NBWS Post Natal depression 6 yrs ago

[Rochelle]

Hi All,
I have a case here where I am not really getting anywhere and wonder what I am missing. I have also thought and asked "what would this woman have to do if she was well". i.e. What is preventing her from getting well?
I am giving you the case + follow ups (I have her permission to post) and if anyone has any ideas for me to work on please let me know. This is not urgent as I am not seeing her for a month now.Thanks
Rochelle
Case JR
20th November 2002
Background - This 37-yr. old woman presented as a very tall slim woman with dark wavy long hair who sat with her arms folded a lot of the time. She was quietly spoken but in an intense manner and quite sparkly eyes considering her PC. She was rocking and her had nodded constantly. She was very nervy. She has been treated by anther homeopath and prescribed Ars. 200, which she has taken at will and Nux Vom of which she has also taken a few. The last Rx she was given was Kali Phos 30. She has also been taking St Johns Wort for the past 3 months. Her Doctor says she is depressed and in the past has been on Prozac that made her so ill when she withdrew from it that she was hospitalised.

Presenting Complaint - Extreme tiredness/stress.

She has not taken any homeopathic remedies for 2 weeks.

She has 2 children and after the second at 5 months she got postnatal depression. She used to work full time and this happened after she started to go back to work. The baby was planned and she had no problems with her pregnancy or the births.

"I feel so tired all the time even with enough sleep. I feel drained and exhausted. I am snappy and narky with the kids. (Age 6and 7). When I wake up I feel wrecked. I feel awful and can't get going. afternoon. The tiredness is overwhelming all the time."

I am a worrier "about finances as I am not able to work. I feel guilty for not working. I worry about how to get better and what someone is saying about me as I read more into it than should be there."

"I am happily married. I used to work all week and go out of a night. I feel that everything is on top of me. I work 5 hours a week as a secretary in a school but I am not coping with it."

"I worry about what is going to happen if I can't get back to work. I worry about things that are not going to happen like my husband losing his job. I worry about making the tea and then on to the next thing."

"My downfall is the house. I have to have the house neat and tidy. I can't stand clutter. I make lists. I do it all the hoovering etc."

NS - cold sores (agg from Ars?)

"I am not enjoying the children. I feel the children are a burden I am better keeping busy."

Used to be on the pill and was fine on it. Not interested in sex now.

"I take things to heart all the time. I take it personally. I am nervous about what people might think."

Fears - what is going to happen if she doesn't get better.

Childhood - fine. "I'm the oldest of 3 and have a brother and sister who both live abroad. I get on with my parents who live near. I enjoyed school and I remember moving to a new house when I was 8. I got married at 27."

First sex was at 18 and mutual agreement.

"I was on Prozac and got worse and was hospitalised for 10 days with chest pains on coming off it."

Moles - a couple.

"I'm always helping other people. People ask for favours and I go out of my way. A (husband) thinks I am soft. I can't say no."

Anger - "I'm not confrontational."

Unhappy - "I would like more money. I would move house as ours is too small."

Happy - "With husband".

Sleep - position left side.
Dreams - people

Food - desires -sweet things, bananas. Likes all meat.
Dislikes - seafood, tomatoes raw, liver.

Temperature - feels the heat but does get cold.

Environment - likes the seaside

Menses - no problems

Family medical History
Grandfather-cancer. Nothing else given

Analysis
The impression I got was of a very quiet nervous person - like a mouse. She has been given remedies by another homeopath which have done nothing. I can understand why Ars was given as she is so fastidious but she doesn't have a lot of Ars traits like the fears and collection of things. This woman doesn't like clutter. Her weariness is extreme except for housework. She doesn't have the sparkle my other patient with the tiredness has. She has also been given Kali Phos but only in 30C which did nothing. I feel that this patient has OD'd on the Ars 200 as ½ a 8g vial has been taken. This may be the cause of the new symptom of cold sores that she has. I wonder if she was given the Nux to antidote the Ars as I can see no reason for this remedy.

The causation was post natal depression and I feel that this should be in the remedy. She said that she felt the children were a burden.
The 2 remedies I am interested in are Sepia and Carc. The Carc because she can't refuse doing things for people.
Prescription
Sepia 30, 200, 1M over 24 hours.

Case JR Follow Up 1
11th December 2002
27th November - She phoned in to say she had been great on the Saturday and awful since then.

On 4th Dec., I gave the Sep. 30 after the original high potency had causedan agg in her original exhausted state and diarrhoea. This Diarrhoea was an OS but she suppressed it with Imodium. After the one dose Sepia 30 she felt a lot better in a few hours but then came out in a cold - her first for years. With the cold came increased energy and she actually went out that night. The next day she had lost her voice and had a sore throat with shivering and sweating. She stayed in bed for a couple of days. The last couple days she has got over the cold and wasn't so tired but today she reckons she is back to wat she was when she came to see me!!!

The only thing I gleaned was that the day after the Sepia she started with a period which was 20 days early. This was most unusual for her. She sailed through the period - no problems and had no PMT either. Now surely the Sepia couldn't have brought on a period so quickly?

She is going around turning all the heating off at home. She doesn't want the windows open ( not Puls) and she loves lying in the sunshine in summer!! She does however say that she has been very tearful because she feels so awful.

Analysis
I am confused and don't know what is happening. I do know I don't want to represcribe at the moment. I have explained this to her and will see her in the New Year. Meanwhile I will give her some Bach Flower Rx to take and will see her in a month.

Prescription
None

Case JR Follow Up 2
7th January 2003
When she saw me last she had a cold until 15th Dec. and then she has been tired everyday since then.

Her menses was back to normal after being 10 days late last time after the Sepia. She had PMT for the day before.

She has been getting a pain that she has had before, in her chest, a tightening. She also gets a tingling in her arms at the top. Sometimes this is in her fingers. We tapped the problem away with EFT.

She was very nervous at the start of the consultation. She admitted than she felt nervous but didn't know why.

She thinks that things are all her fault. "We took the house out on 2 wages."

The fruit she eats are apples and bananas.

She gets stressed out with the kids and shouts at them. She did this morning when they were late for school.

She has had diarrhoea since the operation to remove a part of her colon, which was adhered to a septic appendix.

Analysis
She seems at the same place as when she started and so I think it is time I tried Phos ac as she still looks and acts very Phos to me. Although I am having difficulty repping this case out to Phos Ac it does have the nodding had in it which is a SRP. It is also a good remedy for CFS type of complaints. The doctor wants to put her on anti depressants but her husband has said that she is on her own if she does go back on them. The doctor has said that it is the only way that she will get better but she remembers how bad she was on Prozac.
Prescription
Phos. Ac. 200

Case JR - Follow Up 3
1st February 2003
She has made her appointment earlier because she was feeling so bad. I gave her a Phos Ac. 30 to take a couple of days ago in case the 20OC she took on 20th Jan somehow antidoted or was too much after the original 200 given on 7th Jan.

"I was tired for a couple of days after the remedy and then went a bit better for a day. Then I was better for 4 days and completely fine for one of those. The next day I felt wrecked and last week had to take to my bed. After you sent me the 30 I was better and went to work on Friday. I am also OK today but not as good as I have been."

"I just want to be well enough to work."

"I am nervous going to an interview and worry about what to say to people. I take things to heart and wonder if I have said something to them."

She has been turning the heating off so is warming up. She loves the sun. She has long eyelashes. She doesn't like thunderstorms.

Analysis
She is pleased that she was better for 4 days as she has never had a break like this for 6 years but was upset when it went down again. Taking another 200C seemed to make the problem worse rather than better so maybe she would have come up again eventually. The 30C did the trick of bringing the potency down and she has been better since. I have to ask why won't she let herself get better but this woman doesn't seem to be lacking anything that she is admitting to. She says that she has a caring husband and that she wants to work. But does she feel she wants to work because she feels she has to work financially? She was leaning forward when she was talking to me and I am still thinking Phosphorus here. Maybe what I need is a similar remedy to Phosphoric Acid. One of the similar remedies is Phos. also Mur. Ac and Pic. Ac. I think that I will probably try Phos. next. However at the moment I would rather stick to what is working so am going to a WP but I don't want her to take it unless she goes back down again and then only until she comes back up. We did some EFT to remind her how to do it and used positive affirmations. I showed hr the third eye and head charkra points to massage and also used the E Tox pen on her again which she thinks helps her.

Prescription
Phosphoric acid 30 Water Potency p.n. 5 drops 5 succusions

Case JR Follow Up 4- 21st March
Things are much the same. She presented me with a list of days she had taken the WP and what she was like the following days. (all dates are when she took the Rx)
1st March - fine for 2 days
4th March - not as tired rest of day
6th March- " next day wrecked"
7th March - "next day wrecked " 8th - wrecked
9th -she phoned me and I suggested 10drops 10 succussions
10th - upset stomach, not as tired
11th- in bed all day
12th - next day a bit better, following day very tired
12th - next day not as tired
17th - wrecked also next day. Following day better. Day after "destroyed"

"It's something I've got no control over. I slept 12 hours last night and woke feeling I'd not slept".

She is getting anxiety chest pains again - no pattern to them. Itis a tightening feeling in the chest - under sternum and extends to the right arm. She loses feeling - pins and needles in the fingers of both hands with it."

She was quite nervy again today and smelt again of cooking odours.
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OK that's it so any suggestions very welcome!!
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[Joy Lucas]

Dear Rochelle,

I sort of remember this case but cannot remember my previous thoughts about
it.

Presumably you have considered the Ignatia/Nat Mur possibility of this case
- neglect of duty, guilt, worry and anxiety, full of burdens, doing
everything against her will, sympathy for others, depressed and introverted,
weak and weary, tidiness, nodding head, cold sores, bowel problems, liking
of seaside (can be both >) etc.

But I am interested in another aspect of this case - can you say more about
the septic state of appendix and problem with colon - can you give lots more
details about this please, including those of bowels and stools.

Best wishes, Joy

[Arun]

Hi rochelle,

First choice would be sepia, but
some of it sounds like Calc, like

- Overwork -> Breakdown ? - Weak / tired
- I am a worrier "about finances as I am not able to work
-"I worry about what is going to happen if I can't get back to work
- I worry about things that are not going to happen
- Fears - what is going to happen if she doesn't get better
- fastidious - wants order
- I am nervous about what people might think.

i don't know if calc has "children are a burden" (like sepia) but it is in
the rubric Aversion - family members to

thinking of Aurum also (Postnatal depression, > working, worries,
fastidious, response to children)

regards,
Arun

[Rosemary Hyde]

Dear Rochelle,

Tough situation! It's interesting that two remedies have seemed to help
then produced really big aggravations. It strikes me that a central feeling
in her case is discontent-despair-anxiety about being blamed and blaming
herself, with a too well developed sense of duty. I agree that the
post-partum depression should be included. This makes me think of Aurum.
The cancer miasm feeling about having to please everyone all the time and
avoiding conflict, along with the sense of fatigue makes me think more of
Aur-mur than Aur-met.

She must also be quite sensitive to remedies, and perhaps a different
approach to dosing might also be useful. I find that with people who tend
to be sensitive, I can start with a 12c in water, have them succuss and take
a dose daily, and it's possible to see in a week or two whether this remedy
is likely to have a positive effect. I then switch to LM1 or LM2 for
ongoing treatment. With very sensitive people, I would even use 6c
initially instead of 12c. If they're very sensitive, they respond quickly,
even to lower potencies and are likely to aggravate when they start out
right away with LM. The 6c or 12c gives them a little chance to start
responding and get used to the remedy, and also if they aggravate right away
on a low dose, or nothing happens, we're pretty sure it's not the right
remedy and no damage has been done.

For what it's worth....

Rosemary

[Rochelle]

Thank you Joy, Arun and Rosemary for you thoughts.

Firstly Joy - She had the a septic appendicitis in 1993 and a hemi colectomy(sic) but this was before she had the children. I haven't asked much about the bowels as I saw it as due to the operation and therefore of little overall relevance at the moment. I have to say that Nat Mur is the remedy that reps out top but I just can't see it. There is no past grief at all, she is quiet and the word timid comes to mind. The cold sores was a new symptom which emerged while taking the Arsenicum which had been prescribed previously. Ignatia I hadn't considered. It is quite low down in my rep but I see it has the nodding head which I didn't notice today.

Arun - Sepia was the first remedy I gave her but it agg and didn't hold. Calc I haven't considered. I did ask her about sweat and hot flushes today and got a negative. Aurum I hadn't considered but it really is very low down in my rep. I will look at it.

Rosemary - thanks for your thoughts on potency and prescribing. I will look into Aurum. Mur. and maybe even Aurum Mur Nat maybe an idea to research.

Thanks
Rochelle

www.rochellemarsden.co.uk
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[Wendy Howard]

Rochelle wrote:
I
do

Hi Rochelle

Have just read this over superficially, but have you looked at Cyclamen?

Regards
Wendy

[Dave Hartley]

Hi Rosemary,

Not specifically related to this case, which I haven't had time to look
at- but regarding your comment..

This dynamic would be consistent with a suppression.
Dave Hartley
www.localcomputermart.com/dave
San Francisco, CA (831)464-8127

[Shannon Nelson]

on 2/21/03 6:05 AM, rochelle at rochelle@ntlworld.com wrote:
I'd love to hear more about this!
How does *she* feel about her helping -- is it because she genuinely wants
to (why?), or because her does what she does not intend (there's some rubric
like that), or because she worries about offending, or etc.?
Does she *like* helping out, feel good about it?

Also, what was she like before the childbirth -- are *all* of these entirely
new, since the birth?

If the birth was causative, is there any clue as to what it was about it --
any unusual loss of fluids, change of circumstances (other than gaining an
infant!), illness? Was the baby's health (and sleep etc.) fine? Has she
been this exhausted for (gulp) six years?

Shannon

[Dale Moss]

Rochelle, like Joy I'd consider Nat-m. There doesn't have to be an obvious past grief -- after all, if Nat-m. were more in touch with her feelings, she wouldn't be getting sick. It's the stuff she brushes off, not even thinking it might be a source of grief, that gets her in the end.

Peace,
Cinnnabar

[GEastwood]

depression.

Usually we think of postpartum depression as beginning in the first month
after the birth. (time of great hormonal change, etc.). For causation, you
might want to go into what was happening in her life when the baby was 5
months old.