2.1.1 Lithium carbonicum, Case 1
A 30 year old woman suffers from migraines. It starts with tension and pain in the neck, radiating to the corner of her right eye. It is a stitching type of pain. Before it starts she feels very tired. The pain is worse at menses (3), light (2), stooping (2), coughing, damp and warm damp weather (2), sauna (3), ice-cream, lying in late, alcohol (2), relaxing in the weekend, ergotamine. Amelioration from: rest, lying still, pressure, kneading, motion, cold applications, lying on the right side with the head turned to the left, urination, aspirin. Concomitant symptoms: cold hands and feet, pale face, sometimes nausea and vomiting, sometimes dizzy, feeling dejected and tired, aversion to company. At one time she saw many white spots and lost the right side of her vision in both eyes. The headaches are often caused by tension, like quarrels, exams, having people to dinner, meeting new people. The migraines started when she started her practicals for her Cesar therapy studies, this was too much for her because of having to make contact with so many people.
She says her life goes from one extreme to the other, either she rushes around working very hard, or she feels incredibly tired. She starts something with great enthusiasm, but after three of four times she loses interest. This is because she feels she isn’t doing well enough. She takes things too seriously, everything has to be perfect the first time, otherwise she loses interest. She is too restless to work her way through many trials and errors, she hasn’t got the discipline to see something through. She expects a lot of herself in order to prove what she is worth. But her self image doesn’t fit the reality. She also has certain obsessive traits, like having to check the locks on the doors or checking and rechecking the accounts. She is quite pessimistic and spends much time worrying about things. She needs security and hates adventures.
She feels there is no place for her in society so she withdraws from other people. She is afraid of being criticised or rejected or punished. She can’t bear to work with someone in the same room, because she will constantly feel as if she is being watched.
She is afraid of the future, afraid of getting ill and not being able to manage. Afraid of getting mad from all that worrying. She doesn’t express her anger, unless it has really come to a head.
She is mostly very shy, alternated with extrovert behaviour. She always used to play the clown if things got too much. So people thought that you did not have to take much notice of her.
Her mother sent her to ballet lessons because she was too fat. Then she almost stopped eating for a while which caused her menses to stop.
She has been living with her boyfriend for ten years but the relationship isn’t very all that happy. They find it difficult to talk to each other and to share their problems. The relationship with her mother isn’t very good either. She feels her mother doesn’t appreciate her at all. When she was a child her mother thought her too boyish and boisterous. She felt as if she could never do anything right. She dreamt that she quarrelled with her mother because she had achieved something and her mother denied it.
She thinks her father feels guilty because she isn’t very happy. Her father used to swing between extremes too, just like her, it was always all or nothing. He would start a new hobby or a new project with tremendous enthusiasm and a few weeks later it had petered out completely.
She feels restless and hurried, she can’t sit still.
She dreams that half of her parents house has been swept away.
She often suffers from colds with sore throats, pain above the collarbones and a rough voice.
Even as a child she used to suffer from headaches.
Generals
Weather: cold, cold feet; < cold; < warm, damp weather; in childhood fear for thunderstorms.
Perspiration: copious, especially in summer.
Time: < 3 pm, < from 8 pm; < April and May.
Desires: fish (3), farinaceous (2), sweet (2), chocolate (2), vegetables, egg, cheese.
Aversion: fat (2), pork chops (2), meat, potatoes.
Food: alcohol (2), coffee, fat.
Menses: every 5 weeks; in the past no menses; every other menstrual period cramping pain in uterus radiating to thighs and calves. Depressed, tearful and heavy feeling before menses.
Sleep: sometimes difficult from worrying; sleeps on right side.
Analysis
The vertical hemiopia on the right side is a typical Lithium carbonicum symptom. On the strength of this symptom, and because I couldn’t think of anything else, I prescribed Lithium carbonicum, although I did not have much to go on.
Great was my surprise when it proved to work and I learned a lot about the remedy from this case. it wasn’t until after she had taken the remedy that she told me the story about her father (carbonicum) and his all or nothing behaviour (Lithium). This alternation in mood made me think of the use of Lithium in psychiatric patients with manic depressive psychoses. This gradually enabled me to build up the Lithium picture. Later on I recognised some other beautiful Lithium symptoms in this case: < tension, security, <- adventure, no place for her, fear of the future, disease, becoming mad, shyness alternating with extrovert behaviour, menses absent, her father feels guilty, dream that half her parental home has been swept away.
Reaction
After Lithium carbonicum 1M she gradually starts to improve. The headache gets worse at first, but afterwards it gets better. She is mentally much stronger, more positive, doesn’t get overwhelmed anymore. She is able to express her anger, or rather: she can no longer hold it in. She doesn’t want to beat around the bush anymore in her relationship with her boyfriend. She is not so fixed on her goals anymore, less obsessed by the future, more content to stay with what is happening now. She no longer has to cling to securities so tightly.