Clinical Cases

A Chronic Case of Social Anxiety

Hermeet Suri
Written by Hermeet Suri

Dr. Hermeet Singh Suri presents a case of social anxiety in a man of 29.

On 18th of October 2013 a 29 year old male came to my clinic for help with chronic social anxiety syndrome.  This 29- year-old man was thin with sallow skin, tall, body was lean with developed muscles and vertical frown lines above the nose.

My main reason for coming to see you is due to my social anxiety. The first symptoms I noticed was about 4-5 years ago when I was in transition from school/part-time work to full-time work. Whenever I met people of authority my social anxiety was at the highest level.

What aggravates my social anxiety is a stressful environment, fast food, sodas, crowded environments like restaurants and to think of it even in school I spent time away from people. The social anxiety depends upon what is happening around me. I find it to be worse after 12pm. Symptoms that are accompanied during social anxiety are shortness of breath. During the winter and the fall my social anxiety is greater, when compared to summer and spring. Im sensitive to light and most occasions Im wearing sunglasses. I prefer warm weather and I sleep with the window open it is warm outside or If it is too hot inside.

I dont worry anymore. I used to worry about my finances like when will I be able to afford my place again, travel, have a good relationship. I used to worry as to when I will overcome all these issues and what my family and friends think about me and if they understand me. I deal with my worries by going for a walk, listening to music, journaling and reading about motivational topics.

When I am upset I keep it to myself. I also noticed that when I speak to someone like a doctor or therapist I do feel better. I feel frightened or anxious in a crowd, giving a presentation, and when there is focused on me. During my second year of college I became more isolated and as I got closer to completing my school and getting a job I was at my highest peak of anxiety.

The greatest grief that Ive gone through in my life is when my dad and mom went through a divorce. This was before I started college and my aunt told me this. When I was young my parents fought a lot so it was not a surprise when they want to divorce but I was not happy with it.

My greatest fear is public speaking.  Seven years ago I came to Canada from Jamaica. I grew up with my dad my grandmother and my grandfather in Jamaica and cried when I had to leave Jamaica. I lack self- confidence. I didnt get along and my sister. If I became rebellious my mother would yell at me. At the age of 11 and 12 my mother would verbally shout at me as if I was to be disciplined. In Jamaica, I was physically beaten to be disciplined. I currently am a binary options trader and a freelance web designer and I love my work.

Nine  years ago when I moved from Etobicoke to Mississauga I felt very unhappy and anxious because I have to start all over again and I was very comfortable in Etobicoke. In Mississauga two kids made a comment to me that they didnt like my kind. I never stood up to this or could talk back.

In high school I was working for Maple Lodge Farms and when I got sick, I could not go to work and did not call, as I did not know what to do. I was afraid to call, probably from fear of rejection and failure. In high school I was afraid to be in relationship for the same reasons. I was afraid of rejection or failure. I could never commit to a relationship because Im afraid of a long-term relationships. I fear responsibility of commitment. On occasions I will exaggerate the truth to bolster my low self -esteem. I love a mixture of foods like onions, legumes, oysters, selfish, olive oil, pastries, cookies and chocolate.

Patient: My grandfather had weakness of his lungs. My grandmother had a tumor in her brain. My mother had breast cancer. My aunt had ovarian cancer. And my aunt was also going to depression.

Objective findings

I performed a physical examination. I visually examine the eyes, nose, throat and tongue to understand the physical conditions of the patient.

No physical damage, lesions, bruising, swellings or rashes were present at the time of examination.

Skin

Never had any issues that I remember.

Respiratory

The only time I experience shortness of breath, blockage in my chest and shallow breathing is when Im having my anxiety attack. Other than that I dont have any respiratory problems.

Gastrointestinal

I have noticed that after I eat healthy organic food I feel good and energized. If I eat fast food or greasy foods I feel tired and low energy. I drink coconut milk in the morning with my cereal. I drink water throughout the day. I drink one glass of white wine in the evening 3-4 times a week. I drink green tea after lunch and after dinner. I do not feel really thirsty unless Im playing sports. I have a strong craving for sweets and an aversion to cold drinks or foods.

Reproductive

I do not have any problems performing sex but I am sexually promiscuous. I have noticed that in the initial stages off my relationship my sexual performance is fine but after, when there is no original excitement I develop impotency.

Urinary

I have no issues with urinary problems.

Sleep/Dreams

I sleep between 10 PM and 8:30 AM. I feel very un-refreshed getting up in the morning and I wish I could sleep a little longer. I found that greasy foods make me restless or sleepy. I sleep on my right side.

Winter/seasons

I feel good from cool and fresh air from hot food and drinks and I like to wear loosen clothes. I feel worse during 4 PM to 8 PM whenever I am sick.

Practitioner’s notes:

After evaluating the totality of the symptoms and selecting the characteristic symptoms, which reveal the dynamic disturbance of the patient, I decide to do a repertorization of the case to reach homeopathic diagnosis.

Initial Assessment

Practitioner’s notes

The patient has come for help with getting rid of his social anxiety. He describes himself as being deeply insecure and exaggerated truth to bolster his low self-esteem. He does like change and new challenges can be greatly apprehensive. He has a weakness for sweet foods and is sexually promiscuous. Despite apparently enjoying company he avoid commitment in close relationships. He is irritated by weakness and intolerant of illness. He tends to be an intellectual with a conservative outlook. He loved a mixture of foods like cabbage, sweets and onions. He likes hot foods and drinks.

He fears failure, closed spaces and crowds. He sleeps on his right side and his aggravations are between 4 PM and 8 PM when he is sick.

Based on the presented information I feel the best approach for analysis is the totality of symptoms. Due to lack of physical conditions and a strong picture of mental and keynotes, totality of the case was best approach by repertorization of the case to reach a homeopathic diagnosis.

Repertorization

Mind irritable

Mind love perversity sexual

Mind sensitivity

Mind confidence want of self-confidence

Mine Cowardice

Mind timidity

Mine fear failure of

Mind fear alone of being

Male genitalia ejaculation quick to

Eye photophobia

Generals food and drinks sweet desire

Generals food and drinks oysters desire

Generals food and drinks Cold drinks Cold water version

The remedies considered based on the repertorization were Lycopodium, Silicea and Baryta Carbonica.

Lycopodium

Was one of the remedies I considered, as the patient had sexual promiscuity, premature ejaculation, low confidence, irritability, cowardice, timid, fear of failure and craving for sweets. The theme of Lycopodium is the feeling of inferiority in which a patient constantly tries to overcome is present. The causative effects of fear, abuse, anxiety, wine and masturbation also fit. His desire for sweets, oysters and cold water also are key indications for Lycopodium. Based on the strong mental and totality of these mental symptoms Lycopodium was chosen.

Lycopodium in the 1 LM potency was given.

The first dose the patient took was on October 18th, 2013.

Follow update December 6th, 2013

Patient: After I took the first dose in the clinic I started to feel drowsy. When I reached home I ended up going to sleep. In the morning when I woke up I didnt feel really different other than my mind was less wandering. As I continue to take remedy the changes that occur the last month or so or as follows:

  1. In social situations I felt the same.
  2. I started to get a lot of dreams of past events in my life. These dreams were focused on people I went to high school with and I havent seen them for a long time.
  3. My bowels changed initially from diarrhea to regular.
  4. One symptom I forgot to mention was that when I am tired or hungry my anxiety levels increase. This symptom did not change.
  5. One change, which was very positive for me, was I was able to open up to others.
  6. Another positive was that my sleep became deeper and I felt more rested in the morning.

Practitioner: After hearing the patient my assessment of the remedy was supported and confirmed. My initial assessment of the strong mental picture of the patient and its totality of symptoms made Lycopodium a strong choice.

The partial changes in the mental and the physicals was a good indication of Lycopodium action. The improvement of sleep and the energy of the patient were indicating the deep acting effect of Lycopodium. I was confident that the remedy still needed to be continued for a longer period.

Follow up Feb 5th, 2014

Patient

Since the last two weeks I have been taking Lycopodium 1LM with 8 taps. After my follow up with you I decided to increase the tapping of the remedy. I did feel uncomfortable at the 4-taps for some time but like you suggested I brought the tapping up-and-down according to my feeling. As soon as I was at 6 taps I started feel changes and how I would react with my clients and in the social environment. I was able to handle the social situations very well I was able to interact with my clients and friends without feeling anxious. Overall I have been really good. I feel great, big improvements, in my thinking and thoughts are very positive especially on future aspects of my life. I do on occasions have some thoughts that make me anxious but they dont linger for long.

Practitioner’s notes

Since the patient is indicating a continuous improvement in mental symptoms and now with physical symptoms I feel that the remedy should be continued as its action is still in progress. I decided to increase the potency of Lycopodium to 2LM and instructed the patient to start at 2 taps and move up again gradually.

Follow up May 14th, 2014

Patient

After leaving your clinic I felt hopeful. On a few occasions I had to move forward and backward in how many times I was tapping the remedy. Since the last time I visited I had a public speaking presentation. I was able to present and speak fluently without any kind of anxiousness or sweating of my palms. Ive never felt like this before. It was a great feeling. My sensitivities to foods have disappeared. In my social situations with my friends I feel strong, focused and confident. My last two sexual interactions were without incident of pre-ejaculation. I dont feel irritated or fear of what may be coming in the future like I used to before. And also I dont fear being alone.

Practitioner’s notes

Based on the patients description of events prior to the follow-up I feel that the patient has come to a level where he can manage his life normally without the remedy.

About the author

Hermeet Suri

Hermeet Suri

Dr. Hermeet Suri here is a certified homeopath and acupuncturist. He was inspired by his father, Surindar Singh Suri who was a renowned homeopath. He graduated from University of Toronto (BSc) and subsequently studied homeopathy with the British Institute of Homeopathy. He established his practice, The Homeopathic Plus Centre, in Streetsville, Mississauga in 2005. He expanded his practice to treating Autism and Down Syndrome in children as well as treating Bipolar Disorder, Schizophrenia and Depression. Dr. Suri is a supporting member of The Ontario Homeopathic Association (www.ontariohomeopath.com).

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