards.
8. Any type of frustration.
9. Any type of mishap or incident.
10. Inferiority complex or superiority complex.
11. Pregnancy, period
12. Child birth
13. Marital disharmony
14. Due to sudden grief or sorrow.
15. Psychological factor particularly interpersonal relationships at home, place of work or school
16. Examination funk and repeated examination failure.
17. Loss of prestige, of loss of job.
18. Certain endocrinal disturbances.
19. Ignorance of the person.
20. Any acute of chronic Infections.
21. Persistence dehydration effects.
22. Chemical and drug hydration effects.
23. Alcoholism
24. Excessive fear, emotionally and Jubilance.

Physical Stresses due to :

• –         Trauma, Accident
• –        War & Riots
• –        Starvation
• –        Flood
• –        Fire, Stamped
• –        Volcano. Earthquake
• –        Solar Eclipse & Lunar Eclipse
• –        Whimsical
• –        Cyclone, Hurricane, Thunder storm.
• –        Eddy & Eddy Current
• –        Ebb and Tide
• –        Calamites
• –        Whirlwind
• –        Blackout, Bighting light.
• –        Sun & Sun Rays

26. Death of Family members
27. Much happiness
28. Partition of Family members
29. Due to fight quarrel and violence.
30. Loneliness and Agony
31. Criminal persons
32. Cynic SNOB, Egoist
33. Geographical Distribution of areas
34. Special day or Special night festival or Customs
35. Idiopathic.

some important mental diseases

1.  SCHIZOPHRENIA It is a functional group of illnesses of psychotic manifestation.

C/F:

(A)    It is characterised by disturbances of thinking.

E.g.   (a)     Absence of link between ideas.

(b)     Irrelevant and meaningless ideas.

(B)    Disturbances of EMOTIONS:

The patient laughs instead of weeping of crying.

(C)   Disturbances of BEHAVIOUR:

There is inappropriate behaviour with suicidal and homicidal tendencies.

(D)   Hallucinations and catatonia are PRESENT:

Catatonia: – Differences in thinking & behaviour.

           Types of SCHIZOPHRENIA:

1. Simple SCHIZOPHRENIA: Thinking disturbances and unresponsiveness.
2. Hebephrenic s. : Thinking disturbances are markedly present.
3. CatatonIc s.: Disturbances in thinking and behaviour but delusions and hallucinations are absent.
4. Paranoid s.:  Patient because too much suspicious.
5. Melancholia or DEPRESSION:      It is the functional group of illness of psychotic manifestation.

C/F: It is characterised by

1. Sadness of mood.
2. Poverty of ideas.
3. Feeling of guiltiness.
4. Psychomotor Retardation of activities.

 

2. mania:

It is also the functional group of illnesses of psychotic manifestation, which is characterized by:

C/F:- It is just reverse of the Depression.

(a)     Elevation of Mood

(b)     Flight of ideas

(c)      Increased psychomotor activities.

(d)     Excessive joyful.

(e)      Fantasy.

Now some psychoneurotic (or neurosis) diseases ARE:–

1.  Anxiety reaction: – It is a type of Neurotic state of Psychiatric disorder.

It is characterised by /– C/F are

(a)      Physiological Changes:-

1. Palpation
2. Shortness of breath
3. Dryness
4. Headache
5. Heaviness of Head
6. Giddiness
7. Blurring of Vision
8. Frequency of Maturation increased.
9. Diarrhoea
10. Excessive sweating
11. TachyCardia
12. Increased of systolic B.P.
13. Increased depth & frequency of respiration.

(b)     Psychological Changes:

1. Excessive worries
2. Apprehension
3. Morbid fear
4. Insomnia
5. Night Mares

2. Phobic REACTION:–

It is characterised by unexplained and irrational morbid fears about animals or objects. E.g. :

• (a)     Insects
• (b)     Animal and people
• (c)      Needle
• (d)     Darkness
• (e)      Height
• (f)      Excessive Brightness
• (g)     Water
• (h)     Fire etc.

3. Depressive Psychoneurosis:

It is characterised by depressive & neurotics features. Patient shows mental dysfunctions &  interferences in his capacities of judgment.

4. HYSTERIA:–

It is a type of neurotic state psychiatric disorder.

Def.: It is a condition of unconscious want of relief from intolerable stress characterised by clear cut physical & mental symptoms.

TYPES: –   It has 2 types

(A)    Conversion type

(B)     Dissociated type

(A)    Conversion TYPE:  Neurological examination does not correspond to the anatomical areas served by motor or sensory nerves though the patient may be severally incapacitated by his symptoms. He appears unconcerned about them.

(B)     Dissociated TYPE: – Patient with altered stated of awareness.

e.g.: – Pains, fits, Amnesias etc.

Hysteria is ;

1. Psychogenic in origin
2. Occurs mostly in females.
3. Cannot be terms in organic disease.
4. They are having no anatomical basis.
5. They occur rarely when the Patient is alone.
6. All the symptoms are increased in presence of sympathetic audience.
7. Generally it occurs, in the presence of many persons.
8. There is no specific time.

Etiology of HYSTERIA:–

1. Hereditary and more common in young females, especially unmarried, widowed, divorcees and nallipara women.
2. A/N
3. Environment: – H/O unhappy childhood or abnormal parent child relationship.
4. Excessive obeying in childhood.
5. Unwise psychological management by parents in developing age.
6. Unpleasant consequence.

Symptoms & SIGNS:

They chiefly consist of the reproduction of the symptoms or signs of an illness by the patient for some advantageous purpose without being fully aware of his motive in doing so.

A.  Motor/sensory SYMPTOMS:–

These symptoms do not obey anatomical or physiological law but follow patient’s concept.

1. Blindness or deafness.
2. Loss of cutaneous or deep sensibility.
3. Headache, Pains.
4. Aphonia, Noise in ears.
5. Paralysis and tightening as well as hardness of muscles
6. Tremors
7. Tics and explosive utterances.
8.     Spasm of ocular muscles.
9. Abnormal Gaits.
10. Frequency of urination.
11. Palpitation, Dyspnoea, Pericardial pain.
12. There may be breathlessness on Hysterical Hyperventilation.
13. Nausea, Vomiting, Diarrhoea & water brash.
14. FITS – Varying from simple falling to bizarre fits. Attacks with wild movement of arms and legs when restraint is applied. Absent incontinences, preservation of reflexes such as corneal, and generally no tongue biting.

B. Psychological SYMPTOMS:–

1. Wondering with altered awareness.
2. Twilight state in which consciousness is impaired.
3. Stupor, in which parent lies motionless showing no reaction to environment.

Pseudo DEMENTIA: – Patient behaves as though insane.

Patient may mimic symptoms of psychiatric illness.

C. Other SYMPTOMS:–

1. Patient often comes with tears coursing down her cheeks.
2. Appears severely depressed though superficial.
3. Respond very well to an attentive audience.

Personality & behaviours DISORDERS:–

1. Alcoholism
2. Drug addiction – Eg. : – L.S.D., Smeke, Heroine, Brown Sugar & Excessive use of sleeping pills etc.
3. Sexual offenses and sexual perversions :-

• • Onanism
  • Sadism
  • Bestiality
  • Tribalism
  • Masochism
  • Fetishism
  • Impotency & Frigidity

Investigations of psychiatric disorders

It should be done keeping in view the physical and mental condition of the patient or according to disease and intensity and grade of degree of the disease.

Except all routine examinations, some specific examinations are:

1. X-Ray SKULL AP & LA
2. X-RAY PNS
3. CAT SCAN
4. ECG & EEG
5. ANGIOGRAPHY, ventriculography & fundoscopy should be done in some cases.

TREATMENT: – Regarding the treatment of Psychiatric

1. Rest.
2. Reassurance.
3. Psychotherapy.
4. Causative factors should be treated.
5. Suggestion & Persuasion.
6. Environmental factors should be checked.
7. Sympathetic view to the patient.
8. Occupational therapy.
9. Diversion of mind from the constant irritating factor.

Homoeopathic – treatment

Homeopathic medicines work very effectively and give spectacular results in mental diseases. Names, symptoms and other particulars of such medicines are mentioned below briefly.

(1)     Nux MOSCHATA:

1. Mind is very changeable from laughing to crying.
2. Patient is confused every time with impaired movement.
3. Patient thinks that there are two heads.
4. Vertigo is present when walking in open air with feelings of expression and sleepiness.

Agg. < By cold water

Ame. > Warm room

(2)     THUJA:–

1. Fixed ideas as if strange person were at his side.
2. Patient feels as if soul and body are separated.
3. Emotional sensitiveness.
4. Music causes weeping and trembling.
5. Insomnia is constantly present.

(3)     STRAMONIUM:–

1. Patient sees ghosts.
2. Hears voices and talks with spirits.
3. There are rapid changes from joy to sadness.
4. Delusions are present about his identity. So that he thinks     himself, Tall, double and a part missing.
5. Religious Mania is the present so that pt. worship all the       time.
6. Pt. wants light & company all the time.

(4)     SULPHUR:–

1. Patient is very forgetful.
2. Delusions are present so that he thinks that he is very much wealthy.
3. Patient is busy all the time without doing anything.
4. Pt. is irritable very selfish and no regards for others.
5. He imagines of giving wrong things to people causing their death.

(5)     MEDORRHINUM:–

1. There is extreme weakness of memory and patient cannot remember his own name.
2. Patient cannot spell correctly and cannot speak without weeping.
3. Patient is very impatient, anxious and nervous so he is always in a hurry.
4. Insatiable thirst for alcohol.
5. Arithmetic calculations done wrongly by the patient.

(6)    KALI. PHOS:–

1. Used as a sedative and tranquilliser.
2. Anxiety nervousness, lethargic with extreme depression in present.
3. Cannot recall names or words; mind sluggish, but will act if aroused.
4. Night terrors and loss of memory present.
5. Somnambulism

(7)     NAT. MUR. :-

1. Used for after effects of grief, fright, anger.
2. Depressed particularly in chronic disorders.
3. Any consolation is aggravated.
4. Patient wants to be alone to cry.
5. Laughs so immoderately at something not ludicrous that tears come into her eyes and she looks as if she had been weeping.

(8)     ZINCUM MET. :-

1. Patient very sensitive to noise.
2. He is having aversion to walk and talk.
3. Child repeats everything which is said to him.
4. Patient fears from arrest on account of supposed crime.
5. Patients feel about the head as if it falls to the left side.
6. There are tendencies of melancholia (don’t want to meet).

(9)     SYPHILINIUM:-

1. Loss of memory in the patient with history of syphilis or contact with syphilis.
2. He remembers everything previous to his illness.
3. He feels as if, he is going to be insane.
4. He becomes hopeless and fears the night.

(10)   IGNATIA:-

1. It is highly specific for the hysterical attacks.
2. Moody and mental condition rapidly changes.
3. Mentally and physically exhausted by long concentrated grief.
4. Desire to be alone, very sensitive to mood.
5. Slightest contradiction excites the anger.
6. Headache as if nails drawn out through the head.

(11)   HYOSCYAMUS:-

1. Patient is showing lascivious mania.
2. She is showing complete immodesty. Will not be covered by by clothes.
3. They kick off their clothes and exposes the genital part.
4. She sings obscene songs.
5. She lays naked in bed and puts off clothes in front of any one.

(12)   ANACARDIUM:-

1. Sudden loss of memory & there is irresistible desire to curse.
2. Patient feels that he has two wills. One is commanding and the  other is forbidding.
3. Every event seems to be in a dream.
4. There is very strange temperament, so he laughs at serious matter and is serious about laughing matters.
5. Symptoms one agg. by mental tension better by after sleep.

(13)   CANNABIS INDICA:-

1. Patient is very forgetful and forgets his last works and ideas.
2. He is full of fun and mischievous activities.
3. There is excessive loquacity.
4. Times senses to be very long a few seconds seems to be many years.
5. Sensation of swelling is in perineum or near the as if the sitting on a ball.

(14)  PLATINA:-

1. Female remedy, Nymphomania.
2. Mental symptoms appear as physical symptoms disappear & vice versa.
3. Extreme superiority complex, pride and over estimation of one’s self.
4. Hysterical patient.

(15)   ACONITE:-

1. Tension
2. Great fear & anxiety of mind.
3. Fear & Fright fear of crowed.
4. Predicts the date & even the hour of his death.

(16)   BELLADONNA:-

1. For the delirious condition.
2. Great excitement & violence.
3. The patient has furious rage and anger.
4. The patient imagines various abnormal things e.g. – ghosts, monsters, insects.

(17)   ANTIM. CRUD. :
Sentimental mood in Moonlight

(18)   AURUM MET.:-
Constant dwelling on suicide.

(19)   BORAX:-  
Dread of downward motion.

(20)   SEPIA:-
Bearing down sensation in females.

(21)   BAPTISIA:-
During Typhoid fever & delirium pt. says that his body is scattered and he is two or three persons and cannot cover them up properly so he is trying to get those pieces together.

OTHER REMEDIES:  Cimicifuja, Ars. Alb., Cina, Chammilla, Nux Vomica, C.C., C.P., Cicuuta.V., Opium, Iodium, Moschus, Phos., Gelsemium, Kaliphos, Arnica, Bryonia, Arg. Nit., Lac. Can., Lil.Tig., Lachasis, Crocus Sat., Puls., Baryta Carb., Cu.Met., Caladium, Lycopodium, Etc. & So On.

Bibliography:

[1] Golwala’s Medicine For Student 17^th edition.

[2] Api Textbook Of Medicine 9^th edition.

[3] Boenninghausen Characteristics & Repertory by Dr. C.M. Boger.

[4] Repertory of the Homoeopathic Materia Medica by Dr. J.T. Kent.

[5] Hahnemann’s Organon of Medicine by B.K. Sarkar 4^th reprint edition.

[6] Materia Medica Keynotes by Henry C. Allen

[7] Homœopathic Materia Medica by William BOERICKE, M.D

[8] A Dictionary Of Practical Materia Medica by John Henry Clarke, M.D.

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