Clinical Cases

Chronic Depression in a Woman of 70

Written by Melissa Montoya

Melissa Montoya presents a case of depression in a woman of 70. Delusion, deserted, forsaken, buried in thought, pain in soles, walking ameliorates and lack of vital heat were among the symptoms leading to the simillimum.

Patient: Female- 70 years old
Consultation I: November 19th, 2019
Chief Complaint: Chronic Depression since Childhood
Medication: Isoclon -for insomnia (daily)

Q: How can I help you today?

I am suffering from depression since childhood. My Father punished me all the time (patient started to feel nervous). I come from a family of 7, me being in the middle, my father was abusive especially with me, not so much with my siblings.

Q:  Tell me more about your childhood:

I often heard my parents complaining about my siblings not doing their chores and I will just make up for what they didn’t do. I do not like violence since this alters my nervous system. I just felt like running away from that place to a quiet and peaceful place. I will go on the street, wander off, begging for food, not for my real mom, but for this person, a crazy woman that was clearly abused by others.

Q: How did you feel about needing to beg?

It was different because it was not for me, I was doing something important for someone else. Never able to ask anything for myself, but it was ok for this woman. “I was 6 years old and I did it for half a year.”

One day I went to see her at the shelter, and the place was closed and this woman was not to be found. I was very sad, because she disappeared without saying goodbye. It felt like it was my responsibility because her family abandoned her.

Q: Describe abandonment?

When someone leaves me alone I feel HOPELESS, with no resources. I had depression since I was very little. I cried all the time, even before I was 6. When I went to school I was still crying but I did not recognize I had depression. My parents will ask me why. They punished me and told me I was dumb- (patient started to cry).

When I was 5 my dad was in the dining room, and asked me “ Why don’t you die?”. My father said that I was a woman and women are worthless. I left quietly, with my head down, I felt abandoned by my dad.

Q: How were your Teenage years?

They were really hard. Every time a male friend would come to the house to say hi, my father would lock me up not to go to see him. It was very sad…  My father had a fixation to humiliate me. I used to have long hair and he almost shaved me completely. I was only 14 years old. His reasoning? He told me I was a whore.

Q: What happened afterwards?

When I was 20 years old, I went to university and I went to a psychotherapist, because I realized I could not live with hate and grudge inside me. After 1 year of intense therapy I forgave him but I could never forget what he said and did. After this at age 21 my mom passed away from bronchitis and I went back to severe depression.

Two years after that my father had a really bad accident and ended up in a wheelchair and since none of my brothers or sisters wanted to take on the responsibility, I took care of him for several years. “ I started giving him what I did not get from him” attention, worrying about him, making sure he was ok”.

Q: Marriage?

I know him since I was 7years old. He was a friend of my brother. When I was 15 I dated him, My father never approved of him because he knew he would never appreciate me.

After my mother passed away, I married him and this was the end of my life. I felt like all my life was a loss.

Q: Experience loss?

I have pain in my chest, loss of appetite, completely energy goes down the drain, unable to do anything. When I feel like this I just want to walk, long walks, not stopping, even though I am  more tired or fatigues, I still need to walk.  I get a  burning sensation in my feet, like something rubbing against my sole (hand gesture, friction between her palms). Walking helps with this sensation. The soles are hot and itchy. As I walk the itchiness disappears.

Q: Tell me more about the pain in the chest?

Its pushing hard (hand gesture, similar with the one before, like friction between her palms)., like a weight.

Q: Describe the weight?

It’s more like  sadness, that weight is the “weight of my life”. Weight are my responsibilities, debts, compromises etc.  Pain is the suffering I need to go through, the price for the responsibilities.

Q: Describe depression:

It’s like a desert, desert is my life. I formed a family, but all left and I am alone now in the house filled with memories. I tried to take pills but never worked. I tried to take my life 3 times by taking pills.

Q: Describe anxiety?

I need to move, but when I move my insomnia gets worse.

Q: Symptoms?

Anxiety with palpitations, better when I stay still but I need to move. I need to walk.  Or I feel better by lifting weights at the gym, lifting something heavier than me, than the pain I usually have.

Q: Any other illness in the past?

The Pneumonia started 2 years ago, after I found out that my daughter married a woman  (patient started to cry very loudly). I was disappointed with the way I found out. “ I thought I was dying slowly. Everything was swollen, the chest, I had no reason to live anymore”. I was hurt when my daughter lied,  frustrated because she never opened up.

Head to Toe Examination:

Headaches : No

Vertigo with Loss of balance

Eyes/ nose – no problem

Throat – hoarseness, cough

Insomnia between 11 PM and 1 AM
GI – gastritis from coffee.

Constipation all her life

Sensitivities: noise, pain

Skin: dry and itchy

Colder than other people

Sensitive especially to criticism

Fav temp : 28-32, needs to be in a shade

Hobbies: Gym, swimming

Loss of weight and No appetite

Patient continues: I struggled in life, nothing brought me happiness, my husband became bitter and I got nothing, unfairness with everything that happened to me in my life; there is not point of going forward anymore.

Observations:

Fragile, looks younger than her age, neatly dressed ( white/light pink shirt). She looks tired, sad, overworked, dark circle around her eyes, fine and distinct characteristics. She’s been divorced for over 20 years and actually lives alone in a small house in Colombia. She has two daughters that live overseas. She likes to exercise regularly whenever she has a chance.

Analysis:

  • Sadness like a weight of her life
  • Depressed since childhood with a feeling of being worthless, depression aggravated by sudden death of her mother and later on by her husband being unfaithful. Depression feels like a desert in her life, multiple suicidal attempts.
  • Feeling of being abandoned by her parents, begging on the street for food to help homeless woman.
  • Physical and verbal abuse in childhood
  • Sleeplessness due to fear being alone that something will happened to her
  • Anxiety ameliorated by moving, desire to walk without stopping, with burning sensation on the sole her feet ameliorated by walking.
  • Food and Drinks: likes coffee but aggravated by it (gastritis)
  • With depression, sadness, appetite diminished, loosing weights.
  • Chronic constipation

Rubrics Considered -(Complete Mac Repertory 2017 version)

mind, delusion, deserted, forsaken

buried in thought; sadness

pain; feet; soles; walking; amel.

pain; burning, smarting; feet; walking; while

mind; walk, walking; amel

chronic constipation

appetite; diminished

food and drinks; coffee agg.

heat; vital, lack of

Selection of the Remedy:

Mac Rep repertorisation turned out remedies like Pulsatilla, Rhus-tox, Nat-mur  but the prescription was made on the basis of the essence as perceived by the practitioner –  “When I feel like this so low and depressed I just want to walk, long walks, not stopping,  even though I am  more tired or fatigue, I still need to walk”-

Cyclamen was prescribed.

I considered the sadness and despair, loss of appetite, constipation, anxiety but took high consideration to the SRP: burning of soles of the feet better by walking.

Prescription:  Cyclamen 1M in water, one teaspoon follow up in a month.

This remedy captures the depression, sadness, with weeping desire to be alone. According to Murphy, with this remedy there is sorrow, sadness as if she had committed a bad act or not done her duty. Similar in this case, patient feels sadness and the weight of life, and she believes that this is the suffering she needs to go through being the price for the responsibilities (debts, duty etc.)

1st Follow Up:  12/22/2019

“My appetite improved although I get full much easier and I feel like I have more energy and I am going to the gym more times during the week now. I am sure I gained some weight since my clothes feel a bit tighter now.”

“My sleep improved greatly as well and I don’t need to take the insomnia pill anymore. The cough is gone as well and for the very first time in my life I feel like the weight on my chest has being lifted almost completely. I feel less despair in general about life. In all my years I am finally able to see the light at the end of the tunnel and for that I don’t have enough words to thank you my dear!

Observations:

Patient seems much better than the last time, her eye circles disappeared completely and she looks more relaxed. She was open and cheerful. She feels some hope for the very first time in her life.

Prescription:

Repeat Cyclamen 1M in water, one teaspoon and follow up in a month.

2nd Follow Up:  01/21/2020

Appetite completely normal, patient sleeps about 8- 9 hours non-interrupted, no more vertigo; constipation still varies but patient is working on a diet. She doesn’t have the burning on the soles anymore. She still goes to the gym as this became her habit but she said she is able to mingle more.

She was able to stand up for herself and not let her past hurt her anymore. Patient said that the weight on her heart and her pain had being lifted just like a magic trick.  She is now in harmony with herself and her surroundings.

About the author

Melissa Montoya

Melissa Montoya graduated from the Canadian College of Homeopathic Medicine (CCHM) in 2020 and currently practices in Toronto, Ontario.

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