A Case of Depression Treated Miasmatically
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A Case of Depression is resolved with a series of remedies ending in Psorinum.
Woman aged 39.
“I realise I have lived my life full of fear, insecurity and isolation” she said. “I am betraying myself…I’m stuck and sad”. She had come with depression, relationship difficulties and suicidal thoughts – where she wondered what it would feel like to stick a knife into herself. She was very anxious and on the verge of tears at various points during the session, due to a fight she had had with her boyfriend the night before, and the ensuing silence from him. The quarrel aside, in general she felt stuck in the relationship: She wanted to leave him because of his “selfish” behaviour, but was prevented by her fear of being on her own. She had particular difficulty standing up for her needs – both in her relationships and at work – and was very afraid of any kind of conflict from doing so. If ever she did speak up for what she wanted, she felt very guilty afterwards. Her current predicament seemed to echo a recurrent dream from childhood of needing to run, but being unable to move her legs – feeling stuck and desperate.
The origins of this state, to my mind, lay in her childhood. “We had to be saints” she said, so as not to disturb her sick father, who could neither tolerate noise in the house, nor ‘disturbing’ conversations at the dinner table. The youngest of five, she felt unsupported by her father and unloved by her mother. Her mother herself had had a hard life growing up – the daughter of a poor farming family, working on the land from a very young age to survive, and is reported to have said that she had never had a happy moment in her life. In sum, neglected as a child, she had been taught to sacrifice her own needs and wants and was leading a life of depression, anxiety, guilt and sacrifice.
Natrum Muriaticum 1M – 3 x a week for 4 weeks.
Natrum Muriaticum was a good fit for the centre of the case, which I saw as a deep sadness arising from a loveless childhood, where the patient had had to be the good girl and take care of others’ needs before her own. In addition, her fear of conflict, isolation and inability to let go of her relationship, supported my choice.
She had been sadder than usual initially. In addition, she had become increasingly unhappy with her relationship as the month progressed, till the point where she had opened a conversation with her boyfriend about how unhappy she was with him. By her own admission, she would previously not have had the courage to do this. They had agreed to split. However, after the break-up conversation, her boyfriend had continued to act as if nothing had happened, and she had lacked the courage to finalise the break. She then had gone into an agony of grief, indecision, regret and confusion about the relationship, as well as anger with herself for not being able to make the choice of whether or not to finish it.
Back to square one – apparently. However, in other areas of her life, she had changed her behaviour in a number of different situations: she had stood up for her needs with a close friend, risking potential conflict; she had uncharacteristically not consulted her boyfriend on a decision; and she had accepted a last-minute, spontaneous invitation from a new friend. And despite her unhappiness with her relationship, she had had no depressive or suicidal thoughts during the month.
On the physical level, she had got spots along the hairline on her forehead, and pain in her left knee (having had a miniscus operation on the right knee five years previously). Also, a more general characteristic came to light, which was profuse sweating, even in the cold: she would take off her coat while walking to work to avoid getting drenched with sweat, but would still sweat profusely even though she felt cold without the coat.
Lycopodium 200c 3 x a week for 4 weeks.
I felt that the Nat-m. had done good work, as seen in several new behaviours, but only up to a point. And I was seeing another remedy state uncovered: Lycopodium was a good fit for many aspects of her case – ailments from domination,fear of abandonment / being alone, people-pleasing, depression with suicidal thoughts and despair, low self-confidence / self-respect, avoiding direct confrontations, right to left movement of the knee problem, and perspiring in cold air.
She reported she had been more stable emotionally this month, albeit in a “numb kind of way”, with no more moments of deep sadness. She had been cooking for herself more and had even put up pictures in her flat. She had also been less bothered by whether to break off her relationship, and had noticed that her boyfriend had changed (or her perception of him) e.g. he seemed to be taking more account of her needs and had unusually consulted her on some decisions. She had also been able to speak up for her needs more during the month, and at work had felt less weak and insecure about everything, though she was still quite easily intimidated. Where she was still finding it very difficult, was to make decisions, and she confessed that she wished she could lie less in her relationships, which she did for the sake of a quiet life.
Physically, her left knee was better and though she was still sweating a lot, that had improved too. At the time of the consultation it was autumn, which prompted her to reveal that every autumn she suffered from blocked sinuses and colds with a white discharge.
Lycopodium 200c – 3 x a week for weeks one & two
Lycopodium 1M – 3 x a week for weeks three & four
It seemed the Lycopodium had triggered a good reaction in her, especially on the emotional level, and it fit with the inclination to tell lies, as well as the blocked sinuses and white nasal discharge. However, so did Nat-m. The deciding factor in repeating the remedy was the improvement of the knee.
She reported she had become more depressed, as well as more stressed at work. She was thinking again about what it would feel like to stick a knife in herself, or how easy it would be to throw herself under a bus. Cooking had once again become a chore, and she was fed up with everything. She had become very negative about her boyfriend and their relationship again. She believed the only reason she was with him was because she was afraid of being alone. She was also still extremely indecisive. “There are so many changes in my life that are just pending, waiting for me to decide” – whether to commit to her boyfriend or leave him; whether to leave her current job, which she was dissatisfied with, and study homeopathy. “ I get blocked. It’s just too much”.
In addition, something new came up this month – the issue of feeling boredom versus excitement. Often she would plan something “exciting” and afterwards would feel let down, believing it would have been better to stay at home. She felt that she and her boyfriend never did anything exciting, and a sense of her general dissatisfaction came through.
As for her sinuses, they were still very blocked, with white discharge, slight deafness, and her head felt “empty, light, full of cotton”. She also revealed for the first time, that in the spring she got itchy legs and hay fever; also that when in bed, she could not let her legs touch because they would sweat so much.
Psorinum weekly ascending dose 30c, 200c, 1M and 10M.
On first analysis, the picture still looked very Lycopodium / Natrum Muriaticum, both on the physical and emotional levels. Emotionally the good progress of the previous month had relapsed, so I started wondering about miasmatic blocks. On the one hand, she was quite tubercular with her search for excitement and tendency to be easily bored and dissatisfied; I was also seeing a strong sycotic element with the over-production of mucus. However, the new information about her itchy legs and hay fever in spring started me thinking about the Psoric miasm. What clinched it was when I found the rubric for the newly-revealed, strange, rare and peculiar symptom of how she could not let her legs touch in bed because they would sweat so much – (“Generals, Touch, generals, agg. cannot let limbs touch each other at night” (Murphy 2005)). The only remedy in that rubric – Psorinum. Physically it also fit with “Sweat, easy, profuse, worse cold” (Murphy, 2000).
Then when I looked at the mental-emotional picture of Psorinum, it all fell into place…
low willpower and an inability to act effectively to make things happen in his world. (Coulter, 2002)
anxiety, depression and irritability, general timidity (Coulter, 2002)
difficulty making decisions (Coulter, 2002)
restlessness and changeability (Subramanian & Subramanian, 2001)
despair, hopelessness and suicidal tendencies (Murphy, 2000)
“a chronic grumbler” (Subramanian & Subramanian, 2001)
It was also a great fit with the fear of finishing her relationship – fearing she would not survive, as well as with her mother’s struggle to survive when growing up.
So what started out as a search for a miasmatic block in order to prescribe a nosode to unblock the action of well-indicated remedies that were not completing their action, ended in the prescription of Psorinum as a remedy in its own right.
As she walked through the door she cracked a joke, and she laughed and smiled more in the first five minutes of the consultation than she had in all the previous consultations put together. She said her mood was “more constant and calm” and she was less stressed about everything. She felt much less frustrated by her indecision about her career and relationship: The idea of changing career course did not seem such a big deal any more – she thought she could “survive”. Similarly with her relationship, she was more accepting. AndI could sense this in the way she talked about these issues. The problems had not really changed, but her attitude to them had. She had also become more accepting on the excitement v boredom issue. She didn’t complain about anything in her life during the session, with no evidence of the previous frozen misery.
Nothing – watch and wait. I wanted to let the Psorinum 10M finish its action and see whether it would hold.
During the month she had experienced a relapse: she had felt insecure and unmotivated in her work and had wondered again about studying homeopathy and whether she would “survive” if she took this path. She had started feeling trapped again in her relationship. By the middle of the month she had been feeling depressed once more. Overall, she had felt stuck again – unable to act to change things. “I feel no support from anybody on anything” she said, and when probed, she particularly feared ending up alone and on the streets “talking to the pigeons”.
She had not been able to sleep well at night because of a blocked nose, which had been running a lot and causing her to sneeze during the day; and she had been experiencing a bit of asthma. Her eyes had also been very itchy, which was something she always got in spring, and this time had perhaps been the result of having walked on the heath in what was proving to be early spring weather. Her eyes had then become infected. However, she was still sweating less and was still less stressed at work.
Psorinum 10M split dose
I decided to repeat the Psorinum, as she had done so well on it the first time, and she was showing a lot of Psorinum symptoms still e.g. spring-induced itchy skin and allergies, eye infection, indecision, depression and survival fears.
The day after taking the remedy, she said that her negative emotions had “calmed down” and her mood had improved. She no longer felt desperate and had been altogether less stressed both about her relationship, and her work and lack of clear direction. She had also started anticipating positive reactions from others in certain situations. Previously she had always assumed the worst – e.g. that friends would be very angry with her when she was late. And, out of the blue, she also said that she was not afraid of dying and that she was ready to die – “but not in a depressed way”.
And while the sinus problem / asthma continued, the sweating had reduced dramatically. From then on, the focus of treatment was physical rather than emotional. Psorinum had triggered a wonderful response in her that meant she was no longer stressed, depressed and fearful. In fact, four months later she took a promotion, which involved moving to the city where her boyfriend lived, and she moved in with him.
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