Clinical Cases

Severe Depression & Psychotic Symptoms in a Man of 44

Anaswara Dev
Written by Anaswara Dev

Dr. Anaswaradev Atmadev presents a case of severe and suicidal depression in a man of 44.

Name: x

Age: 44 Years, Male

Job: Business

Family: mother, wife, daughter.

He started treatment on 29th September 2016 and I have been treating him since the aforementioned period.

Presenting complaints diagnosed as F32 Severe Depressive episode with Psychotic symptoms according to ICD 10 classification of Mental Disorder.

Symptoms should include a majority of the following.

 Depressed mood to a degree that is abnormal for the individual, present for most of the day and almost every day, largely uninfluenced by circumstances, and sustained for at least 2 weeks, loss of interest or pleasure in activities that are normally pleasurable; decreased energy or increased fatigability. loss of confidence and self-esteem; unreasonable feelings of self-reproach or excessive and inappropriate guilt; recurrent thoughts of death or suicide, or any suicidal behaviour; complaints or evidence of diminished ability to think or concentrate, such as indecisiveness or vacillation; change in psychomotor activity, with agitation or retardation (either subjective or objective); sleep disturbance of any type; change in appetite (decrease or increase) with corresponding weight change). 

F32.3  Severe depressive episode with psychotic symptoms  F32.30 With mood-congruent psychotic symptoms (i.e. delusions of guilt, worthlessness, bodily disease, or impending disaster, derisive or condemnatory auditory hallucinations)

Presenting Complaints

No interest in anything. Depressed and sad. Not able to concentrate on family or  work. Not able to make decisions or to concentrate at work (his own company.)  Insomnia for more than 6 years due to depression and mental tension.

Addicted to alcohol, smoking.  Appetite low. Low confidence, fear, suicidal tendency (many times attempted)

Hears sound of ringing of mobile phone in the morning , suspicious, feels he is not accepted by society. Doesn’t like to talk to anyone though he was an extrovert before. Not being able to say ‘no’ to others.

Past history

Chicken Pox – 15 years

Measles – 10 years

Operation- 16years for Polyp

Family History

Father -Died of Cancer

Mother- Breast Cancer

Maternal Uncle – Diabetes Mellitus

Generals

Hot weather aggravation,

Thirst- Thirst less, in sips often – like lime water or sour curd water

Appetite-  Less

Desire- warm food, Spice 3+, Sour 2+, Non veg.

Habits- alcohol, cigarettes

Perspiration – Forehead, chest, behind knee.

Urine – NAD

Stool – Hard

Sleep – Snoring, Side- On Left

Dreams –  Day to day family tensions.

Sexual Life – Poor because of family problems.

Regionals – Skin- Itching here and there during sleep at night. Bleeding after scratching.  Past 5 months on allopathic drug Citrizin once weekly.

Life History

Broken family from childhood. Father was a visitor only. Domination from parents especially mother and never got parental love and care. Physical abuse from mother from childhood which continued even after his marriage. No freedom to live his own life. Admonition from relatives for all trivial things happening in life and he couldn’t say ‘No’ or express his views. As he is from royal family, he is not supposed to contradict them out of respect and culture. Never wanted to marry as he believe in negative outcome since he never had a peaceful family life. Got married out of pressure to a dominating wife. Slowly sank into depressed state.

Current Life    

His mother kept records of how much money was spent on him and said he spent all the money. In fact, he didn’t.

Job:  He owns a company but is not interested to work for it. Not attending meetings. Not able to have good rapport with colleagues.

Fear – being alone, snakes, elephants

Positive features – Sympathetic, loving, a family Man.

Attachment – with his daughter.

Mind

Dependent, gullible, very sensitive by nature, loves dressing with gold ornaments, image conscious, guilty feeling, inferiority feeling.

Will – Low

Intellect –Not able to think clearly

Memory – Poor especially academically. Poor concentration and memory.

Morals – Good.  No extra marital relationship though no good relationship with wife.

Ailments –From domination in childhood by mother.

Emotions – Gets angry and want to beat someone,  but won’t do it.

Sensitivity – very sensitive to other’s comments

Disposition – mild, anger, weeping, suicidal

Objective symptoms

Very depressed and sad expression, faint voice. He made sure the door is locked while narrating symptoms. Wells up eyes while narrating life incidents. Hasty in talking with trembling when sad and angry.

Rubrics Taken

Ailments from scorn, being scorned

Ailments from anger, suppressed

Anger trembling with

Delusion, criticized, that he is

Talks hasty

Suicidal thoughts

Perspiration – General knee hollow of

Meat desire

Remedies from repertorization:  Aurum metallicum, Staphysagria, Ignatia, Bryonia, Sepia

Case taking on 09/25th/2016 – Rx Sac lac and specific yoga. Advised to try jogging.

  • 2

The highest ideal of cure is rapid, gentle and permanent restoration of the health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily comprehensible principles.

  • 4

He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health.

I believe a detailed case taking itself will help many, as it works as a vent for   suppressed emotions.

10/15th/2016 Follow up

Slept without disturbance after 5 – 6 years on initial days after case taking. Again after a few days, sleep was not great though far better. Stopped intake of alcohol. Guilty feeling reduced. No Suicidal thoughts. Not much problems towards wife from his side. Smoking reduced to three times a day but couldn’t stop. No change in Inferiority feeling. No change in suppressing emotions.

Rx Staphysagria 200

Analysis: His main problem got much relief with being able to express his pain, so ‘suppression’ is a key point to be prescribed on.  In every sphere he is suppressed: mentally, emotionally, sexually. Very sensitive to what others say about him and trembling when emotional are key notes of Staphysagria. His skin itching here and there is also a peculiar itching of Staphysagria (when scratching stops in one place it goes to another). His dependency on liquor also suggests Staphysagria.

Dr. Hahnemann’s Materia Medica Pura : First she cannot fall asleep before 11:00 p.m., and she wakes up at 4 p.m. for many nights.. Because of the vigil he could not fall asleep before midnight, but he had hardly fallen asleep when he had vivid dreams of struggle and quarrel. He wakes up from 2:00 p.m., and so every hour, for no reason.  Hectic night; every hour he awakens in half, and again falls into a light sleep; he did not fall asleep or wake up completely. All night he did not sleep, and yet his eyes closed. He falls asleep but is immediately awakened by a dream. Restless dreams of an anxious character. Many restless nights: he could not lie down from one side or the other; before midnight he was too busy with too many thoughts. Right at the beginning of each of his dreams he dreams of his daily occupations. He is very prostrate in the soul, has no desire to speak, is unwilling to think, and indifferent to external things.  As if dead in the soul and sad, but not to weep. Unwilling to serious work. Bad mood and no interest for mental work (after 2 h.). Throughout the day sulky and angry; he did not know what to do for the bad moodand was extremely thoughtful. Silent moodiness; he becomes angry with everything, even with what does not concern him. All through the day grumpy and restless; he finds no rest anywhere. Thoughts with great inner anguish, so that he cannot stay in one place, but he says nothing about it. Anxious and fearful. Great anxiety; he fears the future.  Hypochondriac humor; everything is indifferent to him; he would like to die. Sad; he takes the worst consequences from mild things and cannot calm down. Sad, without being able to point out any reason to be like this. Grumpy and sad.  Grumpy and tearful. She does not feel like listening to anyone or anything; she covers her face and cries out loud for no reason. Every word hates it; She cries if anyone talks to her. Grumpy; she often cries for absolutely nothing. Very tearful.

Dr. Kent’s description: The Keynote to Staphisagria is its peculiar mentality, “Complaints that come from pent-up wrath: suppressed anger: suppressed feelings. Speechless from suppressed indignation he controls it, and then suffers from it a Staphisagria patient when he has to control himself, goes all to pieces, trembles from head to foot, loses his voice, his ability to work, cannot sleep, and a headache follows.”

Follow up on 11/19th/2016

Sleep – good

Smoking and alcohol stopped completely

All complaints better in general. No delusions. Stopped Tab. Citrizin.

Follow up on 02/25th/ 2017

Feeling better except regarding suicidal thoughts

Rx. Aurum metallicum 1M

Materia Medica Pura: Great weakness and anxiety, so that he is thought to be near death.  Amid howling and crying she imagines herself to be irretrievably lost.  – He imagines he has forfeited the affections of others, and this grieves him to tears.  Sad, dejected.  – He is discontented with himself and depressed in spirits. Melancholy; he imagines he is unfitted for the world; he is filled with intense delight when he thinks of death, so that he longs to die

03/13th /2017

No suicidal thoughts

05/25th/ 2017

Dreams – Frightful dreams, suicide of relatives, dead body,

Rx Pulsatilla 0/9

M.M.Pura : Timid, lachrymose disposition with a tendency to inward grief and peevishness especially when patient in normal state of health was good tempered and mild (or even frivolous and good humouredly waggish. Dreams- He dreams horrible things)

That was the last medicine given and now he is perfectly fine and has no problem at all. He is very happy and more productive in work. He has a good family life after many years.

About the author

Anaswara Dev

Anaswara Dev

Dr. Anaswaradev Atmadev ( B.H.M.S., M.Sc. Psychology, YTTC ) is Director and Chief Physician at Unique Homeopathy. She is from Kochi, Kerala, India and has been practicing Classical Homeopathy for 10 years. She is a Psychologist, Hypnotherapist and Yoga Therapist as well. Dr. Dev is the granddaughter of late Dr. Nemath Krishnan Moosad (1923 – 2009), founder of the parent Clinic in 1965, which was later made into the first private Homoeopathic Hospital in Kerala, India in 1984. Her father and mother are both Homeopaths and all other family members have been devoted to the healing arts (www.uniquehomeo.com). Homeopathic Consultant - "Natural Health Clinic of Des Moines", Seattle, Washington, USA with Dr. Lynn Mikel, ND.

1 Comment

Leave a Comment

Your email address will not be published. Required fields are marked *