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Case Study

Why Do I Feel Depressed
Dr Manish Panchal
' Lac-defl

Mrs P S, 26 yrs old came for consultation in April '95. I had made some observation about her while she was coming to me for her son. Her mannerisms were mild, she was communicative, loquacious which was not irritating but mild and pleasant. She would laugh easily while narrating her symptoms and like a child she seemed very immature for her age. She was not a complaining type of person. 

She was feeling depressed for quiet some time now.
'I don't know why I feel depressed and what is the exact feeling. I have no desire to live, I do not care to live and I am not happy to live. During this spell of depression if I am able to weep, I feel better but tears do not come. I have to do lot of effort to divert my mind from such depressive thoughts. Recently when I felt depressed I just locked my house and went to my in-law's house, there we all talked with each other. I am not able to describe my basic feeling directly but IT'S AS IF WHEN SOMEBODY DIES HOW YOU FEEL I feel like that, I have no desire to live but have no courage to jump from the window, to burn myself or sleep on a railway track. I can adopt simple method like consuming sleeping pills. During my childhood and adolescence I was always alone by myself. My father and mother were always busy. My mom was very strict and narrow minded. After teaching from school she would give tuitions till late night. When I used to go my friend's house, her family would talk to each other about whatever happened throughout the day. I used to feel bad that such things would not happen in our house. Now after my marriage I don't like to go my mom's place. There no one has time for the other person, forget about me.' 

" I had a love marriage. My husband's family is large and closely knit, they sit together, talk with one another, take care of each other. My own mother tried to spoil my marriage but my in-laws were more understanding and they stood by me." 

" When I was admitted in a nursing home at Malad during my pregnancy, my in-laws, sister-in-laws and their daughters came from Mira road for me but my own mother never came to see me at all. It was my first pregnancy but she came after four days after I delivered a baby. She never had to come out of her way to meet me. She was teaching in a school which was in the next lane to the nursing home. I really felt very bad." During pregnancy once she had a dream of black snake. 
1. She also had severe and persistent headaches since last 4-5 years, starting with a feeling of tension in Lt- temple. At times it is so severe that I have to take Crocins. If I am able to get sleep I feel better but I was not able to get sleep. I have to tie my head very tightly , sometimes even with a rope. I feel better by pulling my hair tightly, and I apply clothes, clip around bridge of nose.
2. I have pain in both lower limbs--- as if pulling amel with tight bandage.
3. Profuse menstrual after CU-T insertion. Blood black3 with pain in legs2 and backache3
4. In the past her Hb would drop to as low as 6 Gms%, Took iron injections. 

I weep very easily at everything 3 --- While watching a movie I always sit with a napkin or handkerchief with me. You name anything and I am fearful.
Appetite: I can eat anything, anywhere, anyhow. I can eat after a full meal. I eat a lot but my thirst is totally opposite of my appetite. For many days I don't even drink a glass of water.
Sweat: almost no sweat3 even in summer. I don't drink water so how can there be sweat?
Craving: I love eggs3.
Aversion: cannot tolerate milk or milk products even smell of milk.
Sleep: can sleep anytime--- have a very good sleep
Dream: I am falling from bed--- hold the side of bed and wake up frightened.
- once during pregnancy BLACK SNAKE.
Other observation: Motion of tongue left to right and have tendency towards obesity. 

Converting into Rubrics, we get:
1. DEL - dead, all her friends are dead and she must go to a convent.
3. DEATH, Desires - meditates on the easiest way of self-destruction (Chitkara's Mind pg 372) of SUICIDAL disposition - meditates on easiest way (Chitkara's Mind)
4. Sadness, despondency, dejection, mental depression, gloom, melancholy- conversation > 
5. Forsaken
6. Av-milk
7. > Tight bandage
8. Headache> tight bandage
Ø Sleep after(Lac-c but Lac-d has headache from loss of sleep)
9. Dream snake
10. Fear falling. 

She was prescribed lac-defloratum 1M 1 dose.
The rubric Del-dead, all her friends are dead and she must go to a convent has to be understood in a broader sense. It is as if a herd of cows is taken to a slaughter house where one by one each cow is going to b slaughtered and gradually every cow feel alone forsaken till her own turn comes. The whole scenario is that of sadness , gloom and despondency. The feeling of our patient, matches similarly with the feeling of cow's milk .Further confirmation is strong aversion to milk and milk product, even the smell. Still further confirmation comes from various Materia medica (kent, Phatak, Clarke) which is given below for better understanding.
Generalities: skimmed milk is useful in disease with faulty nutrition and anaemic condition of blood. Sufferings from loss of sleep. Persons or children who become sick on taking milk. Obesity. Throbbing especially in temples, rest of head feels light.
Worse: Milk. Loss of sleep. 
Better : pressure of bandage. Conversation.
Mind: depression; does not care to live; questions as to quietest and most certain way of hastening one's death. During conversation, headache and depression of spirit > SADNESS, death desires and meditates upon easiest method of self destruction. Imagines that her friends will die and that she must go to a convent.
Head: Persistent headaches, for years. Pain > bandaging head tightly and conversation
Stomach: Aversion to milk. 

Follow -up after single dose of Lac defl 1M)
- headache immediately reduced very much in intensity, the continous but no need for tight bandage and cloth clip. Recurred once after 1 month of the dose, lasted for 4 days > tight bandage but no need to take crocin at all. After 1 month of last recurrence, slight headache lasting from evening to night. After that no headaches.
- Mind: Depression once lasting for only 2 days, no suicidal thoughts. Thereafter only once slight depressed feeling- nervousness as if going for exams 
- restless could not concentrate my mind. Never felt confident of riding Kinetic Honda to my office.
No depression, sad feeling or suicidal thoughts after that.
- Menses: Not much profuse. No tiredness, backache with menses. Felt like normal except slight pain in legs.
- Dreams: 1. Brother was very nearly saved from accident
- 2. Husband's remarriage (felt hopeless, forsaken) continued again after falling asleep 
- Thirst: Feels thirst now.
- Sweat: Feels sweat
- Appetite: not much hogging. Only now. After 3 months again ravenous hunger. Since a week can eat full meal immediately after eating but no headache or depression. Motion of tongue continues though not always.
- She gets up to greet me when I visit her bank for my work.
- I feel she still requires treatment but she has stopped it.