2.1 Lithium, Case 1
A 34 year old woman has come with abdominal pains. The pains are located on the lower right or upper right side, just under the rib cage, and they radiate through to the back. It is a nagging type of pain, occasionally stitching and it is accompanied by nausea and tiredness. The pain is worse in the morning, worse on exercising like aerobics and worse in spring and autumn. The pain is better from lying on the left side, rubbing or putting a hot water bottle on it. No modalities from food or weather, although she doesn’t feel like eating when she is in pain. It all started a few years ago when she had been looking after her boyfriends mother for several weeks before she died. She couldn’t bear to see this lady slowly waste away, couldn’t bear to lose her.
She also complains of headaches on the right side, radiating to the neck. It is a feeling of tension which is worse in the morning and it is sometimes accompanied with vertigo and an ‘unreal’ feeling, as if she is sinking, or as if she is being pulled away. It makes her either hyperventilate or hold her breath. The vertigo also comes on its own sometimes, suddenly without warning, as if a button is being pressed. It is difficult to concentrate properly when she has this.
She is very unsure of herself, she quickly thinks that everything will go wrong, especially when she is confronted with problems. She feels unsure of herself at work and with other people. There is nobody she feels at ease with. She is very sensitive to criticism, particularly regarding her work, whether she will be able to handle it, but she doesn’t say anything. She doesn’t like it when people judge her. She often has to go home from work early, because she is too overwrought to carry on.
As a child she used to be very dependent on her parents, she used to ask them all the time: ‘You won’t die, will you? Because I won’t want to live if you die’. She had difficulty growing up, couldn’t detach her self from her parents, would have liked to stay in that protective environment. She hated it when her body started to mature and her breasts started to develop.
She is melancholic by nature and she gets extremely upset when people die, she can’t accept the fact that she has to lose someone. She was much affected by the death of a schoolteacher when she was little, and by a little boy who was run over. She is overly concerned for her cat, in case he dies.
But there are two sides to her character. There is the passive side with the tendency to withdraw and go quiet, and there is also another, very active and strong side. She can be very positive, chat to other people quite openly and happily and then suddenly she’ll feel ill at ease and go totally quiet.
She finds it hard to make decisions, particularly about big issues such as getting married or having children, she can spend hours worrying about such things. She hesitates a lot, afraid to live, afraid to take steps and accept responsibility. She can become totally fixated on some little trifle and then that has to work the way she has thought. If it goes wrong then she’ll immediately despair about everything.
She is afraid of spiders, disease, death, narrow spaces and crowds.
She has a dream in which she sees her deceased mother, she’ll run after her and then she suddenly sees that it is someone else. Then she wakes up with a start.
A few years ago she received psychotherapy because she felt depressed and insecure, after she had left her previous boyfriend. It wasn’t that she felt unhappy with him, they had a large house with much land and a horse, but he was always away and involved with his work and she felt he wasn’t interested enough in her. Now she has a new boyfriend who is interested in her, but she finds it hard to enjoy sex with him.
When she was a child she had a squint in her left eye.
Generals
Weather: cold type; < gloomy weather, < sun: weak; < damp: short of breath; she finds thunderstorms frightening and exciting.
-> wind and fresh air (3).
Time: < 11 am.
Desires: spinach (2), potatoes (2), vegetables, fruit, eggs, drinks, water (2).
Aversions: olives (2), pork, carrots, alcohol.
Menses: before menses: tension in breasts, insecure, irritable.
Sleep: good; sometimes she suddenly feels something strange in her head and then she is wide awake straight away; sometimes afraid she’ll never wake up again; sleeps on right side.
Analysis
The pronounced sense of insecurity and the weak personality would point to a remedy in the Carbon series. She can’t bear it when people die because it will throw her back onto her own resources and she can’t handle that. She also had difficulty with the fact that she was growing up, she still felt too dependent and helpless (Carbon series).
The sudden mood changes are a characteristic trait of Stage 1 and so we get to the remedy Lithium. It is a bit similar to Crocus and Pulsatilla.
Also typical is the dream here she runs after her mother, who then turns out not to be her mother at all. She doesn’t know what she is doing and without thinking (stage 1) she assumes it is her mother. Then follows the sudden change (stage 1) to fright when it proves to be someone else.
Reaction
One month after Lithium metallicum 1M she is a lot better, mentally and emotionally. Less gloomy, more enjoyment in life, stronger. The fear of death is less too. She associated deep sleep with death, but now feels that this can be nice too. She feels she is allowed to be who she is, without judging herself. At her work things go a lot better. She gets much less uptight, can see things in perspective, can go with the flow.
The stomach appear less frequently, the attacks are less severe. The headache and vertigo is much better.
Several months later these complaints are still improving.
After 9 months she has a slight relapse of her feeling of insecurity. She is moving house to live with her boyfriend, which is causing a bit of stress. A repeat dose of Lithium metallicum quickly clears this up.