Clinical Cases

Bipolar Schizoaffective Disorder in a Boy of 18

Kavita R. Chandak
Written by Kavita R. Chandak

Dr. Kavita Chankak treats a boy of 18 for schizoaffective disorder. The symptoms rudeness, gambling, boasting, dictatorial and desires to be rich were among those leading to the simillimum.

Anamnesis –

Parents of an 18 -year -old boy visited me February 12, 2021.

Father: Our son, Rudra is an intelligent boy in study especially in Math. He is Gold medalist in Karate. He is aggressive and talks in rude tone. We are middle class people, but Rudra wants everything rich, grand and expensive. He is demanding, wants luxurious life style.

He has good convincing power and sometimes makes me follow his wishes. We try to provide him the best possible facilities but he is discontented. He asked for 40000/ INR as his birthday gift and 35000/ INR for trip. My monthly income is just 20000/ INR. How could I provide him such a big amount?

He is over confident and feels that parents are mad, having no knowledge and he is the only smart person in family. He wants me to run a Pub, Bar or Petrol Pump so that I can make big money. He does not understand that we need to invest money to open such big ventures. He just gets fascinated with glamour and showcase.

Six months back we sold his mother’s gold chain to purchase a mobile phone for 80000/ INR, as he wanted to make career in Pub G.  He anyhow wanted it as his friends are having expensive phones. Whatever he sees at his friends, he wants it.

He says I am not getting branded clothes and watches, as you could not afford it. He wants hi-fi life style and fashionable accessories. After phone, his next demand was computer.

He is using my brother’s old car now; he is not getting that. I could not afford its fuel cost. If we reject his wish, then the family has to face volcano! He shouts and creates scene, does not let us to sleep or eat. He knows if I will create drama, will definitely get something.

He always thinks about getting more and more money. He told me that he wants to invest money in stock market, but without proper knowledge, how one could gamble the money.

He keeps on demanding one after one. Once he demanded an expensive Bike.  I refused. He attempted suicide by hanging himself.

Me- Does he attempt suicide frequently?

Father- Yes. Once he cut his vein as I refused to purchase a car for him (when he was 16 years old) and did the same 8 days back. He cannot tolerate slight contradiction and criticism.

Me- Was there profuse blood loss?

Father- Nothing at all.

Me- Did he hang himself in presence of family members?

Father- Yes. He informed his mother earlier as well messaged me too.  He says I got the worst parents in the world.  He keeps on threatening us all the time.  He said that, I should sell my gold chain and give money for his tour; otherwise, he would jump from the Mall.

Mother- His grandfather is extremely harsh person, used to behave like Rudra in past. His grandmother is a jealous woman.

Me-Tell me something about his childhood.

Mother- When he was in eighth standard, he stole 12000/ INR from his father’s bag to put petrol in his friend’s bike. He was mocked and bullied in the school. He feels that nobody is his well-wisher.

He does not like to be guided or counselled. He does not like to study, gives excuses, left tuition classes after deposition of fees.

Life is too difficult for us. He is beyond tolerance. No desire to eat or brushing hairs; I lost enthusiasm in living. I was tired with his mood swings and destructive habits.  When new demand is there, he behaves gently. He quarrels with us only. He can share anything like money or computer with his friends.

He talks only about his favorite subject. Does not care whether the next person is interested in listening or not!  He does not get up until afternoon, avoids bath. He has occasional headache. His friends call him when they need any advice or help. He is a good counselor. He talks so well with everyone except family.

He says- I feel bounded here.  If I will live here, I will never grow. You people are so pushing, compelling me to follow you. Stop pressurizing; I know what is good for me.

Mother said – He is stone hearted, does not care even if I fall sick. He only thinks about earning money as fast as possible. He gets irritated with sister’s education expenses. He says, what will remain for us if we spend too much on her education.

I feel we are responsible for that. He was an affectionate child.

H/O Mother during pregnancy-

Mother:  During pregnancy, I never got proper attention and care. Excessive fetal movements in night did not allow me to sleep well. I exerted a lot during gestation. I could not relax even after his birth. He used to cry whole night until age of 3 months.

Discussion-

My diagnosis was Bipolar Schizoaffective Disorder. (2)

First, I considered it as Schizophrenia as he has delusion of grandeur, not accepting real financial status and lack of emotions towards family. (1)  There is a small line of difference between these two. Schizoaffective Disorder has false, fixed beliefs, despite evidence to the contrary, unusual behavior, impaired communication with family, periods of manic mood, with an increase in energy and a decreased need for sleep, impaired academic and social functioning, talk of suicide, mania and depressive mood.

Schizophrenia has lack of motivation but this boy was not lacking it. In fact, he was all the time thinking about earning money to be a rich man.

Bipolar Schizoaffective Disorder has episodes of mania and sometimes-major depression/sadness.

Rubrics considered (4)

MIND – DELUSIONS – great person, is a

MIND – LUXURY, desire for

MIND – RUDENESS

MIND – QUARRELSOME – family, with her

MIND – AMBITION – increased – money; to make

MIND – GAMBLING – passion for gambling – make money; to

MIND – ANGER – contradiction; from

MIND – SENSITIVE – criticism; to

MIND – DELUSIONS – enemy – everyone is an

MIND – TALKING – one subject; of nothing but

MIND – BOASTER – squandering through ostentation

MIND – THREATENING

MIND – RICH; to be – desire

MIND – AILMENTS FROM – scorned; being

MIND – DICTATORIAL – talking with air of command

MIND – JEALOUSY – quarrelling, reproaches and scolding; with

MIND – WEEPING – children, in – night

MIND – PETULANT

MIND – DESTRUCTIVENESS (only in anger)

Many remedies like Lycopodium, Nux Vomica, Sulphur, Platina, Stramonium, Mercury Sol, Veratrum Album,Calcarea Carb, Carcinosin, Chamomilla and Lachesis came up.

Prescription

Lycopodium 10 M one aqua dose given from the above totality on 12 February 2021.   Actually, no one remedy from the repertorisation covered all symptoms. It was a clear indication to use a nosode. I was thinking about Carcinosin as it covered various symptoms and his mother faced excessive fetal movements during pregnancy.

Nevertheless, Carsinosin does not have the delusion of being great and he does not  crave luxury, which was the keynote symptom of the patient.  I decided to go with Lycopodium and to put up Carsinosin as an intercurrent to support the main remedy.

However, Platina and Sulphur are egoistic/ haughty but Platina lacked jealousy and Sulphur lacked boasting. Nux Vomica is known for sedentary life style, which he lives even without being rich.

Stramonium covers destructive behavior but it is not avaricous, which is the keynote of the person.

Lachesis is jealous, rude with delusion of being superhuman but he does not boast it.

Full of desires, braggart, rudeness, imposing his choice and thoughts on others, talking on his favorite subject, love for power, desire for money and ready to take the risk by investing money in stock market; all these symptoms made me to select Lycopodium.

The following chart with different filters advocated Lycopodium. (4)

10 M selected, as ‘more the dynamic mental sphere- higher should be the potency.’

Follow ups –

March 2021

His parents came to visit me. They said he is a little better.  Irritability reduced. Demands are the same. Restless and impatient.  Rudeness is extreme. Gets easily offended. Blames others especially the father for spoiling his childhood, not fulfilling his desires. Wants to be rich soon. The only difference is that, he is not giving long speeches about his favorite subject.

Prescription-

From the above report, I decided to repeat Lycopodium 10 M one aqua dose. Sometimes we need to give time to the remedy to work thoroughly.

27th April 2021

Parents came to consult me. They said:  In these 3 months, our son is 20-25% better. He is able to distinguish between good and bad. He is calm now. His destructiveness is reduced more than 50%.

(If you see this rubric-you will not find Lycopodium here)

MIND – DESTRUCTIVENESS (4)

Agar. anan. androc. apis aur-m-n. bac. Bell. bufo calc. Camph. canth. carbn-s. carc. Chel. Cimx. Con. Cupr. cur. dulc. fl-ac. gal-ac. hep. hura Hyos. iod. kali-p. lach. laur. lil-t. med. merc-i-f. merc. moni. morph. mosch. Nux-v. oena. op. ozone phos. plat. plb. prot. sec. sep. sol-t-ae. spong. staph. STRAM. stront-c. sulph. Tarent. tritic-vg. Tub. vanil. verat-v. Verat.)

The well-selected remedy usually covers those symptoms which are not even mentioned it. Why?  Homeopathy does not treat the disease; it treats the person in the disease.

They further said:  He broke 80000/ Rs. Mobile phone few months back but now he is normal. He used to feel himself chief of family, commanding person; now behaving well. Respecting us. Now he is calmed down in just half an hour, previously this span was 2-3 days.

He is not demanding a single penny now. He talks about money only during anger but not asking for it. Before meeting you, he used to take 10000/ INR as pocket money by hook and crook.  Now the scenario is totally changed. Today he recharged my mobile by paying 2700/ for yearly package from his account!

Now he is matured enough.  However, his strong desire to be rich soon is not letting him rest. He is still thinking about stock market investment.

Prescription- What and why?

As Lycopodium worked well until now, I decided to repeat it in same potency.

However, somewhere, I had the inside hunch that I am missing something.

11th May 2021

Parents said:   He is 50% better. He is eating well now, which he did not previously. We wish he should continue this eating schedule always. His anger reduced. He is following his duties well. He is filling water in cooler. Previously he never did it. He is sleeping well. Attending online classes but does not want us to pay for his sister’s class fees.

He wants to be a rich man and feels that he is lacking because of us. He says- You could not get me the branded clothes, which can go with my looks. I feel bounded here.  If I will live here, I will never grow. Why do you not understand me? Stop pushing; I know what is good for me.

However, he is improving but his desire to be rich soon troubles us on and off. He then become aggressive and blames us that he could not live a quality life because of our financial condition. What will remain there for his future if we keep on spending money on his sister’s education and our medical issues?  No doubt, his behavior is better than before but his desire to be a moneyed person is growing day by day.

Last week his friends went to Goa without informing him. He felt bad, forsaken and cheated. He was very angry with them. One of his friends called him from Goa, as he needed money transfer.

Rudra sent him money.

Me- Why? You just said he was angry with them.

Mother said- He did so as he has the fear of losing them. He does not have any other friends.

Prescription- what and why?

I understood that Lycopodium comforted up to some extent but it could not touch the core of the patient.  I wanted a remedy, which can address his original core picture hence considered the rubric MIND – RICH; to be – desire, which was there in my repertorization. The only remedy that came up was White Marble.

Sulph-Calc-Lyco! These three remedies form the great anti-psoric trio of our Materia Medica. These polychrests (the first two from the mineral kingdom and Lyco from the plant kingdom) follow each other in a certain order, and one generally finds that if one of these is indicated in a patient, the other two will be required at some time or the other, to restore the patient to total or harmonious health.(3)

Marble is primarily Calcium carbonate, an example of a sedimentary rock that has changed into a metamorphic rock. The pressure experienced by a rock during metamorphism is due to the weight of the overlying rocks.

This boy has a strong sense of being pressured. He was self-oriented, careless about others; felt himself bounded under shell of parents but still wanted to be decorated and to be rich.

Marble is known for its decorative appearance and strength.

I paid attention to the following rubrics from the same remedy- (4)

MIND – AMUSEMENT – desire for

MIND – ANGER – interruption; from

MIND – ANGER – misunderstood, when

MIND – AVARICE – squandering on oneself, but

MIND – CAPRICIOUSNESS

MIND – CARESSED; being – desire to be caressed

MIND – UNSYMPATHETIC

MIND – IRRITABILITY – trifles, from

MIND – INDIFFERENCE – welfare of others, to

MIND – INDIFFERENCE – others, toward

MIND – IMPULSIVE

MIND – HAUGHTY

MIND – DELUSIONS – great person, is a

MIND – DELUSIONS – noble; being

MIND – FANCIES – absorbed in

MIND – FLATTERED – desire to be

MIND – FORSAKEN feeling – isolation; sensation of

MIND – VANITY

MIND – SUICIDAL disposition – throwing – height; himself from a

MIND – SERVANTS; desire to have

MIND – SELFISHNESS

MIND – COMPLAINING

MIND – DELUSIONS – distinguished; he is

MIND – DELUSIONS – enemy – surrounded by enemies

MIND – DELUSIONS – neglected – he or she is neglected

MIND – ENVY

MIND – OFFENDED, easily

MIND – BATHING – aversion to bathe

MIND – REPROACHING others

MIND – QUARRELSOME

MIND – ORDER – desire for – life, in one’s

The marble proving, done by Nuala Eising, brought forth the following themes-(5)

  • Feeling attractive
  • Feeling pleasant
  • Calm and clear
  • Anxiety about future
  • Emotional coldness
  • Self -centered, selfish
  • Indifference toward welfare of others
  • Demanding, but in a quiet manner
  • Dreams of escape, dreams being pursued

(Symptoms in bold font resemble to patient)

Prescription- Marble White 200 CH one dose.

June 2021-

Parents said- Rudra’s behavior is better in many ways but we still have the fear of his aggressive attacks and money demand.

Me- How many times did he demand money for stock market investment?

Father- Not once in this month.

Me-Then what is this fear about?

Father- If he will ask for money, we again will have to face a volcano at home.

Prescription – What and Why?

Placebo    I did not get any complaint from parents.   We should wait if everything is going well as either the first dose is still working or immunity is aroused enough.

July 2021-

Parents said – Rudra has very bad coryza and constant running nose. He wanted medicine but as you suggested we only preferred steam inhalation.

Me-Do any of you or his friends have cough and cold?

Mother- No.

Me- Does he suffer from cold every year?

Mother- In childhood. Not now.

Me- How is his aggression?

Father- He is fine. Not demanding money or not taking objection to his sister’s expenses. He said share market does not give assured income without proper knowledge. He wants to go to Mumbai to learn from agencies.

Me- You must send him for this training.

Mother- Yesterday he said, ‘when I would be rich, I shall buy you a good house. Dad should start new business to earn fast. We should take credit card. It gives us a side of 48 days, we can buy anything now and can pay interest free amount later on.’

Father-He does not understand from where I would pay such huge amount.

Prescription – What and Why?

Marble White 1 M one dose.

Why?   I could observe that his cold is the outcome of the remedy. In homeopathy we say- Nasal drain is cry of brain. 200C worked well at physical level but to cover mental level, I increased potency.

August 2021-

Parents said- he is 80% better as compared to six months back.

His father cried with happy tears!

Me- Glad to see you happy. You tolerated a lot!

Mother- Extreme!

Me- I can see in your eyes!

Mother-We could not eat well even for a week. Now I am satisfied. Rudra decorated his room well, keeping clothes and computer at proper place. Behaving well.

Father- Previously he used to say’ me and mine’ now he says ‘ours.’

Me- Is he feeling himself as a part of family?

Father-Yes!

Me- How was his aggression previously?

Father- Extreme. We could not even talk to him. I used to avoid going home out of the fear what new will I get to see now. He made us to keep awake for whole night to listen to his outburst.

Me- Now?

Father- He is fine with us.  His says- Dad, take retirement in 5 years and I will look after you.

Me- Taking responsibility!

Father- Yes.

He says- We can buy a good car after 2 years.

Me-You mean to say, he can be patient to buy a car in 2 years.

Father- Yes.

Me-Was it same in past when he was 15-16 years old?

Father-No, he wanted it immediately, next day.

For him, car was ‘The Must’ accessary.

He used to be jealous with others but now he is satisfied, not comparing with others.

Prescription – What and Why?

Just placebo.

Psora was already evolved in the form of coryza. At mental level, he accepted the reality. His delusions of grandeur; being a great person, broken with Marble.

In his subsequent follow-ups, I did not get any harsh complaint.  Once or twice, I prescribed acute remedies for fever and sore throat. Lately his parents informed me that he is going to Mumbai for Stock market training.

This case really put me to the test. With persistent effort, I was able to come to a collective understanding of Rudra’s case and choose a remedy that seems to be working well for him. This was a tremendous learning experience me.

References-

  1. https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443-7th January 2020
  2. https://www.mayoclinic.org/diseases-conditions/schizoaffective-disorder/symptoms-causes/syc-20354504- 9 November 2019
  3. https://www.narayana-verlag.com/homeopathy/pdf/Sulphur-Calcarea-Lycopodium-The-Immortal-Trio-Sonawala-Parthasarathy.06238_2Introduction.pdf
  4. Radar 10-Treasure Edition Synthesis Repertory
  5. Provings volume 2Nuala Eising, 2013 by Emryss Publisher

                                                                                           Dr. Kavita Chandak, India

 

About the author

Kavita R. Chandak

Kavita R. Chandak

Prof. Dr. Kavita R. Chandak (BHMS, PGNIH, PG(HOM) London, MD [HOM] PHD(France), Prof. Repertory, P.D. Jain HMC. She is an international speaker and trainer in homeopathy. Dr. Chandak is advisory board member at Turkey clinical journal and Board of Directors, Afghanistan Homeopathic Association. She has presented research papers in India and at international conferencess. Her book Health vs Disease was released in America and is available on Amazon as kindle. Dr. Chandak runs two clinics at Nagpur and a web clinic for the last 19 yrs. Her speciality areas are psychiatry, autism, infertility, allergies and cancer. She is the Director of the Padmaja Welfare Foundation NGO working for health awareness in society. Her articles has been published in various magazines, including Homeopathy 4 Everyone, Homeo Horizon Journal, CleverH magzine and Heritage Magazine. Her name is in the Golden Book Of World Records for homeopathy She has participated in 700 talk shows for non medicos with the theme” Prevention is better than Cure.” For more information, visit her website: www.drkavitachandak.com

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