Clinical Cases

A Case of Social Anxiety and Lack of Confidence

Written by Dimple Kirpalani

Dr. Dimple Kirpalani shares a case of social anxiety in a man of 19. He high school he struggled with concentration problems and fear of failure. Is symptoms led to a nosode in 50 M potency, which proved to be the simillimum.

5/8/2019 – First consultation

D is a 19-year-old young man from an educated well-settled family. Parents are of European descent. He has one older sister studying law at University. He has come in for the first consult with his mother.

D works as a fly in-fly out worker in the mines up north. He is an Assistant Driller. He has a standard roster of two weeks on and one week off. Working conditions at the mines are ‘poor’. He works 12 hours a day and it is hard physical work. His day starts at 4 a.m.

He is very ambitious in spite of the fact that he is working at the lowest job level. He wants to travel and surf. High love for both travelling and surfing is clearly observed. The mining job is a learning curve something he has to do. He wants to start a business at some point. That’s the only way he can think of fulfilling his dreams.

Observation – Eye contact is weak. He is not happy.

What Happened:

D was a GATE (gifted and talented programme) student who went to a prestigious high school based on this merit result. Students who pass this test are generally considered to have over the average intelligence.

High school brought its own challenges both emotionally and academically. He did well and he was sure he would cope. However, in year 12 things took a bad turn. He struggled with concentration. Fear of failure and resentment set in. Bad company at school led him to indulge in drug abuse – Marijuana. No other hard-core drugs – “I knew that was dangerous.” Then “I crashed.”

D had 2 major episodes of throat infections with suppuration ++

Each episode was treated with antibiotics. Multiples antibiotics and lot of different medication was given. He could not function. Iron levels were very low. Going to school became almost impossible. Performance in school suffered as a result of bad health and bad choices. He could not sit for his year 12 exams which meant he got an unsatisfactory result.

D quit studies after that. He could not go to university owing to his bad results and he had lost hope and will. This led to – Lack of confidence. “My brain stops working. I over analyse everything. When I am talking to someone, I feel a loss of words. Analysis paralysis – I start stammering and stuttering.”

He developed social anxiety – “I don’t fit in. I feel I am not capable.” People are judging me – suspicious? Can get along in small groups.  Sensitive to criticism. A deep-seated sense of failure.

Favourite place is the sea. D surf’s – “nothing like it”. Can spend a whole day at the beach – in the water.  The sun – tires me – but I love the sea.  “I don’t want to grow up.”

Concentration is not as bad now.

Needs to lead at work.  Fears – Failure ++, crowds, meeting new people.

A need to please others – but also a need to lead. “I don’t like being corrected.”

Loves flying – wants to go sky diving. “Surfing is my biggest joy.”

Hair loss.

Skin – mild eczema right elbow joint.

Biting nails and cuticles.

Nasal congestion – mouth open when I sleep.

Left Nostril – crusty discharge.

Sleep – 8:30 pm to 4:00 am (wakes up for work). Wakes up fresh. On abdomen.

Dreams – Nightmares – death of some people and I am the reason. Wakes up around 2-3 am.

Desires – Burritos, meat +3, salt +3, Spices, seafood +3, milk +3

Aversion – onions.

H/O # right thumb – it has healed crooked.

HPV vaccine – 3 mandatory doses taken.

Shaking hands

High Fever – last year

Family H/O – Mother – gall bladder removed. Restless legs

Sister – PCOS and anxiety

Shrugs when asked, are you happy with your choices. Hates consolation. My choices, my life. Eye to eye contact is low.

Prescription – Medorrhinum 50 M – single dose.

Potency selection was based on the high similarity between the remedy and presenting symptoms and due to the number of mind-related symptoms.

Level of Health: I placed D in Group B, higher – probably Level 5. He did remember having a high fever the year before, along with a few other acute conditions. I also took into consideration the H/O prior infections which were treated by conventional medication and his drug abuse. According to this, if the remedy is right, his mental/emotional state must improve but he must develop acutes again, elevating him through the level.

Follow Up:

21/7/2019 -Pain in throat since 3 days. “Have not been feeling well – fever since the last few days. Was at the mines – took antipyretics”.

O/E – inflamed tonsils, Glands (sub maxillary) enlarged ++

Pain on swallowing.

Nose blocked (on examination)

Left tonsil was painful at night

Muscular pain/ soreness – lower back > rest, lying down.

Observation – full-on eye contact and he has come alone today. He did not tell his supervisors he was sick (fever) till he could not get himself to work. By protocol he had been prescribed medication on-site and then asked to fly back home on sick leave. This worried D because he did not want the impression that “he was not pulling his weight.”

I posed two questions here – How bad was this sore throat as compared to the infections in the past? “Not so bad. I have had worse.”

I wondered if the infection was not expressing itself fully due to the medication prescribed by the doctor on site.

Prescription – Sac Lac was given.

27/8/2019 –

Pain < swallowing, right tonsil and back of throat. Suppuration of tonsils. Redness of throat.

Left tonsil does not hurt anymore.

< empty swallowing

> cold drinks

< hot liquids.

Stabbing, throbbing, poking pain.

Green discharge – left nostril.

Salivation normal.

Prescription – Lac can 200c – twice today. (as per repertorisation – the main keynote being alternating sides )


Follow up – Anxiety is a lot better.

Eczema is worse – right arm

Dehydrating atmosphere at work – “we work underground. Hence the skin gets very dry and itches”.

Observation – Eye contact is missing again.

Many times, when an acute appears during a chronic treatment, the chronic state may start to relapse after the acute has been treated well. At such times the chronic remedy needs to be treated. In this case as well, though the acute was handled well with the indicated remedy, he had a relapse of his anxiety and lack of confidence post the acute. Therefore, the chronic remedy was repeated.

Prescription – Medorrhinum 50 M single dose.

Outcome: The boy being in Group B, had recurrent acutes along with the chronic psychological suffering. According to the prognosis of this level, he will get even better as his acutes get stronger and eventually he may be elevated to Group A if his defence is strong enough. The acutes are still expected in this case and will need to be treated till they become less frequent and farther apart


I received a call from D’s mother. He had approached the University to study marine biology. He did it on his own at his own will. He has to sit for some tests in order to qualify. He has already signed up for them and will be starting University soon. He feels very confident that he will be able to do it.


About the author

Dimple Kirpalani

Dr. Dimple Kirpalani (B.H.M.S) has been a practicing classical homeopath for 23 years after her graduation with BHMS from university of Pune, India in 1999. She currently practices in Perth, Western Australia and is a registered member of the AROH, the NZHS and Faculty of Homeopathy. She has continued her educational endeavors and been affiliated with the International Academy of Classical Homeopathy and Professor George Vithoulkas since 2016 and is the E Learning coordinator for Australia.


  • myself being engineer by profession timepass interest in homeopathy my diary note is,medo boastful inflated frog, an high ego ambition is his weakness.has fear of opinion of others.better by bending back not soles.actions are wide ranged high capacity to get high heat generated in body not like merc and nat carb who whistle out in narrow range temperature conditions.ayurveds call it pitta dosha.argt nit is pitta simple sulphur double pitta makes orifices red medo triple pitta allows heat to go to soles then only go to doctor.Bengali homeopaths habit is to capture some peculiar point that my note says burning is felt in heart region sleeps on abdomen.

  • Dear Dr. Kirpalani,

    Thank you for sharing the case study.

    If possible can you please illustrate another case study that deals with Dyslexia.

    Although not very wide spread, it is affecting lots of school age children and has the potential to trigger stress and disharmony in families.

    Typically, it also undermines the student’s ability to learn and study and is often the source of anxiety and frustration.

    Best wishes,

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