Many of us would have experienced depression either in the form of just sadness and winter blue or actual depression in one or the other time in the life. Even the celebrities are not spared. Starting from international celebrities like Angelina Jolie and Lady Gaga to Indian celebrities like Shah Rukh Khan, DeepikaPadukone, YoYo Honey Singh, Manisha Koirala, the list is never ending. The point I would like to emphasize here is that depression is not uncommon and is treatable.
When this author had encountered the first case depression in the initial days of practice, Natrum muriaticum was the lifesaver. The day the first dose of the drug was given, it was like a heaven for him. It relieved almost all the symptoms including severe insomnia and made the mind all day afresh. But contrary to the literature reference that the action of Natrum muriaticum will last for 40-50 days, it vanished even before 24 hours. As Hahnemann suggested in the 6th edition of organon for LM potency, it was given 5 drops daily at bedtime with 10 strokes each time but of 1M potency, since LM potency was not readily available. When the bottle of 1M potency finished, instead of going for 10M, I chose to prepare 1001 centesimal potency myself and had given in the same way, i.e. daily dose after giving 10 strokes. In a span of 6 months, he was completely out the condition, with increasing the potency each time when the bottle got finished. It went upto 1006CH potency. Usually it is observed that Natrum muriaticum works up to a certain level from where we need to switch over to some other remedy. But in this case it had relieved completely only with this remedy.
This experience had given me confidence to handle depression. It also taught me that it is not necessary to play only with the commonly used potencies of 30CH, 200CH, 1M and so on. If a remedy is well-selected, physician can raise one potency up and administer to the patient the same way LM potency is administered when not available. And it works.
How do the patients of depression clinically present?
There are patients come with the diagnosis. They are usually under the treatment of conventional medicine and want to switch-over because of adverse effects. It makes the patients drowsy 24×7 and addicted. Another category visits for some other problem like general weakness and report an unknown lack of interest in anything and everything as collateral symptom. Apart from these, prolonged sadness, anxiety, hopelessness, pessimistic thoughts, guilty feeling about something, helplessness, irritability, lack of interest or pleasure in hobbies and activities, diminished energy, fatigue, lack of concentration, weak memory, lack of decision making capacity, both insomnia at night and sleepiness at day, lack of appetite or overeating, weight loss or overweight, suicidal thoughts and attempts, irritability and restlessness are also reported.
Conventional therapy and its drawback
Conventional therapies usually deal depression with selective serotonin reuptake inhibitors (SSRIs), Serotonin and norepinephrine reuptake inhibitors (SNRIs), Norepinephrine-dopamine reuptake inhibitors (NDRIs), etc. Moreover, they only interrupt the intermediate mechanism by inhibiting certain brain chemicals, which is of temporary in nature. All these inhibitors have much more adverse effects. Many patients withdraw the treatment intermittently due to poor tolerability.
Supportive measures
Counselling helps a lot. A good counsellor can be suggested to handle the case. Or even spending time and speaking to old friends will also help. Instead of sitting alone, which may worsen the problem, reaching out to people will make mind free from worries. Regular exercise is also known to reduce the depression. Meditation and yoga are proven to be of help. Foods that contain mood boosting diets sucha as Omega-3 fatty acids have to be included in the diet. Intake of caffeine, sugar, & refined carbs need to be reduced.
What is the homeopathic approach?
Different approaches have been followed by different physicians. As explained above, which is a classical case handled with classical homeopathy, many cases respond well with the single indicated remedy. However cases which take time need multi-dimensional approach. In such cases along with constitutional remedy, inter-current anti-miasmatic drug will stimulate or boost-up the recovery. Collateral condition-specific remedies in physiological doses would give interim relief to the patient until the constitutional and anti-miasmatic drugs give desired result. At times, certain homeopathic formulations containing low potency ingredients available in the market will help as add-on therapy which would work in different plane than the indicated constitutional and anti-miasmatic remedies without interruption. This article tries to give insights on these practical approaches of managing the cases of depression.
Constitutional and anti-miasmatic drugs
Sulphur
It is the Optimus Prime of psora. A typical Sulphur patient is lean and thin with stooped shoulders. His appetite would be good, still suffer from dyspepsia. They are lazy to go out, lead sedentary lifestyle and develop a kind of mania and depression. They look dirty. Though they are under depression, still they talk philosophy. As Hering mentions, they are ragged but false philosophers. Highly imperfect; their desk would be filled with papers and things, not in orderly manner. It is usually given intercurrently when strong psoric features are found. Many a times Psorinum is found beneficial either before or after. At times SCL or PSCL cycle is followed; Sulphur (S), Calcareacarbonica © and Lycopodium (L), and P stands for Psorinum. It is given as weekly, bi-weekly or monthly doses in the given sequence. If the case warrants, where sycotic dominance is observed, Thujaoccidentalis and/or Medorrhinum are given after Lycopodium with the same interval.
Calcareacarbonica
This is another polychrest and ‘great Hahnemannian anti-psoris. Strong indication is the obesity or stout gigantic people. In case of school children and college students, profuse scalp perspiration is the key symptom. They are usually sluggish in nature and easily exhausted, but industrious when it comes to their profession, career and work.
Lycopodiumclavatum
It is a tri-miasmatic drug, of carbo-nitrogenoid constitution (please refer J. H. Clarke’s Constitutional Medicine, Chapter VIII). Gradual development of disease, persistent digestive and urinary disturbances and main involvement of right sided organs are the chief general symptoms I look upon. I start the case with Lycopodium clavatum in almost every the case of modern day lifestyle problems like fatty liver, elevated SGOT & SGPT, hypercholesterolemia, etc. Depression would have started months before and gradually developed; but the patient might have realized much later. Melancholy is manifested in the form of fears and anxiety. They don’t want to be alone, lack of self-confidence, are hurried in nature, confuse themselves, poor in memory.
Natrum muriaticum
They are tearful and with great sadness. They can’t enjoy the happy moment. They laugh and immediately weep. Weak memory; loses the flow while speaking. Mentally become weaker soon. Loss of vital force is another key indication. When they are normal, they have suppress their feelings.
Aurum metallicum
Fear is found everywhere. Apprehension to go out, to meet people, for exams, etc. They work hard and concerned about their work, but easily affected with sad mood which affect their pursuance of career. They don’t get sleep for weeks and months together. Lack of self-confidence; always thinks that s/he could do nothing. Oversensitivity.
Argentum nitricum
Great melancholy, apprehension, illusion, imaginations, fear of death, over-anxious state, predicts the moment he is going to die. Excited, angers easily, becomes vehement followed by weakness,pains in the head and chest with cough.
Arsenicum album
Patient is always in distress, even during normal events. Obsession is predominant. They are perfectionists. Depression is mostly triggered from this; when they could not achieve the expected perfection level, they become depressed.
Ignatia
Depression triggered by sudden loss of something is the key indication. Sudden death of blood relatives and friends, sudden financial losses, betrayal, facing social stigma, robbery, etc. cause depression. They often face insomnia and are sensitive. They get frustration easily and dwell on painful thoughts. Laugh and cry louder without reason.
Pulsatillanigricans
It is a women remedy; suitable for the one who weeps, weeps and weeps. At times their behavior is like childish. They need attention, feel better when they get to some workout, walking, fresh air, etc. Hormonal changes are observed.
Sepia
Sepia is the best medicine if a person wants to be alone and may become angry when other people show their concern for their sadness. They may feel better after crying, and they prefer not to sympathize.
Collateral condition-specific remedies in low potencies
Crocus sativus
It is used in case of anger with violence followed by repentance. Other indications include extreme changes in sensations and mental conditions. Also useful in physical conditions aggravated by anger.A tendency to become angry quickly, which sometimes alternated with cheerfulness.
Cypripedium pubescens
Known tranquilliser. It reduces emotional tension and nervousness in children with intestinal troubles. Cerebral hyperaesthesia (weakness) in young children who wake-up in the night lively and full of play.
Ginseng Q/1x
It lowers both mental & physical stress. Boenninghausen in one of his writings mentioned this drug as “It sustains [or holds up] the seven primary elements, which rule the temperament of men, which are gladness, anger, desire, sad meditations or melancholy, sadness or grief (dolor), terror or confusion, submission or fear.”.
The drug has attracted many scientists who have established it to possess adaptogenic action i.e. it helps the body to adapt to stress, fatigue, cold, improve body’s capacity to cope with hunger, extremes of temperatures or mental and emotional stress. It has ingredients similar to body’s own stress-hormones. Other research findings establish that it improves immune function, liver function; stimulates vitality, works as restorative and used for impotence and premature ejaculation (clinical observations only). Clinical reports have coverage on other vital areas like increase sperm count, lowering of cancer incidence, lowered digoxin support in cardiac problems, lowered angina, senility and coronary benefits, lowering of cholesterol, triglycerides with increase in HDL, improvement in non-insulin dependant diabetic cases, anti-senility action.
Eschscholtziacalifornica Q/1x
It is considered as harmless soporific. It normalises psychological functions and acts like a sedative but without any adverse effect.Its analgesic effect also helps to overcome associated physical problems. It is reported to be effective in depressive symptoms mainly of nervous tension, anxiety and difficulty in sleeping.
Hypericumperfoliatum Q/1x
Known for its anti-depressant qualities, it is a drug delicately linked to nerve injuries, pain and subsequent effects like anger, anxiety, depression, neuralgia, neuritis, hyperhydrosis and nervousness. Historically this European plant in the medieval period was considered to have power to repel evil. Medicinally, it was used to treat emotional and nervous complaints. Homeopaths normally use it for nerve injuries, intense headache and pain from anger. In late twentieth century research studies found that 67% of patients with mild to moderate depression improved with Hypericum extract. It was also established that mode of action of Hypericum is different from that of conventional antidepression drugs which elevate brain serotonin and evoke negative feedback control of serotonergic neurons.
Lupulus Q/1x
It covers depression related sleeplessness, drowsiness during the day, remaining awake with apprehension. It has calming effect on mind. It has an established efficacy for tension, headache and sleep disorders.
Passifloraincarnata Q/1x
It is a well-known drug used for sleeplessness, restlessness after fever and after tedious labour when the patient becomes nervous and excited. It is reputed to have anti-spasmodic and sedative properties.
Zincummetallicum6x, 6CH
It is useful in depression, melancholia with aversion to work or to talk, patient has frickleness (very variable mood) with sadness towards noon and joy in the evening or vice versa. Retarded and disturbed sleep with frequent waking, patient feels unrefreshed after sleep, during sleep has unpleasant dream(REM phases are disturbed).
Zincumvalerianicum 3x/6x
Helps in irritable people who get angry easily followed by depression. It calms and works as a mild tranquilliser. Covers associated sleeplessness.
Role of formulations
In this robotics era people want to see quick results. There have been many formulations available in the market. As stated, they help to manage the cases to gain confidence from the patients. Care has to be taken to select an effective and quality product. Discussion with peer groups will help to make right decision to choose right product.