Consult with neurologist. Better management - have any other person of the very old and very lonely patient? Blood pressure? Blood, urine LAB TEST ESSENTIAL.
Dear Dr. Anu Parmar, Advice for the case. Advice Sarswatarista. Tab. Smruti Sagar Ras.
Walnuts blue berries sunshine ginger lime juice orange lemon lemongrass decoction carrots sprouts pomegranates kalijeeri green leafy vegetables cold pressed coconut oil massage and in naval make him forget stress
रोगी स्मृति भ्रंस से पीड़ित है। चिकित्सा संबंधी योग,,, तगर 50 ग्राम जटामांसी 25 ग्राम लेकर दोनों का पाउडर बनाकर 5 ग्राम सुबह-शाम खाने से पहले दें। बृहमी वटी स्वर्ण युक्त 2 वटी सुबह शाम जल से सेवन कराएं।
Anacardium is a therapeutic remedy but the patient need some constitutional remedy or before this we should know the cause or the onset.
Brahmi Vati Jatamansyadi Kwath Shankh Pushpi Syrup Yogasanas Pranayamas and Meditation Under Guidance Of Yogacharya.
pitta dushti. treat with virechana to clear the excess pitta. then shirodhara should be followed.
Smriti sagar ras Saraswataristham with gold Ashvganda churan
Any trauma?? Suggest normal exercise Majun ood solab
Natrum Mur 1 M single dose Anacardium 30 TDs
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What is your opinion of doing bilateral salpingo Oophorectomy at the time of hysterectomy. Coz patients are of the opinion that if they undergo Tubectomy,they will land with a BIGGER operation that is hysterectomy.therefore some people come asking to do a hysterectomy after child bearing. If only hysterectomy is done when indicated and later if they require laparotomy for ovarian cyst /tumour,patients question "why you didn't remove these appendages earlier. One patient had hysterectomy,followed by laparotomy again for an ovarian cyst,later another cyst on other side -third surgery .she again developed cystic mass in the pelvis for which she had fourth surgery . Though we leave ovaries ,their function gradually comes down after hysterectomy and they have PMS and osteoporosis. When I have to do a hysterectomy ,I remove the appendages if she is above 40 years and retain them if she is young. What are your opinionsDr. Suvarchala Pratap10 Likes18 Answers
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ALZHEIMER'S DISEASE:: This is a chronic neuro-degenerative disease that usually starts slowly and worsens over time.It is the cause of 60-70% cases of dementia,The most common early symptom is difficulty in remembering recent events(short term memory loss),mood swings,loss of motivation,not managing the self-care, and behavioral issues.As a person's conditon declines,they often withdraw from family and the society.Gradually bodily functions are lost and ultimately leading to the death.Although the speed of progression can vary,the average life expectancy following diagnosis is 3-9 years.The causes are poorly understood.About 70% of the risk is believed to be the genetic with any genes involved.Other risk factors are head-injury,depression or hypertension.No treatment stops or reverses its progression,though some may temperorily improve the symptoms.Medicolegal imprtance lies in the fact that whether the will made by them or signed by them is valid or not.The will made before the conditon worsens may be valid if the condition is certified by a panel of medical board consisting of neurophysician,psychiatrists and psychologist who are prolonged interrogation decide the memory loss etc.Dr. Suryakant Bheda2 Likes5 Answers
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*Alzheimer’s disease* ☝ *Today about* ☝is a progressive disease that destroys memory and other important mental functions. At first, someone with Alzheimer’s disease may notice mild confusion and difficulty remembering. Eventually, people with the disease may even forget important people in their lives and undergo dramatic personality changes. Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. Changes in the Brain Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimer’s disease. It seems likely that damage to the brainstarts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain. Cross sections of the brain show atrophy or shrinking of brain tissue caused by Alzheimer’s disease. Abnormal deposits of proteins form amyloid plaques and tau tangles throughout the brain, and once-healthy neurons stop functioning, lose connections with other neurons, and die. The damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As more neurons die, additional parts of the brain are affected, and they begin to shrink. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly. Stages of Alzheimer’s disease Stage 1: Normal Outward Behavior When one individual is in this early phase, he won’t have any symptoms that can be spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether he’s got Alzheimer’s. As he moves into the next 6 stages, patient with Alzheimer’s will see more and more changes in his thinking and reasoning. Stage 2: Very Mild Changes You still might not notice anything amiss in your loved one’s behavior, but he may be picking up on small differences, things that even a doctor doesn’t catch. This could include forgetting a word or misplacing objects. At this stage, subtle symptoms of Alzheimer’s don’t interfere with his ability to work or live independently. Keep in mind that these symptoms might not be Alzheimer’s at all, but simply normal changes from aging. Stage 3: Mild Decline It’s at this point that you start to notice changes in your loved one’s thinking and reasoning, such as: Forgets something he just read Asks the same question over and over Has more and more trouble making plans or organizing Can’t remember names when meeting new people You can help by being your loved one’s “memory” for him, making sure he pays bills and gets to appointments on time. You can also suggest he ease stress by retiring from work and putting his legal and financial affairs in order. Stage 4: Moderate Decline During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your friend or family member might: Forget details about himself Have trouble putting the right date and amount on a check Forget what month or season it is Have trouble cooking meals or even ordering from a menu You can help with everyday chores and his safety. Make sure he isn’t driving anymore, and that someone isn’t trying to take advantage of him financially. Stage 5: Moderately Severe Decline Your loved one might start to lose track of where he is and what time it is. He might have trouble remembering his address, phone number, or where he went to school. He could get confused about what kind of clothes to wear for the day or season. You can help by laying out his clothing in the morning. It can help him dress by himself and keep a sense of independence. If he repeats the same question, answer with an even, reassuring voice. He might be asking the question less to get an answer and more to just know you’re there. Even if your loved one can’t remember facts and details, he might still be able to tell a story. Invite him to use his imagination at those times. Stage 6: Severe Decline As Alzheimer’s progresses, your loved one might recognize faces but forget names. He might also mistake a person for someone else, for instance, thinking his wife is his mother. Delusions might a set in, such as thinking he needs to go to work even though he no longer has a job. You might need to help him go to the bathroom. It might be hard to talk, but you can still connect with him through the senses. Many people with Alzheimer’s love hearing music, being read to, or looking over old photos. Stage 7: Very Severe Decline Many basic abilities in a person with Alzheimer’s, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping him use a spoon, and making sure he drinks. This is important, as many people at this stage can no longer tell when they’re thirsty. History about Alzheimer’s disease Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles). These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Epidemiology of Alzheimer’s in worldwide Someone in the world develops dementia every 3 seconds. There were an estimated 46.8 million people worldwide living with dementia in 2015 and this number is believed to be close to 50 million people in 2017. This number will almost double every 20 years, reaching 75 million in 2030 and 131.5 million in 2050. Much of the increase will be in developing countries. Already 58% of people with dementia live in low and middle income countries, but by 2050 this will rise to 68%. The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours. There are over 9.9 million new cases of dementia each year worldwide, implying one new case every 3.2 seconds. Risk factors Age: Increasing age is the greatest known risk factor for Alzheimer’s. Alzheimer’s is not a part of normal aging, but your risk increases greatly after you reach age 65. The rate of dementia doubles every decade after age 60. Family history and genetics: Your risk of developing Alzheimer’s appears to be somewhat higher if a first-degree relative your parent or sibling has the disease. Scientists have identified rare changes (mutations) in three genes that virtually guarantee a person who inherits them will develop Alzheimer’s. But these mutations account for less than 5 percent of Alzheimer’s disease. Down syndrome: A gene contained in the extra chromosome that causes Down syndrome significantly increases the risk of Alzheimer’s disease. Sex: Women seem to be more likely than are men to develop Alzheimer’s disease, in part because they live longer. Mild cognitive impairment: Those with MCI have an increased risk but not a certainty of later developing dementia. Taking action to develop a healthy lifestyle and strategies to compensate for memory loss at this stage may help delay or prevent the progression to dementia. Past head trauma: People who’ve had a severe head trauma seem to have a greater risk of Alzheimer’s disease. Lifestyle and heart health: There’s no lifestyle factor that’s been definitively shown to reduce your risk of Alzheimer’s disease. However, some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include: Lack of exercise Obesity Smoking or exposure to secondhand smoke High blood pressure High blood cholesterol Poorly controlled type 2 diabetes A diet lacking in fruits and vegetables These risk factors are also linked to vascular dementia, a type of dementia caused by damaged blood vessels in the brain. Working with your health care team on a plan to control these factors will help protect your heart and may also help reduce your risk of Alzheimer’s disease and vascular dementia. Lifelong learning and social engagement: Studies have found an association between lifelong involvement in mentally and socially stimulating activities and a reduced risk of Alzheimer’s disease. Low education levels which is less than a high school education is appear to be a risk factor for Alzheimer’s disease. What Causes Alzheimer’s? Scientists don’t yet fully understand what causes Alzheimer’s disease in most people. In people with early-onset Alzheimer’s, a genetic mutation is usually the cause. Late-onset Alzheimer’s arises from a complex series of brain changes that occur over decades. The causes probably include a combination of genetic, environmental, and lifestyle factors. The importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer’s may differ from person to person. Signs and Symptoms Memory loss Repeat statements and questions over and over, not realizing that they’ve asked the question before Forget conversations, appointments or events, and not remember them later Routinely misplace possessions, often putting them in illogical locations Get lost in familiar places Eventually forget the names of family members and everyday objects Have trouble finding the right words to identify objects, express thoughts or take part in conversations Thinking and reasoning It causes difficulty in concentrating and thinking Difficulty in multi-tasking such as to manage finances, checkbooks and pay bills on time. Making judgments and decisions Responding effectively to everyday problems, such as food burning on the stove or unexpected driving situations, becomes increasingly challenging. Planning and performing familiar tasks Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer’s may forget how to perform basic tasks such as dressing and bathing. Changes in personality and behavior Brain changes that occur in Alzheimer’s disease can affect the way you act and how you feel. People with Alzheimer’s may experience: Depression Apathy Social withdrawal Mood swings Distrust in others Irritability and aggressiveness Changes in sleeping habits Wandering Loss of inhibitions Delusions, such as believing something has been stolen Diagnosis and Testing To distinguish Alzheimer’s disease from other causes of memory loss, doctors now typically rely on the following types of tests. Physical and neurological exam Reflexes Muscle tone and strength Ability to get up from a chair and walk across the room Sense of sight and hearing Coordination Balance Lab tests Blood tests may help your doctor rule out other potential causes of memory loss and confusion, such as thyroid disorders or vitamin deficiencies. Mental status and neuropsychological testing Your doctor may conduct a brief mental status test to assess your memory and other thinking skills. In addition, your doctor may suggest a more extensive assessment of your thinking and memory. Brain imaging Brain-imaging technologies include: Magnetic resonance imaging (MRI). Computerized tomography (CT). Positron emission tomography (PET). Cerebrospinal fluid examination Future diagnostic tests New tools under investigation include: Additional approaches to brain imaging More-sensitive tests of mental abilities Measurement of key proteins or protein patterns in blood or spinal fluid (biomarkers) Treatment and medications Treatment for AD affected individual includes: Maintaining Mental Function Managing Behavior Caring for a person with Alzheimer’s disease Medications for AD persons includes the following: Drugs to treat problems with mood, depression, and irritability includes citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). For people who have anxiety or restlessness, medicines includes alprazolam (Niravam, Xanax), buspirone (BuSpar), lorazepam (Ativan) and oxazepam (Serax). To ease confusion, aggression, agitation or hallucinations (seeing, hearing, or feeling things that aren’t there) options include aripiprazole (Abilify), haloperidol (Haldol), and olanzapine (Zyprexa). FDA-approved drugs The U.S. Food and Drug Administration (FDA) has approved five medications (listed below) to treat the symptoms of Alzheimer’s disease. Drug name Brand name Approved For FDA Approved Donepezil Aricept All stages 1996 Galantamine Razadyne Mild to moderate 2001 Memantine Namenda Moderate to severe 2003 Rivastigmine Exelon All stages 2000 Donepezil and Memantine Namzaric Moderate to severe 2014 Prevention of AD Consumption of fruit and vegetable juices was associated with decreased incidence of Alzheimer’s over seven to nine years of follow-up. Berries contain high levels of biologically active components, including a class of compounds called anthocyanosides, which fight memory impairment associated with free radicals and beta-amyloid plaques in the brain. Eat berries each day for maximum benefit. Levels of docosahexaenoic acid (DHA) found in fatty fish like salmon, mackerel, and tuna, measured at baseline had lower rates of Alzheimer’s over nine years of follow-up. These fish are all rich in omega-3 fatty acids. Take folic acid supplements Drink a glass of red wine or purple grape juice with your evening meal. Components in grape skins protect brain cells from the toxic effect of oxidative stress and beta amyloid Control your blood pressure Adherent to the Mediterranean style diet had a lower incidence of Alzheimer’s, compared with those who did not follow this diet.Dr. Shailendra Kawtikwar4 Likes4 Answers
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Good piece of information - my future ,..... mid life crisis n then dementia Depression Midlife crisis 1/21 . Midlife Can Make You Miserable Feel like middle age is closing in on you? You're not alone. A 2008 study of data from 2 million people found that midlife depression spans the globe. In the U.S., it peaks at around age 40 for women and 50 for men, and usually starts to lift in the 50s. Why? People may learn to adapt to their strengths and weaknesses and value life more, the researchers say. 2/21 Depression Trigger: Overload Squeezed between the demands of children, aging parents, marriage, and your job? Feeling sad, worthless, and guilty? Women tend to shoulder more of the "sandwich generation" burdens -- and up to half become depressed as a result. Solution: Make sure you're caring for yourself, too. Exercise, get enough rest, eat healthy, see friends, and get help -- for care giving demands and depression -- if you need it. 3/21 Trigger: Low Vitamin B12 If you're feeling lethargic or depressed, too little vitamin B12 may be to blame. If you're older, you're more at risk for the B12 blues because you may not have enough stomach acid to release B12 from food. Solution: Ask your doctor to measure levels of B12 in your blood. If it's low, talk to your doctor about diet, oral supplements, or an injection to see what might be right for you. 4/21 Trigger: Changes in Sex Drive As men age, their bodies produce less of the important sex hormone testosterone. Low testosterone levels can cause depression, as well as erectile dysfunction (ED) -- trouble getting or keeping an erection -- and a decreased interest in sex. Solutions: Ask your doctor to test the levels of testosterone in your blood. If it is low, ask your doctor about replacement therapy and other treatment options. 5/21 Trigger: Thyroid Disorders Depression can be one symptom of an underactive or occasionally overactive thyroid. And if you are older, it may be the only symptom. Or it may appear with a subtle symptom. In the case of overactive thyroid, it could be accompanied by heart flutters, tremors, or fatigue. An underactive thyroid can cause constipation or fatigue. That's why this very treatable problem is often mistaken for bowel or nervous system disorders in older people. Solution: See your doctor, especially if a close relative has thyroid disease. 6/21 Trigger: Achy Joints Living with a condition that causes chronic pain, such as rheumatoid arthritis or osteoarthritis, increases the chance of having depression. In fact, people with chronic pain are three times as likely to have depression or an anxiety disorder. And depression can make pain worse. Solution: Exercise, meditate, or listen to music. An hour of classical music a day has been shown to ease arthritis pain anddepression. If the depression or pain doesn't lift, talk to your doctor. 7/21 Trigger: Perimenopause and Menopause Hormone fluctuations, hot flashes, and life changes related to perimenopause and menopause can make your mood plummet. If you have trouble sleeping, a history of depression, or PMS, mood swings or depression may worsen during this transitional period. Solutions: For mild depression, try self-calming skills such as yoga or deep breathing. Do things that make you feel better, such as exercise or going out with friends, or find a creative outlet. For more serious, long-lasting symptoms of depression, prescription medication or talk therapy can help. 8/21 Trigger: The Empty Nest If your child has left home, an "empty nest" can make you feel empty. Going through menopause or retirement at the same time may make it harder. Solutions: Try to see it as an opportunity. Reconnect with your spouse, other family members, and friends. Pursue hobbies and interests you didn't have time for before. Give yourself time to adjust. If your mood doesn't lift in a few months, talk to your doctor. 9/21 Trigger: Type 2 Diabetes Do you feel too listless to check your blood sugar regularly? Are unpredictable blood sugar levels making you feel out of control? Depression is a common and dangerous complication of many chronic conditions, including diabetes. Depression also may keep you from taking good care of your diabetes. Solution: Talk to your doctor if you've been depressed for more than two weeks. Talk therapy, medication, and better diabetes control can help you manage both conditions. Depression is serious and if left untreated can be life threatening. 10/21 Trigger: Drinking About 1 in 4 older people who drink heavily has major depression. Some older people start drinking more because of stressful events, such as retirement or a spouse's death. Yet alcohol problems are often mistaken for other age-related issues. Solutions: A combination of medications can treat both alcohol dependence and depression. Individual or group therapy can also help deal with issues that may trigger drinking. 11/21 Trigger: Poor Sleep Insomnia and other sleep disruptions, which are common as we age, are closely related to depression. Insomnia can be a sign that you are depressed, and if you have insomnia but aren’t depressed, you’re at higher risk of developing mood changes. Obstructive sleep apnea and restless legs syndrome also have been linked to depression. Solutions: Talk to your doctor about possible reasons for your sleep problems and get treatment for them. Learn good sleep hygiene habits, such as regular bedtime hours. Exercise early regularly and avoid caffeine, alcohol, or nicotine, which interfere with sleep. Prescription medication may also help. 12/21 Trigger: Retirement If you were forced into retirement -- because of poor health or other reasons -- you might very well be depressed. Factors such as financial insecurity or lack of social support can also make retirement a downer. Solutions: Busy retirees tend to be happier retirees. Learn new skills, take classes, get exercise. Be flexible: For example, if your health makes activities like travel difficult, take in museums and foreign films. 13/21 Trigger: Heart Problems It's common to feel depressed after a diagnosis of heart disease or having a heart attack or cardiac surgery. But many people with heart disease go on to experience severe, long-term depression. And that can worsen heart health. Solutions: A healthy diet and sleep, mild exercise, relaxation techniques, and joining a support group can help you get through the blues. If depression lasts, antidepressants or talk therapy can help. 14/21 Trigger: Blood Pressure Pills Could the drugs you take for high blood pressure or other health problems also be bringing you down? Some blood pressure medicines -- as well as certain antibiotics, antiarrhythmics, acne products, and steroids, among other drugs -- may be associated with depression or other mood changes. Solutions: Be sure to ask your doctor if any new medications you may be taking could be linked with changes in mood. If it is, you may be able to switch to another drug. 15/21 Trigger: Loneliness Social support can help prevent or ease depression. But some kinds of social support may be better than others. A study of people in a retirement community found that those who stayed connected with friends living elsewhere had less depression. Support from within the community didn't affect mood. Solution: Maintain ties with close friends and family members. Explore Internet technology that can give you virtual face-time with distant friends. 16/21 Health Hurdles Any chronic or serious condition -- such as Parkinson's disease or a stroke -- can lead to depression. A stroke can also affect the areas of the brain that control mood. Solution: Be realistic but positive. Learn how to cope with physical effects of your illness. Don't let them get in the way of taking care of yourself and having fun. If you have symptoms of depression, don't wait -- get help right away. 17/21 Trigger: Senior Moments Feeling foggy and forgetful? It could be depression or dementia, a condition marked by memory loss. The signs and symptoms can be similar. Or it could be both -- depression is more common in older people who have dementia, especially Alzheimer's. Solutions: If you don't know what's causing your symptoms, see your doctor so you can get the right treatment, if necessary. 18/21 Trigger: Grief It's normal to grieve after losing a spouse or other loved one. But grief can grow into depression. Memory problems, confusion, and social withdrawal can be symptoms of depression in older people. Both grief and depression raise the risk for heart-related deaths. Solutions: Let yourself grieve. Express your feelings to friends, in a support group, or to a grief counselor. For depression, medication and talk therapy can help. 19/21 Any-Age Mood Booster: Pets To keep your mood up, it helps to have good emotional and social support. But who says social support needs to be human? Studies show that pets can help people have less depression and loneliness and more self-esteem and happiness. Pets are friends with other benefits, too. Walking a dog, for example, is good exercise and a great way to meet people. 20/21 Any-Age Mood Booster: Laughter A good laugh can relax muscles, reduce stress, and relieve pain. And research suggests that a good sense of humor can take the bite out of depression. For humor on demand, create a laugh library of funny books, cartoons, and DVDs. Or try laughter yoga, which uses playful activities and breathing exercises to provoke giggles. 21/21 Any-Age Mood Booster: Volunteer Helping others can help you forget your own problems. Volunteering feels good at any age, but it may hold special benefits for older people. If retirement has you adrift, for example, it can give your life a new sense of purpose and satisfaction. Recent research suggests that it may even prevent frailty in older people. Find a cause that has special importance to you and get involved. Reviewed by 22/22 That’s where ketamine comes in. Among those with treatment-resistant depression, an estimated 50% respond to ketamine, says psychiatrist and researcher Carlos Zarate Jr., MD, chief of the Experimental Therapeutics and Pathophysiology Branch of the National Institute of Mental Health.Dr. Vinod Kumar Goyal2 Likes3 Answers
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Friends today I am discusing about depression, stress and fear . We at Kamla Clinic Railway Road Pathankot treat all chronic problems with holistic medicines without any side effect. Visit or book ur appoint ment by call or whatsapp @ 9463311100. Five to ten per cent of patients visiting their GP will be suffering from “clinical” or “major” depression. This means that as a GP, two to three of the patients I see in a normal working day will be experiencing debilitating and disabling symptoms of feeling down, depressed or hopeless and will have little interest or pleasure in doing things. Too many people still think that depression is “all in the mind” and there is a great deal of guilt felt by sufferers that they cannot just snap out of it. Having a “nervous breakdown” still carries a stigma, especially if symptoms are severe enough to need a hospital admission or referral to a psychiatrist. I spend a great deal of my professional life reassuring people that they are not going mad and their symptoms do have a rational explanation. As well as clinical depression, where symptoms are severe enough to affect day to day living, 15 to 30 per cent of my patients will have depressive symptoms but still manage to continue with work or home life without serious problems. This situation is referred to as “subthreshold” or “mild” depression, depending on the severity and number of symptoms. This is probably the largest group of patients with a psychological problem that I see in my surgery every day. People come with a variety of complaints, including a feeling of persistent fatigue, lack of appetite or excess appetite resulting in comfort eating, not being able to look forward to enjoyable events such as holidays or family celebrations, poor sleep, feelings of anxiety and low selfesteem, guilt for “not really being ill”, feelings of not coping, lack of interest in activities or relationships, loss of sex drive and generally feeling cut off from the world. Whilst most of us can experience all of these feelings at some time to a greater or lesser extent, it is when they last for weeks on end that we start to feel unwell and out of balance. It is in these circumstances that the body starts to need a little help to recover. The good mood hormone What causes depression? Most people know that our brain produces a “good mood” hormone called serotonin. If we do not produce enough of it or it gets broken down too quickly, then a low mood results. Quite what triggers off this chemical imbalance is the subject of hot debate by scientists, but its results are only too clear to sufferers of this common condition. There may be an inherited element to depression, possibly a genetic factor but scientists are unsure whether depression is due to nature or nurture. I suspect it is a mixture of both. Certainly I come across some people whose brains permanently seem to produce low levels of good mood hormone, meaning they always feel somewhat under par mentally. Treatment In the past, people with symptoms of depression or anxiety were often treated with tranquillizers, or benzodiazepines like diazepam (Valium). This is because depression is really a mixture of feeling low combined with symptoms of anxiety. The latter can range from waking up with a sinking feeling or butterflies in the stomach or panic attacks to full blown physical symptoms of acid indigestion, problems with swallowing, diarrhoea, a feeling of tightness in the throat, difficulty breathing, weight loss, and a sureness that “something serious is wrong with me”. Although tranquillizers may still be used by the medical profession if symptoms of anxiety are very severe, they are now generally recommended only for short term use (up to two weeks at a time). The most common medications for depression these days are antidepressants which help to rebalance the mood hormones, commonly selective serotonin reuptake inhibitors (SSRIs) and less often, the tricyclic antidepressants (TCAs). Talking therapies NICE suggests that GPs use either counselling or cognitive behavioural therapy (CBT) to treat mild depression. This has been shown to be more effective in the first instance than medication for most sufferers with less troublesome symptoms. I find the socalled talking therapies extremely useful to help people change their sometimes negative way of thinking and such treatments can be life changing, helping people regain normal function without a reliance on tablets. I have worked as a GP in both Dorset and Hampshire and have always been able to refer patients on the NHS, but waiting times for nonurgent cases have become longer and longer over recent years, as more and more people are referred. So although my patients and I can access this invaluable treatment free of charge, there can be a three to four month wait to see a therapist and sessions may be limited to a certain number rather than what the individual really needs. This can be very frustrating for both client and therapist! Homeopathy’s place It is whilst waiting to see a therapist that I find homeopathy has a place for my patients. It can also be used as a sole treatment if patients do not feel that they want to see, or need to see a counsellor or therapist but nevertheless want some help to recover from their illness. I would emphasise that I am not suggesting that homeopathy should be used as the only treatment in serious depressive illness where there are feelings of wanting to die or a risk of suicide, or in mental health problems such as bipolar disorder (manic depression), schizophrenia or severe postnatal depression. These are complex and potentially life threatening illnesses and need advice from a psychiatrist alongside the GP and other healthcare professionals. Homeopathy may have a part to play as an additional or complementary treatment but NOT as a stand alone therapy in these situations. There are so many homeopathic medicines that can be used to treat the numerous symptoms of depression and anxiety that it can be difficult to know where to start. It is important to make sure that your symptoms are not due to another illness such as an underactive thyroid or a stomach ulcer, so please talk to your GP first to make sure of the diagnosis before starting homeopathic treatment. Arsenicum album One of the first medicines that I think of when I see someone with all the symptoms of anxiety with depression, particularly when there are gastric symptoms of indigestion and diarrhoea, combined with panic attacks, is Arsenicum album. This medicine is based on white arsenic which causes severe gastroenteritis if taken in a toxic dose, which is why it can help similar symptoms when taken in a homeopathic potency. Somebody doing well with Arsenicum will probably be neat, tidy but restless. They may look anxious and drawn and tend to have a fastidious way about them, being able to give a lot of detail to their symptoms. Often I find that such a patient has to tell me all their troubles in a very methodical but sometimes time consuming way. Arsenicum patients can be convinced that they have a physical illness which is being missed because they feel so ill and may in fact end up having a number of investigations such as endoscopy and colonoscopy before finally accepting what is wrong with them. They can feel that they will never be well again. Fear is a prominent symptom, causing apprehension and dread, with an overwhelming feeling that everything will go wrong, and they despair of their recovery. These can be patients that I have to try very hard to reassure and I will often use a 30c dose, three to four times a day, with Aconite 30c taken as needed if they are having additional panic attacks. Ignatia Where depression follows from bereavement, loss, or a shock, such as witnessing a fatal road accident, Ignatia can be useful. The symptom picture is typified by emotional ups and downs with mood swings and is often quoted in homeopathic reference books as “laughter alternating with tears”. Having suffered the loss of my own parents, I know myself the separation feeling that one undergoes when someone close to you dies and I remember being able to talk quite calmly one minute, and then being overcome with tears soon afterwards before becoming calm again a few minutes later. Often the sufferer can prove difficult for friends and loved ones to deal with as they are SO up and down, being resistant to sympathy and oversensitive to well meaning advice, which may be wrongly taken as criticism. Ignatia patients tend to “bottle things up” and cry and give deep sighs during the course of their consultation. It may be hard for them to talk if they are overcome with their miserable situation and friends can find it well nigh impossible to cheer up such patients. Poor sleep is common and so is the feeling of a ball or something stuck in the throat, known conventionally as globus syndrome. I often give a few Ignatia 30c tablets to recently bereaved patients to take when needed, especially around the time of the funeral, and will use a 200c on a weekly or monthly basis for persistent depressive symptoms. Natrum muriaticum Another remedy that can bottle things up, but reacts quite differently to the Ignatia patient is Natrum muriaticum. This is one of my most frequently used homeopathic treatments for symptoms of stress, such as those typified by mild depression. I find it very useful when a patient has never been well since a shock or loss and feel as if they have a glass wall between them and the rest of the world. Often they have been unable to cry since bereavement and feel that they have not grieved properly for their loss. They feel worse for sympathy yet are very empathetic people. They sometimes build up a barrier emotionally and can appear somewhat cold and distant. They can worry about upsetting people unintentionally by saying the wrong thing and also can take things the wrong way. I tend to view these people as the “salt of the earth” type, having a strong sense of duty, but can find themselves being overwhelmed by the responsibility of their work, especially if they are caring for an elderly or sick relative. Such patients can feel that they should be doing more, not less, and feel they must “just get on with it”, and yet feel more and more tired and low in spirit as time goes on. Grudges can build up, with resentment. There may be an increased sensitivity to noise; certain passages of music may move them to those long awaited tears, but without relief from their low mood. I have discovered to my cost that using too high a dose of Natrum mur can cause emotional upset without improving the symptoms of depression so I tend to use a one off dose of 200c when there is a clear history of a definite cause to the illness and a daily 30c dose if the trigger is less clear. Sepia When all energy is drained, and my patient feels that they are unworthy of anybody’s love or attention, I turn to Sepia, a remedy which I have written about in the past for its use in the menopause and postnatal depression. I have used this almost exclusively for women who are sad, silent, solitary individuals, completely lacking in zest. Tears are never far away and a feeling of having to keep emotions under control otherwise one will have to scream is typical of the strain that such patients can feel. There is a wish to keep busy but with no incentive to do so and these patients can spend hours sitting motionless in sadness. Sepia women will often tell me that they love their husbands or partners but cannot manage the physical side of the relationship, which they feel is starting to cause difficulties for their other halves. Sepia usually suits women who tend to feel chilly and they can either feel incredibly hungry, being unable to ever feel full or have nausea at the mere smell of food. They often have a sinking, or “allgone” feeling in the pit of the stomach, especially when they wake, which is not relieved by eating. Older people One area of depression and anxiety I would like to mention is that of the older patient. I am really referring to the over 75s and those perhaps with physical frailty or other health problems and not all “pensioners”, as the media seems to refer to anybody over the age of 60 these days. Depression in this older age group can sometimes give rise to symptoms of forgetfulness and memory loss and lead to a mistaken diagnosis of dementia or Alzheimer’s disease. This is why antidepressant medication is often given by doctors if such symptoms appear. Unfortunately it can take up to three months for conventional treatment to have a full effect, and because memory problems may affect an older person’s health, and their ability to stay at home to a great extent, doctors tend to treat earlier than later. If you have a sympathetic GP, or, even better, one that it is homeopathically trained, it may be possible to try a remedy such as Alumina for a trial period first. This is a homeopathic potency of aluminium and is indicated where there is confusion about time (“time seems to pass too slowly”), difficulty making decisions, unease in the evening (“as if something were going to happen”), involuntary weeping without cause and a dazed feeling, making mistakes in writing and speaking. All such symptoms are worse in the morning and tend to improve as the day goes on. An alternative to try is Baryta carb, which I have found especially helpful if symptoms are worse with worry or come on after a stroke. Both Alumina and Baryta carb can be given at 30c strength daily. Finding a quiet place Depression is all too often seen as a problem of women, and although it is true that twice as many female patients are treated for anxiety and depression as men, both sexes can be affected. However, it does not have to be the “black dog” that the late Winston Churchill suffered from and does not always need to be treated with medication. Regular exercise can help, as this increases the endorphins produced by the brain, which are responsible for the highs that athletes can experience. Many GPs can refer patients to local “exercise on prescription” schemes which often offer a supervised course of gym sessions at a reduced fee. Finding a quiet place, through meditation, painting or walking the dog, can really help rebalance the mind and body; too many patients look blank when I ask them “and what do you do for yourself?” after listening to what they do for others. Look for your own quiet place if any of the above applies to you and please take further advice. It will be worth it, I promise.Dr. Rajesh Gupta5 Likes4 Answers