Case – Female 40 years old
- Low energy
- Depression for 30 years
Interview Date: April 23, 2016
I= interviewer O=observation
A woman age 40 came for help with lifelong depression and low energy, sleeping a lot day and night, always feels like falling asleep. She has suicidal thoughts out of nowhere, even though life is going well and constant low feelings, heavy depression. She’s dressed casually, a little overweight, tall and engaging.
Notable on her intake form: Thyroid disease, migraines, sleep apnea, frequent UTI’s in the past, endometriosis. She’s taking Levothyroxine and Bupropion. Becomes sleepy after meals. She already had one abdominal surgery, and due for another in 6 weeks for her uterus. Seasonal allergies and hay fever.
I just want more energy! I skip working out and eat sugar. I go under the covers, I’m tired and like the cozy blankets. Hard to get to sleep at night, but I don’t want to wake up in the morning. I’ll usually nap then I get my kids and I’m on until 10pm, I’m around the kids I’m good. Morning until 3pm is the worst. I usually nap 1-1.5 hours daily. I’ve never been a morning person; I used to put my school clothes on under my nightgown so I could sleep until the last minute as a kid.
I feel sleepy in the head, put my head down, it’s heavy, feel cozy in a blanket or warm bath. I feel better in warmth but hate the hot summer and humidity. I have a short temperature range like 71-73 F. I tolerate the cold better than the heat. San Diego weather is boring to me, though.
I: Tell me about the depression
Looking back I had it as a kid, used to cry myself to sleep. My brother would tell me to shut up. I was sad a lot at night, I was 4. The first time I experienced it really strongly I was in college. I felt I would feel this way forever. I was put on antidepressants. I moved to CA and went off them cold turkey. I thought I was homesick. In college, I didn’t want to be alive, why did I have to be here to begin with, I didn’t ask to be born. I was crying a lot, sleeping a lot, drinking (alcohol). My work was a lot of pressure; I had a high managerial job at _____(large corporation) with 22 people underneath me coming to me with things daily. I was traveling so much, 35 cities per year. At work I was ok. I’d go to sleep and not do much of anything until Monday when I went to work again. Just didn’t get out of bed.
I got a job with a large pet organization, I don’t like animals, and it was a depressing atmosphere. They were losing shares, I was crabby, they had “bring your pet to work day” and birds were flying everywhere, dogs jumping on me I hated it. My husband and I tried to have babies, and the weeping began again. Months built up, disappointing, no baby after 1.5 years, they put me on meds again. We tried everything and nothing worked with the baby. We finally got pregnant that July, had twins. I was shocked I didn’t have post partum depression! I had so much energy it was amazing, they needed me (babies) I’d wake up walk around the lake, feed the babies, then 6 months I hit a wall. We bought a new house, one day I sat on a swing and thought I’d like to jump in the lake and drown myself. I was crying. It was hideous, I called and got back on new medicines, my mood lifted, we tried to have another baby. I got pregnant and went off the meds again and same thing, after the birth I had so much energy and 6 months I crashed. I’ve been on antidepressants ever since.
I: how is the depression now?
Today I’m ok, but tomorrow maybe not. It’s just there; if I think about my life I can count my blessings, but still feel this down. I’m embarrassed I can’t pull it together, I feel worthless, and my husband would be better without me, with someone more stable. I’m a good mom to my kids, they can sense when I’m down and ask if I’m ok, I tell them I’m tried and have a headache. When the kids are around I don’t have to be on and can crash. I don’t like consolation except from my husband.
I: What thoughts does the depression generate?
You’re fat, ugly, exercise more. I feel like I have time now that the kids are in school I should be working, help financially. I have guilt about not working during the day.
I: How is your sleep?
I have sleep apnea, I jerk so much I wake up about 47 times, never in a deep sleep. I’m jerking a lot.
I: What are your dreams?
I dream a lot, every night I remember my dream, vivid and crazy, some pleasant. Someone’s going to kill me, robbed, running from something, husband has a different girlfriend, yelling at my sister. My high school boyfriend, they are often like that, disappointed in the dream. I dream about my parent’s house, a lot more stair levels to it and can only get in one way, exploring things to see. The street is all connected like a mall, I like to go see new things, and I’m not cold inside and can go into all the shops.
That reminds me when I was in college I did 2 study abroad programs, I’ve been to 48 states, I like checking them off, I had this wander lust and travel cravings early in my marriage. If there’s a new opera, I like to take my daughter to things. Eating, I’m very boring, chicken, mashed potatoes, chocolate cake, meat and potatoes. Comfort food.
I don’t like animals, I hate mice, mice freak me out, spiders don’t bother me but MICE!!! Dogs are gross, cats are sneaky, and birds freak me out. I don’t like other people’s kids and babies, like nephews and nieces, I wonder when they are going to leave.
I: Do you have any fears?
Heights when I think I might fall, if I see my kids standing by an edge I freak out. I don’t like water. My kids can drown, we live on a lake and I make them swim with life jackets. I was convinced my husband was dying, he lost a lot of weight, I worried a lot about it. I worry about money sometimes I overspend. I like little conveniences, the coffee shop.
I: What do you love in life?
Laughing, immediate family, seeing my kids laugh or be proud of something. I have a good group of friends.
I: How is exertion for you with the low energy?
I can be on my treadmill and feel good, but I pick up a sleeping bag and feel winded. I never sweat as a kid, I did track, and get red and tingly, now as an adult I sweat mostly the head, smells like onion sometimes.
I: Tell me about the migraines?
Mostly first day of cycle, stress can be a trigger. They start in the back of the head, feels like squeezing, really bad around my eyes, feels better to PUSH on it, push hard. Otherwise, I have to lie perfectly still and put a wet rag on me, not a lot of light. Sleep it off. 5-7pm they come on, in the back of my head.
I: What other things do you react to in life or are sensitive to?
I don’t like much noise, kids in the car, chaos, in a crowded place, I don’t like CROWDS! In kindergarten round up kids are everywhere, so many of them, like animals, it’s gross, I don’t like kids.
I: Tell me about your sleepiness and sleep at night more?
Sometimes I’m happy I have a headache, I can take a Tylenol pm, lay there more than an hour, thinking about what I have to do, I like to read and think about the story. I like cities a lot, seeing buildings and excitement, small towns are GROSS!
I: What other physical sensations do you have?
Tingling down my left arm sometimes, when working out I notice it. I used to get backs of knees when standing numbness and tingling.
I: how is your digestion?
Gurgly stomach after I eat with bloating after sugar, bloats way out and hard. If I eat at night, laying down with heartburn. About twice per month I notice it here in my chest. I also have ringing in the ears, both.
I: What was your nature like as a kid?
Silly and outgoing. Social always at a friend’s house. Neighborhood friends didn’t live by my school friends. I enjoyed a job well done at work, but didn’t care about school. I liked stories, English, history; I liked having fun, going out with my friends, games.
I: How is your body temperature?
I run a little warm, then I was cold after Hashimoto’s diagnosis. It started after the birth of my 2nd child, my entire life felt like hormones out of whack. Horrible periods in high school, cramps, like stabbing in my stomach. I felt irrationally irritable, weepy, raging crazy person before my period, out of control, couldn’t remember anything, and I had a great memory.
I have endometriosis, clotting was so heavy out of control, found huge, thought my tubes adhered to my bowels, and uterus, scarring to remove everything, all the things adhering to one another, bleeding was hideous. It’s worse as I get older.
When I analyze this case, I want to understand what is the axis she operates on? She’s so smiley, bright and witty in contrast to this very low depressive energy and suicidal tendencies to not want to live. Her kids are her bright spot and fun is a theme. There were obvious themes to a few well-known remedies in her case, like the fear of mice and head sweat in Calc, and her feelings of children and animals love of travel and fun in Tub. I focused on the themes that were with her the longest period of time in her life and were most outstanding:
- Adhesions – especially after abdominal surgery (required 2 surgeries)
- Menses clotting, profuse
- Thoughts of death with weeping
- Worse hot sultry weather
- Sleepiness & dark vs. cheerful brightness
I began researching remedies for scarring, and remembered a remedy called Thiosinaminum (Mustard seed oil) in Pathology class used mainly for adhesions and keloids. I searched for this remedy, little is known about it, but after reading several cases and materia medica the following became clear:
I found this remedy to be used for pelvic inflammatory diseases and infertility issues in conjunction with depression, alternating moods and aversion to consolation. Confirmatory symptoms were seasonal allergies, which she had.
The mustard state shadows an individual with darkness, an overall depressive state weighted down as a whole. The person likes the rays of the sun; it’s the lightness, not the heat. They are attracted to interesting cheerful things. It’s the typical dark cloud over the head depression; it clouds out the light of life turning into a small world inside. We see this in her love for books, reading, stories and how she is better with her kids and going out into the bustling city with vibrant energy which pulls her out of her inner world. For someone who needs Thiosinaminum, life is not appealing and without joy. She asks, why was I even born? The purpose of existence is obscured in the mustard state.
There is a deep sense of weepiness, self-pity, boredom in this state, retreating from others, succumbing to the darkness. Physically the mustard state leads to lethargy, chronic fatigue, appetite disturbances, weight gain or loss. A general decline of healthy living or interest in it.
If we study the plant itself, we find it spreads wildly, outgrowing other grasses in the field and grows above everything, seeing the need to reach for lightness. Just seeing a field of them looks bright, cheery and full of yellow and how they sway in the breezes – such a contrasting state!
Another confirmation of this remedy is tinnitus. Noises are annoying. We find enlarged glands and dissolving of scar tissue, especially in abdomen, rectum and pelvis.
REMEDY: Thiosinaminum 200c 3 doses. (She instead took 3 doses daily for 3 days)
I noticed a lift in my mood, I wasn’t sad, I still take more naps than normal but not nearly as many. I still had cookies, but not craving them. I went in for my surgery and they couldn’t open up my uterus there’s so much scarring. Now I have to have a hysterectomy, I have abnormal bleeding.
I actually started looking for a job and found one that seems manageable. One surprise was I was able to talk to my husband and tell him he’s crabby, and confessed how I spend money when I was really mad at him, I don’t feel that way anymore suddenly, I can’t believe I could talk about it with him, it was amazing and felt so good.
I: How are the suicidal thoughts?
I didn’t have many at all, I usually get a low mood after my cycle, and this time my period wasn’t as intense. I started a chest cold over the weekend, the feeling of tightness came on, and then it went away. I used to have those symptoms like hay fever, but it went away.
I: how were dreams since you took it?
No nightmare, it’s crazy! Weird, I didn’t wake up screaming like I usually can. Only 1 bad dream about my husband being on the TV show the Bachelor and my friends promised they wouldn’t date him and they still did. That stayed with me during the day. In fact, I’m remembering a few years ago one of my best friends liked to go to the Casino with my husband and I asked them to not do that, I didn’t like that, it hurt my feelings and they stopped doing it.
I: How is your sleep?
I was taking Unisom, but I didn’t need to this month. I fell asleep pretty fast!
I: How is digestion?
I have gas, and bowel movements after I eat.
Her needs were going into surgery the following week so we discussed pre and post surgery protocols. No remedy this visit.
Follow up 2 months
The surgery went well. I had a hysterectomy, I can’t believe how much this stirred up, I have a PMS feeling, I’m hormonal, I’m anxious with butterflies and feel weepy, but can’t weep. This was right after the surgery. Now I haven’t been weepy, but somewhat listless, not finding a ton of joy, slept all day because I had company the day before.
The stress of the month is with my kid’s baseball coach. He’s terrible and I don’t want to be part of the witch hunt going on with the parents. I want to stay out of it.
My husband takes on too much; he’s managing the house while I’m lazy.
I: How have your dreams been?
Nothing scary still, but off the wall, like haven’t thought about that person since 3rd grade.
I’ve been going to the movies, loved the whole experience, the popcorn, previews everything.
PLAN: Thiosin 200c 3 doses
Follow up phone call 1 month
Feeling much better again, mood is elevated, no crying, anxiety is gone, and feeling bright, overall good, frustrated with the doctors, after the hysterectomy, the surgeon didn’t see my prolapsed bladder, so I’m dealing with that mistake now.
Plan: This is a beneficial remedy for her and resonated deeply on the core mental/emotional level for sure, wish I had seen her in her 20’s to help with the scarring and progress of her disease. I’ll continue to work with her, the goal is to stop taking her antidepressant meds after these surgeries, we’ll continue to dose as needed.