14/02/2016
POST TRAUMATIC STRESS DISORDER - CURED BY PHOSPHORUS
History:
A patient of mine brings her sister aged 32 years for her psychological problem. This lady stays in New Delhi and has arrived in her sister’s house (in Durgapur, WB, India ) for treatment.
Profession:
Interior designer – works mostly from her home and is working on her laptop always.
Date of consultation: 19/05/2015
Excerpts of conversation:
Patient: Doctor, I am suffering from a peculiar problem. I did share my problem with my husband but he is too busy with his official commitments – I cannot remain alone in my flat anymore leave alone doing my regular work. Suddenly I have developed a great fear since the terrible Nepal earthquake on 25/04/2015. I was working on my laptop at that time when I felt tremors – people started shouting and running out of their flats. I could realize that it was an earthquake and I was all alone in my room. Suddenly I felt that the building is going to collapse and run of my flat terror-stricken. I ran down the flight of stairs and came out in the lawn. People were panicked – mostly women were there at that time. Doctor, didn’t you feel it here?
Doctor: Yes – please continue your experience and problem in detail.
Patient: Since that day, I couldn’t get out of that phobia. I feel that everything is shaking. I can’t sleep lest the building comes down. I can’t remain alone in my flat – feels the earth is shaking.
Doctor: Any other problem?
Patient: I don’t feel like eating since that shock. But I’m not like that, you know. Basically I’m not a coward though I become stressed easily. Triffling matters affect me too much but I can get out of these easily. You can say – I’m sensitive. I am not able to watch TV news these days who are telecasting the devastating images of the earthquake.
Doctor: Did you take any medical help?
Patient: Yes. Initially I thought that I could get out of this traumatic fear but it was gripping me regularly. I went to a local physician who advised me to take some sedatives for a few days – I took them but they were really not helping me. I consulted with my sister who asked me to come down to her place for a change. She insisted me to come to meet you and take your professional help. Doctor, please help me.
On examination:
Physicals were normal. Pulse: 80/ min. BP – 110/70 mm of hg.
Diagnosis: Post Traumatic Stress Disorder (PTSD)
What is post traumatic stress disorder?
It is natural to be frightened in danger. But if that traumatic event continues to scare the affected person even when the latter is out of that situation, that reaction is known as post traumatic stress disorder (PTSD). PTSD was first brought to attention and coined in relation to the plight of US war victims during the Vietnam war but it can also result from variety of traumatic incidents such as mugging, r**e, torture, being kidnapped or held captive, child abuse, car accidents, train or ship wrecks, plane crashes, bombings or natural disasters like flood, earthquake etc.
Scientists are currently focusing on genes which play a role in creating fear memories. They have identified chemicals and proteins which are released during fearful memories. They are also focusing on areas of brain such as amygdala which help in retaining fearful memories. Sometimes these painful memories (such as touching a hot plate in childhood) help in learning to be careful in future but if these memories cause hyperarousal features, it becomes a problem and precipitates into PTSD.
FEATURES OF PTSD:
PTSD develops slowly over a considerable period of time right after the traumatic incident till weeks or months or even years.
They can be divided into 3 types:
1. RE-EXPERIENCE THE TRAUMATIC EVENT
• Reliving painful or upsetting memories of the event
• Flashbacks
• Nightmares
• Helplessness or distressed when the event is recalled
• Physical uneasiness or symptoms like rapid breathing, palpitation, nausea, sweating etc
2. AVOIDANCE AND NUMBLING: The patient avoids the reminders of the traumatic event.
• Avoid places, thoughts, feelings or activities that remind of the incident.
• Loss of interest in activities and life in general
• Feeling detached from other and become emotionally numb.
• Inability to remember important aspects of the event
• Depressed and loss of interest in leading normal life or participate in normal social activities.
3. HYPER-AROUSAL OF EMTIONS OR INCREASED ANXIETY
• Difficulty in sleeping and remains awake
• Outbursts of anger
• Difficulty in concentrating
• Felling on the edge always – feeling tense.
Children may not have the same symptoms as those of adults. They may have some very innocuous but annoying symptoms which include:
• Bedwetting ( suddenly forgetting the already acquired skills)
• Being unusually clingy to parent or anybody nearby
• Sleep problems and nightmares
• New phobias
• Aching and pains without demonstrable cause
• Aggression and irritability.
Treatment module:
1. Behavioural therapy: This involves careful, gradual exposure of the patient to the traumatic feelings and replacing these distorted facts or thoughts with more balanced picture.
2. Family / Social support: This is too important as the family members or friends can build up a great support base for the victim – ensure that the patient is safe and involves them in social events more intensely. These victims should not get disconnected from the surrounding society or else they might enter a point of no return. In this context, we can always refer to the ORGANON where Hahnemann insisted on this supportive therapy rather than inflicting injurious punishments or abandonment. Here the sister and her family were doing this part of the job.
3. Individualised medication: Conventionally the PTSD patients are prescribed some medicines by doctors to relieve secondary symptoms of depression or anxiety or restlessness. While these drugs might help the patient temporarily in lifting mood, pulling out of depression or getting medicine induced sleep, they do not treat the cause or relieve the core problem of this stressful ordeal – PTSD.
In this case, the most important symptoms were identified –
a. Fear of earthquake and the after shocks
b. Fear of being alone
c. Delusions of accidents or harm arising out of earthquake
d. Delusion of trembling or shaking of surrounding objects around her
e. Sympathetic to the plight of victims
f. Industrious
g. Insomnia
The following rubrics were taken and repertorised:
1. Mind, Ailments from fright or fear
2. Mind, Ailments from fright or fear: Fear of the fright still remaining
3. Mind, Ailments from: Fright or fear: long lasting
4. Mind: Ailments from: Fright or fear: ordeal, of an
5. Mind: Fear: accidents of
6. Mind: Fear: alone, of being
7. Mind: Fear, Sleep: go to, to
8. Mind: Delusions, imaginations: Earthquake of a
9. Mind: Delusions, imaginations: accidents
10. Mind: Industrious
11. Mind: Sympathetic
Repertorial result:
Phos: 6/12; Arg Nit: 5/10; Lyc: 4/10; Nat Mur: 6/9; Opium:3/9; Caust: 5/8
Prescription: Phosphorus 10M / 1 dose in distilled water.
I did not hear from the patient any further. On 12th January, another lady brought her brother with depression to me – from her I came to know that the patient could come out of her problem after Phosphorus and that the earlier patient had actually referred this lady to me.
Case by: Dr. Partha Chakraborty
MD(Hom), BHMS, B.Sc, FF Hom, FSS(Apollo)
drpartha@yahoo.com
0091-9433288849