Psychological Conditions… on the Rise “What Naturopathic Medicine can accomplish - under pressure” 35305 Grünberg Am Silberloch 3 Phone 06401/8690 Fax 06401/951306 [email protected] www.naturheilpraxis-kaemmerer.de Psychological Problems Health of young employees One in five employees considers his/her workday to be very stressful Rather laid-back Very stressed Somewhat stressed Psychological Problems Clear increase in psychological illnesses since 1994 Cases of worker disability due to mental health issues 1994-2010 (Scale used for data presentation: 1994 at 100) Cases Days Psychological Problems Increasing number of days absent due to mental health issues Evolution of periods of absence (Absent days in 2000 at 100%) Mental health issues Respiratory illnesses Injuries Musculoskeletal illnesses Psychological Problems Worker disability according to ten of the most important illness types Musculoskeletal system Respiratory system Injuries Mental illness Digestive system Symptoms Infections Circulatory system Nervous system, Eyes, Ears Neoplasms (Cancer) Other Psychological Problems Increase of Psychotropic Drugs from 2006 to 2009 Costs Prescriptions Costs/Prescriptions Patients Model to explain the development of ANXIETY - DEPRESSION genetic predisposition psychosocial burden factors of personality neurobiological changes (lack of neurotransmitters) nervous restlessness - anxiety - burn-out depressive symptoms (e.g. low mood, states of weakness, loss of interest, etc) somatic diseases Depression is often not diagnosed... Epidemiological background: • 340 million people world-wide are currently afflicted with depression. • Approximately 20% of citizens in Germany alone will be afflicted with depression at least once in their lives. • Approximately 25% of adult women will be afflicted with depression compared to only approximately 10% of adult men. • Approximately 2% of children 12 years and younger and 5% of youth 20 years and younger will be afflicted with depression. • Approximately half of all depression cases will be identified; of these, half will remain untreated. • 10 - 15% of all patients with depression will commit suicide. TREATMENT OF PSYCHOLOGICAL CONDITIONS So you would prefer a natural treatment without pharmaceuticals or radiation? Signal transduction in depression and anxiety ➨ The amount of serotonin in the synaptic gap regulates signal transduction. ➨ Depressive patients produce insufficient amounts of serotonin. ➨ Sufferers of anxiety and sleep disorders often lack GABA GABA = gamma-aminobutyric acid Psychological disorders/diseases caused by different factors trauma-based death in the family trauma, cancer etc. depressive disorders genetically-based long-time stress e.g. job/ unemployment burnout anxiety depressive disorders Advantages of St. John’s Wort combination-products Hypericum increases serotonin neurotransmission • slow improvement of mood • slow increase in GABA neurotransmission Passiflora direct activation GABA neurotransmission • rapid decrease in anxiety and sleep disturbances • improvement of patient compliance • improvement in the chances of delaying the effects of increased serotonin neurotransmission Valerian direct activation GABA neurotransmission • rapid assistance for falling asleep GABA as a target in the treatment of depression reduced serotonin concentration sleep disturbance serotonin depression bad mood GABA reduced GABA concentration anxiety anhedony Psychological disorders/diseases caused by different factors long-time stress burnout e.g. job/ unemployment acute stress conflicts e.g. family-, social-, career-, exam stress anxiety anxiety depressive disorders Psychological disorders/diseases caused by different factors long-time stress burn out e.g. job/ unemployment acute stress conflicts e.g. family-, social-, career-, exam stress anxiety anxiety depressive disorders When to use? many symptoms … • • • • • • • … one solution: stress nervous restlessness anxiety (caused e.g. by job, school, exams, etc.) irritable stomach irritable bowel functional cardiovascular diseases initial insomnia/problems falling asleep recommended daily dose: 2-3 tablets PASSIFLORA: Clinical study Patients with generalized anxiety disorder were treated with Passiflora incarnata extract or Oxazepam. Hamilton Anxiety Scale Length of study (days) Results: After 7 days, Passiflora was as effective as Oxazepam in the treatment of generalized anxiety disorder. Passiflora incarnata reduces pre-operative anxiety Placebo-controlled, double-blind study of 60 patients Dosage: 500 mg Passiflora-Extract 6 Placebo Passiflora-Extract 5 4 Anxiety Score between 1 and 10 3 2 1 0 0 20 40 60 80 100 Time (minutes) Movafegh et al. (2008), Anesthesia & Analgesia DepressionAnxietySleep disorder Herbal sedatives and anxiolytics Passionflower, Valerian, Chamomile, Hops, Kava GABA neurotransmission Herbal antidepressants and anxiolytics St. John’s wort, Ginkgo, Ginger serotonin neurotransmission Psychological disorders/diseases caused by different factors trauma-based death in the family trauma, cancer etc. depressive disorders genetically-based long-time stress burnout e.g. job/ unemployment acute stress conflicts e.g. family-, social-, career-, exam stress anxiety anxiety depressive disorders When to use? • low mood • mild depression (caused by stress, anxiety, menopause, etc.) • sleep disorders (caused by depression, menopause, stress, anxiety, etc.) • burn-out, suffering from fatigue… Sleep – The Motor of Life Disturbed Sleep Psychological conditions frequently accompany sleep disturbances. But: Chronic sleep disturbances can also lead to depression. Disturbed Living Sleep – The Motor of Life High comorbidity of depression with anxiety and sleep disturbances Anxiety Depression 80% Sleep disturbances 90% Psychological disorders/diseases caused by different factors depressive disorder long-time stress acute stress sleep genetically based disturbance trauma or autonomic syndrome depressive disorder sleep disturbance (architecture) burn-out anxiety initial insomnia initial insomnia anxiety nervous restlessness … Vegetative dystonia Exhaustion (physical & mental) … from practice for practice 26 Metabolism -Diet -Fluid intake -Acid-base -Hormones -Gut Basis -Constitution -Disposition -Diathesis Planning treatment Individual -Continual stress Important!! Know boundaries, don’t over-estimate -Energetics -Redox system -Psyche The Neurogenic Iris Zincum Spl. Large-small pupils Fine and taut iris stroma “Angel hair” The Neurogenic Iris Zincum Similiaplex Frequently suffers from headaches and migraines Frequent heart complaints with no organic results Functional autonomic disturbances of inner organs Tendency of vessels towards cramping Indications Autonomic syndrome, constitutional agent in neuropathic-psychopathic children and women, organ neuroses, neuroasthenia. Nervous hypersensitivity, irritability, impatience, and irritable weakness. Dosage and administration 8-10 drops in 1 teaspoon of water, 2-3 times daily R Patient: Female Born: 1964 Diagnosis: Reactive depression Burn-out / Exhaustion Sleep disturbance Future - anxiety R Patient: Female Born: 1964 Diagnosis: Reactive depression Burn-out / Exhaustion Sleep disturbance Future - anxiety Therapy 1. ZINCUM Splx 10-10-10 drops PASCONAL 0-0-30 drops NEURAPAS balance 2-2-2 tablets 2. BASENTABS pH-balance PASCOE according to urinary pH 3. PASCOFLAIR 1-0-1 tablets Psychological disorders/diseases caused by different factors depressive disorder long-time stress acute stress sleep genetically based disturbance trauma or autonomic syndrome depressive disorder sleep disturbance (architecture) burn-out anxiety initial insomnia initial insomnia anxiety nervous restlessness … Vegetative dystonia Exhaustion (physical & mental) “N - Remedies” (Nerve Remedies) Influence a “derailed” autonomic nervous system, both in the sympathetic and parasympathetic spheres. Illnesses of the nervous system are often determined by toxic irritations of the neurons, which can be treated effectively with targeted drainage via the skin-kidney-gastrointestinal elimination systems. N-remedies act as an adjuvant, serving to calm the hyperexcitable state that may arise from the demands of modern life and/or so-called “manager syndrome.” 33 N 9 ZINCUM Similiaplex Psychovegetative syndrome Constitutional remedy for neuropathicpsychopathic children and women, organ neuroses, neurasthenia. Nervous over-sensitivity, angry temper, impatience, and a tendency towards irritability. IRIS Neurogenically sensitive Narrow pupil 34 N3 AVENA SATIVA Similiaplex Neurasthenic conditions, Autonomic dysregulation, Nervous insomnia, Nocturnal enuresis especially among children. IRIS Neuropathic constitution 35 … from practice for practice Case Example History: Anxiety Female patient (born 1959) suffers from intense anxiety related to driving. For the past six months, she has not driven a car by herself. As soon as she seats herself in the car, she experiences a feeling of oppression in the thoracic region, a racing heart, and nausea as well as breaking out in a sweat. Once she was able to start the car, yet she became very dizzy. She is not anxious when a passenger. According to the patient, the cause of this anxiety is related to an intense quarrel with her daughter. Since this argument, driving independently has no longer been possible. Case Example History: Anxiety She indicates that she has always been a rather anxious person. During the intake, the patient appears to be emotionally inhibited. In addition, she suffers daily from suddenly-occurring heart racing, which arises from inner unrest and anxiety. For many years, she has had problems sleeping through the night. The cause of this condition is dependent on her nervous state as she is constantly worrying about everything. She does not believe that the recommended allopathic treatments will be successful; as such, she does not wish to pursue them. Case Example Diagnostics Physical Examination: • • • • • • Reduced general state of health (anxious, nervous, restless), Reduced nutritional state (height: 170 cm, weight: 52kg), Respiratory rate: 115/90, Pulse: 86 and rhythmic, Lung-Heart: auscultation reveals no significant findings, Gastro-intestinal: auscultation reveals no significant findings, Lymph node congestion: no significant findings noted. Case History Diagnostic Previous Findings: • From general practitioner, specialist in internal medicine: no significant findings. • Neurologist: Tavor 1.0 to be taken as needed and regular injections of Insidon (antidepressant and anxiolytic). 40 Case History Naturopathic Diagnostic Indicators Iridology: • Lymphatic constitutional type, with a neurogenic and sensitive disposition as well as a radial loosening in the urogenital sector. Note: Patients with anxiety often demonstrate a genetically determined structural weakeness in the urogenital sector. This phenomenon points towards the kidney-anxiety connection from Chinese Medicine and requires treatment. 41 R 42 43 L 44 45 Kidney - Bladder Kidney - Bladder 46 Case History Therapeutic Measures Measures to influence the constitution, disposition, and diathesis • ZINCUM Similiaplex (10 drops, 3 times daily) as the constitutional remedy • AVENA SATIVA Similiaplex (10 drops, 3 times daily) as the disposition and diathesis remedy in daily alternation to stabilize the anxiety symptoms • JUNIPERUS Similiaplex (10 drops daily) as the disposition and diathesis remedy to promote renal elimination. This acts on the kidney-anxiety connection, which was determined by the iridology assessment to be an area necessary of treatment. Regressively fortifying and organ-supporting measures • BASENTABS pH-balance PASCOE (4 tablets, 2 times daily, 1-2 hours after meals) 47 Case History Therapy Measures Additional, causally effective but also symptom-influencing measures • • • • Medicinal hypnosis: Hypnosis allows for the generation of a relaxing state that simulates car driving and the associated anxiety. Because hypnosis creates a safe and secure environment, the anxiety can consequently be released and cleared. PASCONAL Forte Amp s.c. injection (once weekly) exellent anxiolytic PASCOFLAIR exellent oral anxiolytic Spartium junceum D6 (10 pellets as needed) as a symptom remedy for paroxysmal tachycardia 48 Case Example Course of Treatment • Already after the first two hypnosis sessions, the heart racing had ceased. • Working through the conflict with her daughter (in-practice supervised discussion with both the patient and her daughter), hypnosis, and medication led to an improvement of the anxiety symptoms. • The patient was able to sleep through the night after three months (06/98). • Because the pH-values did not remain changed without medication, the therapy with Basentabs was continued. 49 Case Example Course of Treatment • Although the anxiety had improved over four months so much so that the patient could drive again, continuous and regular hypnosis sessions and solution-oriented therapy discussions to stabilize the anxiety were followed for another four months. • The Basentabs therapy could be discontinued after six months once the pH values had normalized. Psychoneuroticum injections are still given as needed when the patient experiences life situations that trigger the anxiety. • The constitutional and dispositional therapies continue to be prescribed as ongoing medications at a dosage of 5 drops, 3 times daily. 50 … from practice for practice 51 R Patient: female, born 1962 (Pharmaceutical technical assistant - Pharmaceutical company) Diagnosis: a driven tension difficulties sleeping through the night restlessness with consequent exhaustion 52 R Therapy: Patient and Diagnosis: 1. PASCONAL 10 drops, 3 timesdaily see previous slide PASCOFLAIR 1 tablet, 3 times daily NEURAPAS balance 2 tablets, ½ hour before sleep 2. BASENTABS pH-balance according to urine pH 3. 100 ml NaCl 0.9%, once weekly + 2 ampoules PASCONAL forte 53 PASCOFLAIR - 3 tablets, once daily + *CNS: Central Nervous System ANS: Autonomic Nervous System PASCONAL 50.0 ml (CNS + ANS Relaxation*) ZINCUM Similiaplex 50.0 ml (States of excitation and/or agitation) m.d.s.: 20 drops, 3 times daily Important: Cupping (with the release of blood) over the Gall bladder zone 54 … from practice for practice 55 Case Example History: Depressed Mood The patient (born: 1936) has had constipation for many years. A bowel movement occurs every 3-4 days, and the stool is of a very firm consistency. She uses Miniklystiere as necessary. The patient frequently begins to cry during the intake. Her husband passed away four months ago. Since then, she has lost interest in life. The children have moved away; nobody is there to care for her. In addition, she suffers from sleep disturbances, which have led to a decline in her performance of tasks. 56 Case Example History: Depressed Mood The patient speaks only about herself and often refers to physical complaints, which have not been confirmed by specialists in internal medicine and general physicians. The patient presents an overall melancholic and sad picture. A strong pattern of travelling thoughts during the intake is noted. The patient agrees that this also occurs when she is trying to fall asleep: she feels tired, goes to sleep, and then the thoughts come and do not stop. 57 Case Example Naturopathic Diagnostic Indicators Iridology: • Hematogenous constitutional type, with cramping rings and solar rays. Note: This is described as a vegetative, spastic diathesis in iridology and points towards a vegetatively weak constitution. 58 R 59 60 L Case Example Naturopathic Diagnostic Indicators Dark field: • “Coin stacks” and Aspergillus symplasts EAV: • Gall bladder ↑, Liver ↑, Heart ↓ According to the 5-Element Theory, the Wood and Fire Elements are being influenced. If there are disturbances in the liver and gall bladder, the heart (with its associated emotion of joy) may be negatively influenced. 61 = Gastrointestinal burden (according to Prigge) = Lemon-yellow 62 structures similar to symplasts = Upper abdomen Case Example Naturopathic Diagnostic Indicators Laboratory diagnostics: • GOT (AST) 35, GPT (ALT) 30, GGT 45; Cholesterol 260, HDL 35, LDL 180, Triglyceride 310; Alkaline Phosphatase 125; Urinary pH (permanent) 5.9 Spenglersan • Within normal results Uricolor • Foamy formation (sign of severe dysbiosis) 63 Case Example Case Evaluation and Treatment Goals Treatment goals are: • Normalization of the digestive function • Relief of the liver metabolism • Stabilization of the mental situation 64 Case Example Treatment Measures Measures to influence the constitution, disposition and diathesis • QUASSIA Similiaplex (10 drops, 3 times daily) as the constitutional remedy • NEURAPAS balance (2 tablets, 3 times daily) as the disposition and diathesis remedy; a good accompanying remedy, which especially in light of the combination of St. John’s Wort and Passionflower - acts as a balancing remedy for the autonomic nervous system in cases of reactive depression. Regressively fortifying and organ-supporting measures • BASENTABS pH-balance PASCOE (2 tablets, 3 times daily, 1-2 hours after meals) • PASCONAL Forte 3 ampules in 100 ml NaCl (0.9%), 1 time weekly for stabilizing the autonomic nervous system 6 Case Example Additional Measures • Biochemic cell salts according to Dr. Schüssler, MD Nr.5 (Potassium phosphorus), Nr.8 (Sodium chloride): Sodium and potassium are important extra- and intracellular regulating minerals, which are often misregulated in patients having psychological disturbances. Administering this combination improves these conditions. • LEGAPAS (8 drops daily) to soften the stool. Case Example Course of Treatment • One month after beginning treatment (11/2003), the constipation had improved. LEGAPAS was halted. • Urinary pH-values demonstrated basic “flooding.” BASENTABS were halted. • Based on the changed bowel movement situation, the medication was reduced to 10 drops daily of QUASSIA. This remedy is also acting as the patient’s ongoing constitutional remedy. • The weekly practice visits were scrupulously upheld by the patient (she loved them and insisted upon coming). Case Example Course of Treatment • Thus, the infusions could be continued weekly. The consequent connection to the practice served to stabilize the psychological symptoms. • Three months after beginning treatment (01/04), the grieving and circulating thoughts became less prominent. The administration of NEURAPAS, Biochemical Cell Salts, and infusions were ongoing. • After two years, the patient still comes for her weekly visits. Her mood is clearly stabilized. Her thoughts are now also sometimes oriented towards the outside world. Case Example Naturopathic Diagnostic Indicators Drainage Processes Cupping (with the release of blood) in the depression zone (lumbar area) and Gall bladder zone; Baunscheidt therapy of the back Neural therapy Procaine injected as wheals (paravertebrally in Th4, Th5, and Th6, right) Wheal in the epigastrium area, right Table of Reflex Zones on next page 69 Kidney Kidney Gall bladder Heart Uterus Tonsil Tonsil Heart Gall bladder Stomach Duodenum Stomach Liver Pancreas Gall bladder Genitalia Kidney Kidney Gut Ovary Ovary Kidney Kidney Gut Bladder 70 Gut Holistic Naturopathic Treatment 71 72 … from practice for practice 73 “Explosives” Explosive types are those who have • quick tempers and • an extremely excitable/irritable nature, • and a tendency towards irrational acts and primitive reactions. The slightest provocation causes them to flare up; they tolerate no contradictions; and they can work themselves into such a state of agitation that they may hit wildy around themselves and even destroy an entire room. 74 Therapy Concept for “Explosives” NEURAPAS balance 3 tablets, 2 times daily + 2 x 1 infusion weekly 100 ml NaCl 0.9 % + 2 Amp PASCONAL® Forte Duration of the infusion: 20 minutes R Patient: male born.: 1966 Diagnosis: short-tempered and impatient behaviour pattern 76 R 77 78 L R Patient and Diagnosis: see previous slide Treatment 1. QUASSIA Splx 10 drops, 3 times daily NEURAPAS balance 2 tablets, 3 times daily 2. BASENTABS pH-balance PASCOE 4-0-0-4 3. 100 ml NaCl 0.9%, twice weekly + 2 Amp PASCONAL® Forte … from practice for practice 80 R Patient: female born: 1939 Diagnosis: “Choleric” Type 2 Diabetes R 82 83 L R Therapy 1. NUX VOMICA Similiaplex 10 drops, 2 times daily Patient and Diagnosis: see previous slide 2. PANCREATINUM Splx 10 drops, 3 times daily, alternating with MYRTILLUS Splx 10 drops, 3 times daily 3. 2 Amp PASCONAL® Forte in 1ml of patient’s own own blood, once weekly Psychological disorders/diseases caused through different factors depressive disorder long-time stress acute stress sleep genetically based disturbance trauma or autonomic syndrome depressive disorder sleep disturbance (architecture) burn-out anxiety initial insomnia initial insomnia anxiety nervous restlessness … Vegetative dystonia Exhaustion (physical & mental) Thank-you very much for your attention !!!!!! …. Sincerely, Kay Kämmerer
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