A Case Of PTSD

Words: Dr Amy ROTHENBERG

We’ve seen unprecedented acts of terrorism and violence in the United States and abroad — from Orlando to Brussels, Paris, Istanbul, Baton Rouge, Mumbai, and beyond. Any society that experiences such tragedies has deep issues across wide areas, such as income inequality, racism and, of course, untreated mental illness. Solutions are not easy; they are political and societal in nature. But, for a practicing physician, the problems come in the form of sick patients.

Constant exposure to the global 24-hour news cycle with instant images via computer and cell phone has many of my patients feeling a strong impact from such tragic events, no matter where in the world they occur. Resisting news coverage of disasters, terrorist attacks, and other intense and frightening incidents proves challenging too, because it comes at us from so many directions — TV, Internet, social media, radio, magazines, and newspapers. On top of that, many people find it difficult to look away. I have thought about this and wondered why. I believe that some people are seeking information, so they might be prepared for the possibility of being the victims of such attacks, or disasters, themselves. Others are looking for some way to process such unfathomable events for themselves, or perhaps their children. And, still others watch with a kind of strange obsession, or fascination, similar to watching an action-packed movie.

Regardless of what drives us to expose ourselves to such frightening stories and images, some people are more troubled by them than others. For especially sensitive people, exposure to such news stories can be stress that triggers strong physical, emotional, or cognitive symptoms. And, for people with first-hand experience of these major tragedies, whether as a survivor, or a family member of a victim, the situation is, of course, even worse.

A State Of Panic

Twenty-eight-year-old Kelly lived in a town that had gone through a mass-shooting event, and her whole world had been shaken to its core. She knew several family members of victims and she had lived through the heavy media coverage with reporters, cameras, and news trucks swarming her community, and then watching friends and associates being interviewed on the evening news shows. Some years after this event, Kelly first came to see me for help because she was in a state of overwhelmed anxiety. A previous doctor had diagnosed her with panic disorder. Both Kelly and her mother reported that though she had been a sensitive child and a somewhat shy teenager, anxiety had not been a part of her day-to-day experience before the mass-shooting event near her home. Both mother and daughter saw this tragic event as a pivot point, which had powerfully impacted Kelly and made it so difficult that she could not move forward in her life.

Kelly was experiencing post-traumatic stress disorder [PTSD].

A lively and talented artist and teacher, Kelly now found it difficult to leave her parents’ home. She was afraid to be out of the house alone, and she could not bear to be in the dark, either inside, or outside the home. If she did not know where her mother was, or if she found herself alone, or in the dark, she could have a classic panic attack with shortness of breath, sweating, and a sense of confusion. Kelly worried a lot about dying, about her own mortality, and about the death of people she loved most, even though everyone was in good enough health and there did not seem to be any imminent reason anyone close to her would die.

In addition, Kelly was plagued with nightmares in which images of scary creatures pursued her; she became afraid to go to sleep. Images from the local tragedy would move across her mind. She wondered what the purpose of life was if such terrible things could take place. She felt defeated before she even began.

Kelly had been prescribed a host of anti-depressants, anti-anxiety medications, and sleeping aids from previous physicians. Some of the drugs relieved her symptoms somewhat, but she did not tolerate them well, having developed side-effects, such as weight gain and feeling ‘emotionally flat,’ so she had stopped taking them for the most part. Kelly told me she was philosophically more aligned with natural medicine and did not like the idea of being on pharmaceuticals, which was why she had come to see me.

Except for having difficulty falling and staying asleep, Kelly was in good physical health. She did not suffer with headaches, digestive complaints, or respiratory, musculoskeletal, hormonal, urinary, or skin symptoms. She had developed a strong facial tic over the past several years, manifested by a sudden crinkling of her eye and lip on the affected side. This tic occurred more frequently when she was especially nervous, or feeling stressed, and it was disturbing to her and her family and friends when they saw it.

Stuck On Death & Destruction 

After spending time with Kelly and her mother, I could understand how Kelly’s sensitive nature had been strongly impacted by her proximity and experiences relative to the mass shooting. A fabric of safety, a sense of closeness and belonging, and a belief in the underlying goodness of people had been shattered. Kelly was stuck instead on the horrible images of the devastating event and the long trail that trauma, loss, and grief often leave behind. On top of that, her own imagination was taking hold and running away with things, by bringing in additional frightening images and possibilities. Kelly was focused on death and destruction in a way that is not typical of a young and healthy person.

Healing Choices

In considering a homeopathic remedy for Kelly, I thought of a number of possibilities. Mancinella came to mind, because people needing this remedy can be timid and have difficulty keeping dark, or evil thoughts, out of their minds. They can also be strongly fearful of the dark and at night-time, and their symptoms can be triggered by a big shock, or event, as was true for Kelly. People needing Mancinella, however, usually have a sense of being possessed by bad spirits, or the devil, as well as a persistent fear of going crazy, which Kelly did not have.

I also thought about Calcarea carbonicum, a commonly used homeopathic remedy for all kinds of health issues; individuals needing it can also suffer with panic disorder and several fears and anxieties, especially when they do not feel they are in control of their environment. They may fear the dark, have nightmares, and be greatly affected by cruelty and horrible events, as was true for Kelly.

A Remedy For Kelly

In the end, I decided on Stramonium for Kelly because of the distinctive kind of fear and anxiety she experienced, which was tinged everywhere with a fear of death — her own and others — and, a sense of being unable to find safety. Further supporting the Stramonium prescription were the scary images recurring in her mind. In individuals needing Stramonium, we often hear about nightmares, or even night terrors. It’s as if in the night-time darkness, the world becomes chaotic and threatening to them. We also see in individuals needing Stramonium a strong fear of being alone, which Kelly had developed, and an equally strong desire for company and light. Stramonium is also indicated when ailments come on after a person has witnessed frightful violence and death, or has experienced life-threatening situations.

Kelly’s facial tic, which came on fast and disturbed both her and people who saw it, was a good confirmatory symptom for me, because violent tics of the face, or other types of spasms — e.g., convulsions, cramps, twitching, jerking, stammering — point to Stramonium, especially when they arise after a fright.

I prescribed Stramonium 200C with the idea that this was the remedy Kelly needed at that point in time. Since her troubling symptoms could be traced back so clearly to the mass-shooting event, it was as if the acute state of fear and anxiety that she had experienced at the time of the event had never left her. I assumed that at some point, once she came out of her chronic state of anxiety, she would need a different remedy, such as Phosphorus, Silicea, or Carcinosin, to address her overall [constitutional] sensitivity and her need to be supported and taken care of by others. But, those remedies would not address her high degree and type of anxiety, her underlying fears, or her focus on darkness and death the way Stramonium would, so I wrote them down to consider in the course of our future work together.

Putting The Mind To Good Use

I also encouraged Kelly to learn to meditate and acquire some basic skills and breathing techniques to encourage relaxation. I will often take a few minutes from my appointments to model and teach such approaches and ask my patients to practice 5-10 minutes each day, not just when they are anxious. Like anything, if you practice, you get better at it, and then when you need that tool, it is there for you. I gave Kelly a link to some free, online guided imagery to listen to, as a way to help her relax, especially before sleep.

In my experience, we might as well put the mind to good use on emotions, and such kinds of approaches often help. I like the free guided meditations from UCLA’s Semel Institute for Neuroscience and Human Behavior-Mindful Awareness Research Center, which can be found at: https://marc.ucla.edu/body.cfm?id=22

Back To Her Old Self

Kelly returned to see me two months after our initial appointment, and I could tell right away that she was better. First of all, she came in without her mother. Secondly, the first thing she asked about was related to her skin rather than her previous focus on fearfulness and anxiety; she reported that she had acne for the first time in her life and wondered if natural medicine could help with that. When I questioned her, Kelly reported that her anxiety was much better. She felt back to her old self, more independent, and more able to be out and about in her community. This was a good response to the remedy.

When a patient gets better in such powerful, or deeper ways, we will often see a discharge of some sort somewhere in the body, so I did not view the appearance of acne as a bad thing. I also did not think it would last too long. I explained this to Kelly and also shared with her some basic ideas about hygiene, such as washing her face with soap and water, being sure to remove make-up each night, and using facial products without pore-clogging ingredients.

A New Life Ahead

Two months later [and, four months after our initial interview], Kelly came back to see me. She was ‘very excited,’ as she had decided to move to another city and start a new chapter of her life. She was thrilled at all the opportunities ahead and did not feel that anxiety was much of a problem for her anymore. She was sleeping well on her own and had only the occasional scary dream, which was nowhere near as bad as before. She was not thinking about her town’s incident much and, in any case, was so excited about her proposed move that she mostly talked about that. Her skin was still not great, but she did not seem as bothered by it. In cases like this, where a mild discharge [skin complaint] arises after a person has a good overall response to a remedy, I don’t prescribe for the skin complaint; rather, I trust that it will resolve on its own over time. And, because I often see some type of discharge after a patient has a good overall response to Stramonium, I was especially not concerned about Kelly’s acne. By the way, I saw Kelly’s facial tic as another type of ‘discharge,’ and as Kelly’s anxiety retreated, the tic, too, was greatly reduced in incidence.

I saw Kelly recently, about a year after our initial appointment. She wanted to check in with me but had no particular complaints and continues to do well. She has settled in nicely to her new life. The persistent nightmares, fears of the dark and of being alone, and worries about death and dying that had haunted her for several years are largely “things of the past,” she told me. She will be back in touch with me as and when needed going forward.

I have not yet had the chance to prescribe another underlying remedy for Kelly, but I look forward to doing so when the time comes. She knows where to find me should anxiety creep back, or if any other issues arise.

Turn Off The News

I would like to end this article by encouraging you to limit your own exposure to bad news and, in particular, to shielding your children from it. I always told my [now, adult] children that they needed to be the caretakers of their own souls. No one else could do that for them. One part of that is to limit repeated exposure to the media. Look for some good news to read, or watch, or listen to. Here are some of my favourites: https://huffingtonpost.com/good-newshttps://goodnewsnetwork.org,  and  https://sunnyskyz.com/good-news.

And, by this, I do not mean to live with our heads in the sand. When I am working with patients who have been impacted by tragedy, I also try to understand and explore with them what might empower them to feel that they are helping, instead of focusing primarily on the fact that they are victims, whether directly or indirectly by being present to the daily news cycle. For some people, it helps to give money to causes they believe in, or become active in an advocacy group related to a topic they care about, or help in some way with victims’ families. Being proactive and involved can be a part of our healing paths, or roadmap.

Dr AMY ROTHENBERG, ND, the American Association of Naturopathic Physicians 2017 Physician of the Year, practices in Connecticut, US. She blogs for The Huffington Post [www.huffingtonpost.com/amy-rothenberg-nd/] and authored the book, The A Cappella Singer Who Lost Her Voice & Other Stories From Natural Medicine. Dr Rothenberg and her husband Dr Paul Herscu, ND, MPH, teach through the New England School of Homeopathy [NESH]. She has raised three wonderful children and can often be found in her art studio, in the garden, and on the ballroom dance floor. This piece [©Dr Amy Rothenberg] was previously published in Homeopathy Today, the magazine of the National Center of Homeopathy [NCH], US [http://www.homeopathycenter.org]. Websites: www.nesh.com, www.nhcmed.com, and https://amyrothenberg.com

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