Dr Deoshlok please advise re:chronic depression.

Hello Dr Deoshlok,
I'm asking for your help. I take meds, have a psychotherapist but i'm going hardly anywhere. I know homeopathy works but i haven't found remedy that is the one.

Below i have filled out the usual questionnaire plus a mental symptoms one.

1. Age,sex,weight,country,occupation.
44, female, 70 kg, 1m70cm, Italy, private language teacher

2. Main complaints and other associated troubles.
a)Where is the trouble; The exact locality of the complaint like hands, legs etc; duration of trouble.
Chronic depression, anxiety (nail biting), social isolation/avoidance, self-hatred, mastitis with pmdd (or pms), tiredness, lack of energy, cystitis, insomnia, pain around left hip and buttocks (due to hernia and slipped disk caused by unbalanced hip)., and oedema (swelling eyelids upon waking and of ankles).

b)What exactly do you feel, Sensation as pain, how pain feels or burn etc.
Cystitis causes burning and is caused by stress. As for pain, I need to change position

c)What are the factors that causes this trouble according to you.
Anxiety, depression, hernia and pmdd.

d)Condition under which the complaint is reduced or you feel better like, cold or hot application, cold or hot weather, position as standing, walking, rest etc.
- sleep and rest ameliorate (after lunch rest is better)
- fresh/warm dry weather.
- showering (temperature of water according to season)
- eating

e)Condition under which the complaint is increased like, cold or hot application, cold or hot weather, position as standing, walking, rest etc.
-sun (causes headache, palpitation, itching), during perspiration, in stuffy room
- in cold damp weather (especially cold wind)
- hungry and sleepy.

I never know what to expect because my energy levels change constantly, like mood. When I’m very depressed and sleepy the one day, the next day I am well spirited and energetic. It’s crazy and unnerving!!!

f)Any other complaint any where in the body.
Some acne before menses. I believe I have hormonal imbalances. A doctor suggested polycystic ovary but haven’t run tests.
A scan of the liver revealed that it is enlarged and there is hyper trophy of left lobe, perhaps due to accumulation pathology and hypo density, of cystic nature. Also pancreas is enlarged (I had to translate medical terminology in English so it's not precise).

g)Onset time of troubles in detail, i.e which came first, after that what problem and so on.
Anxiety, sleepiness, lack of energy, social avoidance, constipation, tendency to perspire easily= all my life. ------Depression, insomnia=15 years --- Pain around left hip and buttocks=10 years (due to hernia, slipped disk left side back)------Mastitis before menses = 10 years-----Pmdd (or pms) =2 years

h)Treatment method adopted and its result.
Currently taking antidepressants and benzo. I’ve taken many different types of meds but effects were poor. Luckily the last time I was in a psychiatric clinic, the doctors were able to help me more. Unfortunately the beneficial effects seem to be decreasing.
I’ve tried homeopathy but poor results. I can’t remember what I took; they were lots (mainly aurum met., nat mur., ignatia, sepia and others). I’ve tried electroconvulsive therapy, acupuncture, reiki, shiatsu, bio-energy, and bach flowers. I’ve also tried psychotherapy: all these treatments done for nothing!

3. History of diseases in family.
Heart disease (both sides of family), schizophrenia, diabetes, tuberculosis.

4. Personal History.
a)About childhood.
I was born in Africa but parents are European. We moved to 3 countries before settling down in Italy when I was a teen. It was difficult getting used to new culture of each country and making friends due to my reserved-ness. I was very shy, insecure, quiet, obedient, and sulky. I used to curve my shoulders as if to hide myself from others so I developed caved in chest.
As for complaints in childhood, I had German measles (itchy red spots, right?), tendency of ankles to sprain, and I used to wake up in early morning with stomach-ache because I had not urinated during night. A peculiarity is that I never get high fevers but a tendency to colds during cold season.

b)Academic performance.
Results were satisfactory but had to work hard to obtain them. I hated schooling because of low self-confidence/esteem. My heart would beat really hard when the teacher called out my name. I was afraid of making a fool of myself and I didn’t like hearing my voice. I didn’t want to attract attention to myself; I blushed.

c)Any major incidents in life and the effect of it on life.
A work experience caused onset of depression in 2000. I was living in Italy and had no real inclination to any type of job. I liked languages and loved travelling so I wanted to be a tourist guide but I realised I felt too uneasy and insecure when with people. I then decided to study to become a casino croupier because I was starting to feel restless and because it would allow me to travel around the world. I found work on a cruise ship, and although I felt insecure, I was happy. Unfortunately due to my low self-esteem, I started getting depressed. I was frequently tired and wasn’t performing well at work. I had been disappointed by a person i was seeing. in addition, my supervisor reported me to the headquarters. When she gave me the news I was speechless When i returned home i realized I was clinically depressed.

d)How you are satisfied with your sex life, friends, family members, company etc.
I’m single and unmarried, therefore unsatisfied with sex life. I have a couple of friends but there was romantic involvement in the past. Relationship with family could be a lot better; I’m disappointed and some of them irritate me a lot.

5. Habits/Addiction.
a)Smoking, Alcohol, Sleeping pills, Laxative etc.
Smoking tobacco (yes) alcohol (no, only wine for pleasure), sleeping pills (yes), laxatives (yes)

b)Masturbation and frequency.
No

6. How is your Appetite and Thirst.
Appetite=good, (sometimes I need food to comfort me). Thirst= little (with food only). Normal during hot weather.

7. Likes and Dislikes.
a)Alcohol Bread Butter Bitter Salt Sweet Sour Fats Milk Mud Chalk Egg Spicy food Meat Fish Fruits Fried Food
Warm food-drink Cold food-drink Ice Ice cream Chocolates Tea Coffee.

I prefer salty food on the whole but I also like pastries, chocolate and cream.
I enjoy fish and meat (I love it smoked and dried) and fried food (but I am rather health and weight conscious).
I like food and drink to be hot or cold. I prefer hot in winter and cold in summer.
I can’t live without coffee (always hot); it wakes me up but I also love taste. I like chocolate around menses but I mainly enjoy potato chips.

b)Anything else about like and dislike of any activity with you or surrounding.
I don’t understand the question.

8. Bowel movements.
a)Nature of stool, frequency, satisfactory or not.
Formed (not same shape), never diarrhoea, constipated so stool once every 7/10 days depending on stress levels, satisfactory when I use laxatives. No particular colour except that I get mucous and gas.

b)Any discomforts associated with stool.
Feel better after stool, worse when constipated. Sometimes I think stool is due but nothing.

9. Urine.
a)Frequency, nature, volume.
Maybe 3 times a day, normal colour, quite scanty.

b)Any discomfort before, during or after urination/odour
Stomach ache if I don’t go after impulse is felt. Burning sensation when cysystis which lasts 2 days. Odour is quite strong but not overly.

11. For Females.
a)Menses, Regular, Irregular, Early, Late.
They started at 15 years of age. They are Early, every 18/25 days.

b)Duration of menses.
4 days (stops on 3rd day).on 4th day hardly any discharge

c)Nature of flow, Scanty, Blood colour, Consistency, Odour, Staining, itching/ when and what makes it worse/better.
Rather scanty, bright red, no clots, some itching, mastitis, leucchorrea after end of period. I feel worse more than a week before it is due. All my mental and physical symptoms are exaggerated; weeping, extra sensitiveness, irritability, hunger and sleepiness Depression is worse before and after, better on onset.

12. Sleep.
a)The quality of sleep, the quietness or restlessness of sleep, position of sleep, times of waking and reasons for waking,
need for cover over various parts of the body, whether the window must be open or closed etc. common dreams, peculiar sounds or gestures during sleep, etc.
Rather poor. Insomnia, change of position (mostly on left side), waking early at about 3pm , difficulty to fall asleep so eat, Cover all body, never head (no cover not even close), window closed in winter, open in summer.
Common dreams: losing my way and going from room to room or being ignored by people

13. Sweat
a)How much, what parts, staining, Odour.
sweat in cold and in hot weather, mainly head/face, armpits, back and feet. Staining yellow armpits. Some odour armpits and feet, acrid smell

14. Weather
a)Tolerance to heat and cold, dryness, humidity, weather changes, sun, foggy weather, cold wind drafts, closed rooms, etc.
I get headache in heat and in cold weather when humid. Sensitive to weather changes; it seems body can’t adapt. Dislike cold wind drafts, feels it goes through to bones. Can’t stand stuffy rooms, need fresh air.

15. Mental Status
a)The quality of the patient's life in relationship to loved ones, family, friends and colleagues. Overall quality of energy available to function in daily life, and under various circumstances.
I like being with people (if well) but I’m a person who likes to be alone too. I limit my social life to work because it involves teaching. I rarely go out. I would love to have a man in my life and friends.
I have little energy, am moody, and get stressed easily.
I want people to notice me (when I feel ok) me because I don’t want to feel invisible but when I feel down I’d like to be invisible, I feel like a worthless person. I sometimes hide away in my room if there are guests in the house.

b)Any mental/emotional shocks occurring in the patient's life-grief, major financial losses separation from loved ones, death, identity crisis and other stress in life.
Look above re: work experience.

c) Memory, ability to concentrate/comprehend.
I underwent electro convulsive therapy and memory has got worse. Short memory is ok. Need time to remember and understand what was read. Concentration is good.

d)Are you fearful of anything eg: Animals, people, being alone, darkness, death, disease, robbers, thunder, storm, high places.
Fear of people and remaining without air to breath. Fear of never healing, fear of remaining alone.

e)Are you anxious about anything: if yes, give details.
Already mentioned

f)Are you impatient.
Yes, because I’m judgemental of others and dislike waiting. I also have high expectations of people and myself.

g)Are you doubtful or suspicious.
Doubtful I will heal, sometimes suspicious of sincerity of people I know. If they are nice to me, I think that they feel pity for me and that makes me angry.

h)Are you hurt easily (emotionally) how do you react. Does it cause hatred/revenge.
Yes, often (more so before period). Sometimes I don’t say anything, other times I confront that person. Often I don’t know if I am right in an argument.
No, but I become distrustful

i)Does your pride get hurt easily.
Fairly. I need to be acknowledged, approved of, and respected by others.

j)Are you depressed, if so, reason/circumstances.
Yes, very. Already mentioned.

k)Do you like to share your problems.
Yes, I like others to ask how I am and what’s wrong. If they don’t I feel hurt and worthless. However when I’m very down, I don’t feel like talking. It’s as if I don’t have the energy to do it.
.
l)Effect of consolation.
Better if person is sincere and cares for me.

m)Do you ever become suicidal when? How.
Yes, before menses.

n)Memory- quality if poor, for what ( eg. Names, places, people, what you read).
Poor for names and what I read.

o)Do you weep easily, effect of weeping, ie, does it make you worse or better.
Sometimes, mostly before period. I feel worse!!!

p)Are you easily irritated. What makes you angry, how do you express it.
Yes, I am. I get angry when I am not capable of doing or obtaining what I want from myself or others. I don’t express it outwards. I just get depressed. Sometimes I feel like screaming but I’m too inhibited.

q)Are you destructive.
No.

r)How good are you in making decisions.
Not good at all. I take time and sometimes I make the wrong decisions. It depends on the situation really.

s)Do you like company or like to remain alone.
Yes, I do if I feel at ease with that person. I need my private space most of the time.

t)How seriously are you affected by disorder and uncleanness in your surroundings.
Dislike untidiness but not obsessed

u)How does failure appear to you?
It affects me badly because my level of self-esteem depends on what happens in my life.

v)Are there any matters that you deeply dislike?
Injustice, exploitment, and selfishness.

w)What activities you deeply like? How does it affect your mood?
Sleeping, watching tv, eating. Feel relaxed, no worries

x)Are you affectionate? How does others sorrow affect you?
Not really. Have difficulty showing I care, I’m reserved, cold (since on start of depression). Others sorrow affects me little because I’m self-centred and apathetic.

y)Any present fears in your life or future.
I won’t have a ‘normal’ life, I’ll be unsatisfied, won’t feel at ease with myself and others, not be able to love and be loved. I’m afraid that I will have to end my life if I’m not able to feel happy with myself. I can’t stand the thought of living my current life for much longer.

z)Any present life or future life desires.
I want to love and accept myself. I want to have lots of energy and be interested in people and activities etc.
Since this negative experience, I have felt the need to live my life fully. I’d rather live a short life but having lived a passionate life than a meaningless long life. I’ve wasted so many years being shy, insecure, depressed, and tired and I’ve had enough!
I wish to teach English in some far away country and then also travel around. I miss travelling, I miss interesting places and people. But I need to feel self confident, optimistic and self dependant.

16.Describe your face and tongue by doing FACIAL AND TONGUE DIAGNOSIS by visiting homeomzp.blogspot.com
See photos included.
As for tongue you will notice that it has crack down middle, it’s pale pink with a bit of white coating and there are teeth marks.
As for face, eyes are sunken, bluish/purple ecchymosis, swollen eyelids in mornings, delicate skin (slight pressure causes reddening), some moles etc.

17.For medical astrology tell your birth place, location, timing, date (dd/mm/yyyy format)
Zimbabwe (ex Rhodesia), Africa, Bulawayo, 8am, 26/07/1971.

If there’s something missing or incomplete, please let me know. I desperately need to feel less sleepy at least.
CASE PRESENTATION FOR CLASSICAL HOMOEOPATHIC PRESCRIBING

1. What are the issues in your life that bother you the most. Not physical issues but mental or emotional ones. List each one separately and describe why each one bothers you so much.

-Negative self image. I don’t like myself. It makes me feel very insecure and I tend to stay away from people.
- Feeling sleepy/ low energy. It makes me feel very frustrated because I end up napping if I have time to. I know exercising is beneficial but I rarely have enough energy to do it. And I have to study for my job. Instead I waste time napping or can’t concentrate.
-Inferiority complex. I feel inadequate so I feel worthless, like a piece of sh…. (excuse my language)
-Over sensitive. Rejection, criticism and trivial events affect my mood enormously.
-Self –conscious. I feel observed, judged and cannot be spontaneous. So I am very reserved
-Critical and judgemental. It makes me feel guilty, a bad person
-Feel guilty. I think over something I did or said I consider inappropriate and scold myself.
-Memory weakness. For my job I need to remember lots of things but I have difficulty.
- Shyness. I wish I were more extrovert and not quiet. I feel I have missed a lot of great opportunities in my life due to it (together with feeling inadequate).

2. What emotions are the most troublesome for you? What situations provoke these emotions. How do these emotions make you act? Do you feel any ill effects from expressing or not expressing these emotions.
-Sadness When i’m sad i am taciturn and want to be left alone, talking tires me, I feel tired and want to sleep to avoid thinking, because it makes me feel worse
-Pessimism I expect the worse to happen. When the school I work for calls me I’m afraid they are going to tell me I’m not good enough as a teacher.
-Feeling I don’t fit in or belong to this world, I’m different from ‘normal people’.
-Anxiety When I have to go to work i feel anxious. I worry about my performance. Mainly because I’m not exactly English mother-tongue, having lived in Italy for most of my life. Smoking helps me relieve the anxiety.
-Frustration I am frustrated because I’m not living the life I imagined I would. Sometimes being very upset causes a stomach-ache.
-Moodiness I’m more depressed before menses
-Irritability Trivial events (mainly when kept waiting if in a hurry) make me feel irritable and I can’t control it. I get rude sometimes.
-Worrying Trivial events make me worry. And the more i postpone, the worse I feel. I don’t get things done because I’m not in the mood for doing them or I’m too tired to get them done

3. What incidents in your life have had a deep impact on you? Describe each incident in detail and how they made you feel? What did you do in those situations? What effect have they had on your life?
My upbringing has affected me greatly and personality inherited from my parents.
My mother is a person who is very concerned with external judgement and is prone to criticizing, worrying, and making us children guilty. Nevertheless she believes she’s a good mother.
My father didn’t really want children in the first place. He loves pet animals more. His job took him away for months. He’s not a loving person and insensitive. I remember being jealous when he was affectionate with my mother. My parents believed in punishing us physically for trivial reasons.
The roots of my insecurity lie in my childhood and have conditioned my way of interacting with people and world.
It’s no wonder I’m a loner, I’m single, don’t have friends and don’t feel the need to have children (I feel guilty for this and sad). Obviously, I can’t blame my parents because that’s the way they are, but I am the result of their behaviour and mindset.
My family has moved to 3 countries since the age of 5. I’ve had to adapt to new cultures and new people. It has been very difficult due to my shyness. I’ve lived in Italy for 31 years but I feel I’m not Italian, I don’t have an identity. My mindset suits more a Northern European country though. Italians are family oriented, sociable but dishonest and careless of others except for family or friends. I give importance to justice, respect and honesty above all.
Once I will have normal moods and be self-confident, I will leave Italy, hopefully together with a life companion.

4. What are you afraid of? Especially important are phobias, but it might be objects, situations or events that just produce a high level of anxiety. How do you manage your fears? How do you react when confronted with these fears? What would be the worst situation for you to be put in that would provoke these fears? You may need to talk about each fear/anxiety separately.
The only thing I’m afraid of is not getting over depression and insecurity, that I’ll ever meet someone who completes me and that I’ll end up a spinster. I’d rather die!!!!!!

5. What hobbies do you have? Why do you like each of these activities?
I enjoy watching good films. They transport me to other places, and realities but above all I forget myself and can dream. I used to lo love travelling but I’ve lost interest in that. The same goes for dancing and reading.

6. Do you have any persistent thoughts, ideas or beliefs that are difficult to stop or cope with? What are they?
Everyday I say to myself how I hate my life and wonder what am I living for? And very often I wish I could die painlessly.

7. Do you have any unusual gestures or movements of the body? Do you feel any unusual sensation or pain throughout your body? What exactly does it feel like is happening in your body?
No, unfortunately nothing to speak of.

8. When you experience your fears, persistent thoughts, or difficult emotions, what kind of sensation or reactions do you get in your body?
When I am anxious or sad I sigh, bite my lips, or frown . When very upset, I get stomach ache.

9. When did you feel at your best in your life? What was that like for you? If you imagine the complete opposite of this feeling or moment, what would that be like?
I’m afraid to admit that I’ve never felt my best in life. When I used to travel for my job, I was partly happy, partly unhappy due to my difficulty relating to others. When I’m crazy about someone, I feel good.

10. Do you feel like you are stuck in a pattern of behavior, especially when trying to deal with your problems? What is this pattern? THIS IS AN IMPORTANT QUESTION PLEASE CONSIDER CAREFULLY AND GIVE DETAILS.
I tend to postpone. I should communicate my feelings more often but I tend to keep them to myself. I prefer not to burden people with my negativity unless it’s my therapist.
And, I am doubtful whether someone has treated me unfairly. I believe I am in the wrong.

11. What difficulties or problems do you have in relationships? Talk about your family, your romantic relationships, your spouse or partner, your friends, and your work colleagues. You may need to talk about all of these separately.
I don’t make friends but I am befriended. My low self-esteem and pessimism puts me off from making friends. Anyway I tend to not care much for people.
I feel disappointed by my family. I feel they could have given me more support. I am a functional person now but I’ve had episodes of major depression. I wasn’t able to work and was completely apathetic.
In my previous relationships, I’ve always found flaws in all of them. At the beginning I regard them as perfect but later, when I get to know them better I change my mind. I think that when I am disappointed, when I don’t feel as if I’m the centre of their universe, I feel hurt so I literally erase that person from my life!

12. List 5 positive things about yourself. Are there any situations where this positive attribute becomes negative (is a problem)?
That’s a tough one. When I’m in a good mood (it happens rarely) I have a sense of humour, I am determined, sweet natured, and thoughtful. I am a sincere person but I risk letting people know my limits (referring to my lifestyle or sadness). Determination can also become stubbornness.

13. List 5 negative things about yourself. Are there any situations where this negative attribute becomes positive (is useful)?
I am irritable, judgemental, critical and moody. Nothing positive

14. Do you have any reoccurring dreams? Describe them in detail, including any feelings that come while dreaming. Dreams are very important in unlocking the deepest truth of a patient’s case, but it is not enough to simply describe them in a sentence. Give as much information as you feel comfortable doing.
A recurrent dream is getting lost and not finding my way, or being excluded by people. I also often dream about escalators. There are often some of my family members in my dream: mother and sister. Or I’m on a cruise ship (I used to work on them). I feel upset (exclusion) and it takes some time to get over it.

15. Did you have any reoccurring dreams as a child, or earlier in your life? Describe those in detail including any feelings that came with them.
No, can’t remember.

16. What were you like as a child, your character, your personality, your fears, your dreams, your problems?
I was very quiet, played alone, didn’t search for my mother. But I was a happy child according to my mother. I remember taking the wrong bus when I was at kindergarten; I was so scared. Once when I was at school run by nuns, I was daydreaming. Suddenly the nun shouted out to me. I felt so embarrassed. I was afraid of storms or wild animals ( i was born in Africa).

17. What kind of environment did you grow up in? What problems where there at home, with your family, with your parents, with your siblings, with school?
I answered some of that above. My mum would get upset over trivial things, things that children usually do. I was responsible for my younger sister. At school in England boys used to make fun of me because I wore glasses. This hurt me a lot.
(Symptoms that don’t fit anywhere else, but are things that tend to affect all of you as a person, but are not emotions or thoughts)

1. Sleep - what position do you tend to sleep in? Mainly right side but also left, legs partially bent, hands next to neck
- what position can you not sleep in? On my stomach (mainly because I need a lot of air to breathe) or back
- do you do anything unusual in your sleep? No, except when I was ditched by a person I dated. For a while, during sleep I would move my arms, doing what I was dreaming of
- any problems with going to sleep, staying asleep, or waking up?
Yes, very much so. I have to take big dose of benzo to fall asleep. I usually wake up early morning. I need a strong coffee to wake me up.
2. Appetite - What foods do you crave/desire strongly?
I like Coffee
- What foods do you hate eating (have an aversion to)?
None
- What foods have a negative effect on you or cause symptoms? Raw garlic; it makes me nauseous
- What foods have a positive effect on you or seem to improve your health or symptoms in some way? None

- What is the effect of hunger or fasting on you? I feel weak

3. Thirst - What drinks do you crave/desire strongly? None a part from boiling hot coffee
- What drinks do you hate to take (are averse to)? None
- When are you most thirsty? Hot weather
- When are you least thirsty? Cold weather

4. Stool - Do you have any problems with your bowels or passing stool?
- What is the shape, color, odor of the stool?
Yes, anus is too dry. Sometimes irregular shaped balls due to dryness, sometimes, quite slim, normal length. Light to dark brown. No odor in particular.

5. Urine - Do you have any trouble passing or retaining urine? I get stomach ache if I retain
- What is the color, odor of the urine? Darker yellow in morning, then lighter. After coffee urine smells of it
- Do you have any sediment or debris in the urine? No but it stains underwear.

6. Sweat - How do you feel about the amount of perspiration you have? Excessive
- Where do you have the most sweat? Head, feet, arm pits and back
- What is the odor? Acrid
- What color does it stain clothing? Pale yellow on white clothing
- Does anything in particular cause you to sweat abnormally? The cold and when with people in an important event

7. Sexuality - Any problems with your sexual desire?
Little desire (some before menses)
- Any problems with your sexual ability or function? Vaginal dryness, difficult orgasms
- Any history of sexually transmitted diseases? No

8. Menses (Women)
- How many days is your cycle? From 18 to 25 days
- How many days does the flow go for? 4 days, but ceases on 3rd day. 4th day hardly anything. Not heavy periods
- What is the appearance of the flow? Normal red, a little black 4th day
- What is the odor of the flow? Nothing unusual
- What kind of stain does the flow leave? None
- Any discharge before, during or after? Spotting 2 days before
- Any pain before, during or after the flow? Before and during but mild.
- What symptoms come before the flow? Breasts swell, warmer, and painful.
- What symptoms come after the flow? Some leuchorrhea a few days after end

9. Environment – How does the weather affect you? Quite a lot. I have difficulty adapting to changes of temperature
- How does the temperature affect you? I dislike humidity, whether hot or cold. I can’t sunbathe because I feel weak and get headache or if prolonged, rash.
- How does the season affect you? I prefer sunshine
- What physical activities affect you? Vigorous exercise relaxes me
- Is there anything else in the environment you are sensitive to? No

10. Anything else you feel is important that hasn’t been covered by previous questions?
I’m over sensitive to pain. Unbelievable! Even a strong handshake is painful!
I faint when I feel pain from a cut in the finger.