Depression and Homoeopathy. – Dr. Sayeed Ahmad

Index

Depression
and Homœopathy (2/2).
Dr. Sayeed Ahmad D.
I. Hom. (London)

I.
– INTRODUCTION

Depression (psychology), mental illness in which a
person experiences deep, unshakable sadness and diminished interest in
nearly all activities. People also use the term depression to describe
the temporary sadness, loneliness, or blues that everyone feels from
time to time. In contrast to normal sadness, severe depression, also
called major depression, can dramatically impair a person’s ability to
function in social situations and at work. People with major depression
often have feelings of despair, hopelessness, and worthlessness, as well
as thoughts of committing suicide.

Depression can take several other forms. In bipolar
disorder, sometimes called manic-depressive illness, a person’s mood
swings back and forth between depression and mania. People with seasonal
affective disorder typically suffer from depression only during autumn
and winter, when there are fewer hours of daylight. In dysthymia people
feel depressed, have low self-esteem, and concentrate poorly most of the
time—often for a period of years—but their symptoms are milder than
in major depression. Some people with dysthymia experience occasional
episodes of major depression. Mental health professionals use the term
clinical depression to refer to any of the above forms of depression.

Surveys indicate that people commonly view depression
as a sign of personal weakness, but psychiatrists and psychologists view
it as a real illness.

II.

–
PREVALENCE

Depression is one of the most common mental
illnesses. At least 8 percent of adults in the United States experience
serious depression at some point during their lives, and estimates range
as high as 17 percent. The illness affects all people, regardless of
sex, race, ethnicity, or socioeconomic standing. However, women are two
to three times more likely than men to suffer from depression. Experts
disagree on the reason for this difference. Some cite differences in
hormones, and others point to the stress caused by society’s
expectations of women.

Depression occurs in all parts of the world, although
the pattern of symptoms can vary. The prevalence of depression in other
countries varies widely, from 1.5 percent of people in Taiwan to 19
percent of people in Lebanon.

A number of large-scale studies indicate that
depression rates have increased worldwide over the past several decades.
Furthermore, younger generations are experiencing depression at an
earlier age than did previous generations. Social scientists have
proposed many explanations, including changes in family structure,
urbanization, and reduced cultural and religious influences.

III.

–
SYMPTOMS

Although it may appear anytime from childhood to old
age, depression usually begins during a person’s 20s or 30s. The
illness may come on slowly, then deepen gradually over months or years.
On the other hand, it may erupt suddenly in a few weeks or days. A
person who develops severe depression may appear so confused,
frightened, and unbalanced that observers speak of a “nervous
breakdown.” However it begins, depression causes serious changes in
a person’s feelings and outlook. A person with major depression feels
sad nearly every day and may cry often. People, work, and activities
that used to bring them pleasure no longer do.

Symptoms of depression can vary by age. In younger
children, depression may include physical complaints, such as
stomachaches and headaches, as well as irritability, “moping
around,” social withdrawal, and changes in eating habits. They may
feel unenthusiastic about school and other activities. In adolescents,
common symptoms include sad mood, sleep disturbances, and lack of
energy. Elderly people with depression usually complain of physical
rather than emotional problems, which sometimes leads doctors to
misdiagnose the illness.

Symptoms of depression can also vary by culture. In
some cultures, depressed people may not experience sadness or guilt but
may complain of physical problems. In Mediterranean cultures, for
example, depressed people may complain of headaches or nerves. In Asian
cultures they may complain of weakness, fatigue, or imbalance.

If left untreated, an episode of major depression
typically lasts eight or nine months. About 85 percent of people who
experience one bout of depression will experience future episodes.

A. Appetite and Sleep Changes

Depression usually alters a person’s appetite,
sometimes increasing it, but usually reducing it. Sleep habits often
change as well. People with depression may oversleep or, more commonly,
sleep for fewer hours. A depressed person might go to sleep at midnight,
sleep restlessly, then wake up at 5 AM feeling tired and blue. For many
depressed people, early morning is the saddest time of the day.

B. Changes in Energy Level

Depression also changes one’s energy level. Some
depressed people may be restless and agitated, engaging in fidgety
movements and pacing. Others may feel sluggish and inactive,
experiencing great fatigue, lack of energy, and a feeling of being worn
out or carrying a heavy burden. Depressed people may also have
difficulty thinking, poor concentration, and problems with memory.

C. Poor Self-Esteem

People with depression often experience feelings of
worthlessness, helplessness, guilt, and self-blame. They may interpret a
minor failing on their part as a sign of incompetence or interpret minor
criticism as condemnation. Some depressed people complain of being
spiritually or morally dead. The mirror seems to reflect someone ugly
and repulsive. Even a competent and decent person may feel deficient,
cruel, stupid, phony, or guilty of having deceived others. People with
major depression may experience such extreme emotional pain that they
consider or attempt suicide. At least 15 percent of seriously depressed
people commit suicide, and many more attempt it.

D. Psychotic Symptoms

In some cases, people with depression may experience
psychotic symptoms, such as delusions (false beliefs) and hallucinations
(false sensory perceptions). Psychotic symptoms indicate an especially
severe illness. Compared to other depressed people, those with psychotic
symptoms have longer hospital stays, and after leaving, they are more
likely to be moody and unhappy. They are also more likely to commit
suicide.

IV.

–
CAUSES

Some depressions seem to come out of the blue, even
when things are going well. Others seem to have an obvious cause: a
marital conflict, financial difficulty, or some personal failure. Yet
many people with these problems do not become deeply depressed. Most
psychologists believe depression results from an interaction between
stressful life events and a person’s biological and psychological
vulnerabilities.

A. Biological Factors

Depression runs in families. By studying twins,
researchers have found evidence of a strong genetic influence in
depression. Genetically identical twins raised in the same environment
are three times more likely to have depression in common than fraternal
twins, who have only about half of their genes in common. In addition,
identical twins are five times more likely to have bipolar disorder in
common. These findings suggest that vulnerability to depression and
bipolar disorder can be inherited. Adoption studies have provided more
evidence of a genetic role in depression. These studies show that
children of depressed people are vulnerable to depression even when
raised by adoptive parents.

Genes may influence depression by causing abnormal
activity in the brain. Studies have shown that certain brain chemicals
called neurotransmitters play an important role in regulating moods and
emotions. Neurotransmitters involved in depression include
norepinephrine, dopamine, and serotonin. Research in the 1960s suggested
that depression results from lower than normal levels of these
neurotransmitters in parts of the brain. Support for this theory came
from the effects of antidepressant drugs, which work by increasing the
levels of neurotransmitters involved in depression. However, later
studies have discredited this simple explanation and have suggested a
more complex relationship between neurotransmitter levels and
depression.

An imbalance of hormones may also play a role in
depression. Many depressed people have higher than normal levels of
hydrocortisone (cortisol), a hormone secreted by the adrenal gland in
response to stress. In addition, an underactive or overactive thyroid
gland can lead to depression.

A variety of medical conditions can cause depression.
These include dietary deficiences in vitamin B6, vitamin B12, and folic
acid degenerative neurological disorders, such as Alzheimer’s disease
and Huntington’s disease ; strokes in the frontal part of the brain;
and certain viral infections, such as hepatitis and mononucleosis.
Certain medications, such as steroids, may also cause depression.

B. Psychological Factors

Psychological theories of depression focus on the way
people think and behave. In a 1917 essay, Austrian psychoanalyst Sigmund
Freud explained melancholia, or major depression, as a response to loss—either
real loss, such as the death of a spouse, or symbolic loss, such as the
failure to achieve an important goal. Freud believed that a person’s
unconscious anger over loss weakens the ego, resulting in self-hate and
self-destructive behavior.

Cognitive theories of depression emphasize the role
of irrational thought processes. American psychiatrist Aaron Beck
proposed that depressed people tend to view themselves, their
environment, and the future in a negative light because of errors in
thinking. These errors include focusing on the negative aspects of any
situation, misinterpreting facts in negative ways, and blaming
themselves for any misfortune. In Beck’s view, people learn these
self-defeating ways of looking at the world during early childhood. This
negative thinking makes situations seem much worse than they really are
and increases the risk of depression, especially in stressful
situations.

In support of this cognitive view, people with
“depressive”personality traits appear to be more vulnerable
than others to actual depression. Examples of depressive personality
traits include gloominess, pessimism, introversion, self-criticism,
excessive skepticism and criticism of others, deep feelings of
inadequacy, and excessive brooding and worrying. In addition, people who
regularly behave in dependent, hostile, and impulsive ways appear at
greater risk for depression.

American psychologist Martin Seligman proposed that
depression stems from “learned helplessness,” an acquired
belief that one cannot control the outcome of events. In this view,
prolonged exposure to uncontrollable and inescapable events leads to
apathy, pessimism, and loss of motivation. An adaptation of this theory
by American psychologist Lynn Abramson and her colleagues argues that
depression results not only from helplessness, but also from
hopelessness. The hopelessness theory attributes depression to a pattern
of negative thinking in which people blame themselves for negative life
events, view the causes of those events as permanent, and overgeneralize
specific weaknesses as applying to many areas of their life.

C. Stressful Events

Psychologists agree that stressful experiences can
trigger depression in people who are predisposed to the illness. For
example, the death of a loved one may trigger depression. Psychologists
usually distinguish true depression from grief, a normal process of
mourning a loved one who has died. Other stressful experiences may
include divorce, pregnancy, the loss of a job, and even childbirth.
About 20 percent of women experience an episode of depression, known as
postpartum depression, after having a baby. In addition, people with
serious physical illnesses or disabilities often develop depression.

People who experience child abuse appear more
vulnerable to depression than others. So, too, do people living under
chronically stressful conditions, such as single mothers with many
children and little or no support from friends or relatives.

V.

–
TREATMENT

Depression typically cannot be shaken or willed away.
An episode must therefore run its course until it weakens either on its
own or with treatment. Depression can be treated effectively with
antidepressant drugs, psychotherapy, or a combination of both.

Despite the availability of effective treatment, most
depressive disorders go untreated and undiagnosed. Studies indicate that
general physicians fail to recognize depression in their patients at
least half of the time. In addition, many doctors and patients view
depression in elderly people as a normal part of aging, even though
treatment for depression in older people is usually very effective.

A. Antidepressant Drugs

Up to 70 percent of people with depression respond to
antidepressant drugs. These medications appear to work by altering the
levels of serotonin, norepinephrine, and other neurotransmitters in the
brain. They generally take at least two to three weeks to become
effective. Doctors cannot predict which type of antidepressant drug will
work best for any particular person, so depressed people may need to try
several types. Antidepressant drugs are not addictive, but they may
produce unwanted side effects. To avoid relapse, people usually must
continue taking the medication for several months after their symptoms
improve.

Commonly used antidepressant drugs fall into three
major classes: tricyclics, monoamine oxidase inhibitors (MAO
inhibitors), and selective serotonin reuptake inhibitors (SSRIs).
Tricyclics, named for their three-ring chemical structure, include
amitriptyline (Elavil), imipramine (Tofanil), desipramine (Norpramin),
doxepin (Sinequan), and nortriptyline (Pamelor). Side effects of
tricyclics may include drowsiness, dizziness upon standing, blurred
vision, nausea, insomnia, constipation, and dry mouth.

MAO inhibitors include isocarboxazid (Marplan),
phenelzine (Nardil), and tranylcypromine (Parmate). People who take MAO
inhibitors must follow a diet that excludes tyramine—a substance found
in wine, beer, some cheeses, and many fermented foods—to avoid a
dangerous rise in blood pressure. In addition, MAO inhibitors have many
of the same side effects as tricyclics.

Selective serotonin reuptake inhibitors include
fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). These
drugs generally produce fewer and milder side effects than do other
types of antidepressants, although SSRIs may cause anxiety, insomnia,
drowsiness, headaches, and sexual dysfunction. Some patients have
alleged that Prozac causes violent or suicidal behavior in a small
number of cases, but the U. S. Food and Drug Administration has failed
to substantiate this claim.

Prozac became the most widely used antidepressant in
the world soon after its introduction in the late 1980s by drug
manufacturer Eli Lilly and Company. Many people find Prozac extremely
effective in lifting depression. In addition, some people have reported
that Prozac actually tranforms their personality by increasing their
self-confidence, optimism, and energy level. However, mental health
professionals have expressed serious ethical concerns over Prozac’s
use as a “personality enhancer,” especially among people
without clinical depression.

Doctors often prescribe lithium carbonate, a natural
mineral salt, to treat people with bipolar disorder. People often take
lithium during periods of relatively normal mood to delay or even
prevent subsequent mood swings. Side effects of lithium include nausea,
stomach upset, vertigo, and frequent urination.

B. Psychotherapy

Studies have shown that short-term psychotherapy can
relieve mild to moderate depression as effectively as antidepressant
drugs. Unlike medication, psychotherapy produces no physiological side
effects. In addition, depressed people treated with psychotherapy appear
less likely to experience a relapse than those treated only with
antidepressant medication. However, psychotherapy usually takes longer
to produce benefits.

There are many kinds of psychotherapy.
Cognitive-behavioral therapy assumes that depression stems from
negative, often irrational thinking about oneself and one’s future. In
this type of therapy, a person learns to understand and eventually
eliminate those habits of negative thinking. In interpersonal therapy,
the therapist helps a person resolve problems in relationships with
others that may have caused the depression. The subsequent improvement
in social relationships and support helps alleviate the depression.
Psychodynamic therapy views depression as the result of internal,
unconscious conflicts. Psychodynamic therapists focus on a person’s
past experiences and the resolution of childhood conflicts.
Psychoanalysis is an example of this type of therapy. Critics of
long-term psychodynamic therapy argue that its effectiveness is
scientifically unproven.

C. Other Treatments

Electroconvulsive therapy (ECT) can often relieve
severe depression in people who fail to respond to antidepressant
medication and psychotherapy. In this type of therapy, a low-voltage
electric current is passed through the brain for one to two seconds to
produce a controlled seizure. Patients usually receive six to ten ECT
treatments over several weeks. ECT remains controversial because it can
cause disorientation and memory loss. Nevertheless, research has found
it highly effective in alleviating severe depression.

For milder cases of depression, regular ærobic
exercise may improve mood as effectively as psychotherapy or medication.
In addition, some research indicates that dietary modifications can
influence one’s mood by changing the level of serotonin in the brain.

HOMŒOPATHIC TREATMENT

Arsenicum album

:
Anxious, insecure, and perfectionistic people who need this remedy may
set high standards for themselves and others and become depressed if
their expectations are not met. Worry about material security sometimes
borders on despair. When feeling ill, these people can be demanding and
dependent, even suspicious of others, fearing their condition could be
serious.

Aurum metallicum:

This remedy can be helpful to serious people, strongly focused on work
and achievement, who become depressed if they feel they have failed in
some way. Discouragement, self-reproach, humiliation, and anger can lead
to feelings of emptiness and worthlessness. The person may feel worse at
night, with nightmares or insomnia.

Calcarea carbonica:

A dependable, industrious person who becomes overwhelmed from too much
worry, work, or physical illness may benefit from this remedy. Anxiety,
fatigue, confusion, discouragement, self-pity, and a dread of disaster
may develop. A person who needs this remedy often feels chilly and
sluggish and easily tires on exertion.

Causticum:

A person
who feels depressed because of grief and loss (either recent or over
time) may benefit from this remedy. Frequent crying or a feeling of
mental dullness and forgetfulness (with anxious checking to see if the
door is locked, if the stove is off, etc.) are other indications. People
who need this remedy are often deeply sympathetic toward others and,
having a strong sense of justice, can be deeply discouraged or angry
about the world.

Cimicifuga:

A person
who needs this remedy can be energetic and talkative when feeling well,
but upset and gloomy when depressed—with exaggerated fears (of
insanity, of being attacked, of disaster). Painful menstrual periods and
headaches that involve the neck are often seen when this remedy is
needed.

Ignatia amara:

Sensitive people who suffer grief or disappointment and try to keep the
hurt inside may benefit from this remedy. Wanting not to cry or appear
too vulnerable to others, they may seem guarded, defensive, and moody.
They may also burst out laughing, or into tears, for no apparent reason.
A feeling of a lump in the throat and heaviness in the chest with
frequent sighing or yawning are strong indications for Ignatia. Insomnia
(or excessive sleeping), headaches, and cramping pains in the abdomen
and back are also often seen.

Kali phosphoricum:

If a person feels depressed after working too hard, being physically
ill, or going through prolonged emotional stress or excitement, this
remedy can be helpful. Exhausted, nervous, and jumpy, they may have
difficulty working or concentrating—and become discouraged and lose
confidence. Headaches from mental effort, easy perspiration, sensitivity
to cold, anemia, insomnia, and indigestion are often seen when this
remedy is needed.

Natrum carbonicum:

Individuals who need this remedy are usually mild, gentle, and selfless—making
an effort to be cheerful and helpful, and avoiding conflict whenever
possible. After being hurt or disappointed, they can become depressed,
but keep their feelings to themselves. Even when feeling lonely, they
withdraw to rest or listen to sad music, which can isolate them even
more. Nervous and physically sensitive (to sun, to weather changes, and
to many foods, especially milk), they may also get depressed when
feeling weak or ill.

Natrum muriaticum:

People
who need this remedy seem reserved, responsible, and private—yet have
strong inner feelings (grief, romantic attachment, anger, or fear of
misfortune) that they rarely show. Even though they want other people to
feel for them, they can act affronted or angry if someone tries to
console them, and need to be alone to cry. Anxiety, brooding about past
grievances, migraines, back pain, and insomnia can also be experienced
when the person is depressed. A craving for salt and tiredness from sun
exposure are other indications for this remedy.

Pulsatilla:

People
who needs this remedy have a childlike softness and sensitivity—and
can also be whiny, jealous, and moody. When depressed, they are sad and
tearful, wanting a lot of attention and comforting. Crying, fresh air,
and gentle exercise usually improve their mood. Getting too warm or
being in a stuffy room can increase anxiety. Depression around the time
of hormonal changes (puberty, menstrual periods, or menopause) can often
be helped with Pulsatilla.

Sepia:

People who
feel weary, irritable, and indifferent to family members, and worn out
by the demands of everyday life may respond to this remedy. They want to
be left alone and may respond in an angry or cutting way if anyone
bothers them. They often feel better from crying, but would rather have
others keep their distance and not try to console them or cheer them up.
Menstrual problems, a sagging feeling in internal organs, sluggish
digestion, and improvement from vigorous exercise are other indications
for this remedy.

Staphysagria:

Quiet,
sensitive, emotional people who have difficulty standing up for
themselves may benefit from this remedy. Hurt feelings, shame,
resentment, and suppressed emotions can lead them to depression. If
under too much pressure, they can sometimes lose their natural
inhibition and fly into rages or throw things. A person who needs this
remedy may also have insomnia (feeling sleepy all day, but unable to
sleep at night), toothaches, headaches, stomachaches, or bladder
infections that are stress-related.

Note:

Any
information given in this Article is not intended to be taken as a
replacement for medical advice. Any person with condition requiring
medical attention should consult a well qualified classical homœopath.

Reference

: Dr. D. B.
Cohen (MS Encarata Encyclopedia 2002)

Copyright © Dr. Sayeed Ahmad
2004

Index