Case Study About how Chocolat and Naturopathy Cured Depression in an 11-Year-Old
Shannyn Fowl, ND
The father of an 11-year-old girl, who seemed depressed, inquired to see if I could possibly help his daughter. Naturopathic medicine is not well known yet in East San Diego County, California, but this family was looking for any alternatives to the antidepressants that had been recommended. I suggested a homeopathic intake, not realizing what a nice “hole in one” this case would make. The young lady came in with her mom and younger sister, with the chief complaint of anxiety over “the change.” Friends and family thought it was all related to puberty because mom had experienced the gloomy mood too, although not as intensely.
Remarkable Medical History
The young lady expressed fears about getting her period. She stated that getting her period means she is a woman and that she still wants to be a kid. She is afraid she will not turn out normal in the end and notes that one breast is growing faster than the other. Fortunately, this patient has a good relationship with her parents and her sister, whom she describes as “kind of crazy.” This young lady spent 4 to 5 evenings a week sobbing in the bed of her mom and dad. I reassured mom that this is not a normal reaction to growing up and that I was glad to see them in my office.
Following a vaginal birth that mom describes as a rough birth, the patient’s medical history is remarkable for dyslexia, Salmonella, 2 ear infections, Epstein-Barr virus, streptococcal sore throat 3 times, and sensitivity to cats, dairy, kiwi, and the Solanaceae family. Her family history is notable for prostate cancer (2-3 cases on both sides of the family). A review of systems reveals some ringing in the ears, micturition that feels hot, a painful pressure in the chest, and neck and back pain that feels like someone is squeezing her. Her menses have not begun. Her belly is sensitive to emotion and hurts after eating because she cannot help but scarf down her food. She is fair, with freckles and brown hair, and is hesitant to converse at first but then talks freely. Her belly is tender throughout the upper quadrants, and her breast buds are Tanner stage 2.
When asked about mechanism, mom and patient recall her birthday slumber party at her house with friends. Dad had told all the girls to go to sleep at 2:30 am, and this triggered a feeling of being “down” or weird perceptions of sadness, like someone is squeezing her. Since then, she has felt so sad that she often cries in her parents’ bed in the evening. Sleep was good, but she had trouble falling asleep and felt tired throughout the day. As we investigated why the slumber party seemed to be the trigger, no clear understanding was apparent on her part, which led me to believe that it was a somatic response based on a previous event. I asked what other events may have made her feel the same way.
She recalled a visit to a friend’s house months before the slumber party, perhaps 6 months before. She was really looking forward to this visit with someone she previously got along with well. The friend ended up treating her poorly, telling her that she was too immature to watch certain shows and preferring another friend who unexpectedly showed up. My patient did not feel welcomed. She did not feel liked. Although she had been previously homeschooled, her parents felt that seeing friends at school would help with the depression, so they had put her in school. She reports that she does not feel included in conversations at school.
Routinely, I ask children to draw pictures for me, if they are willing, while we are in the visit together. Enormous understanding of what is going on in their mind can be gathered through an impromptu picture. This patient drew hills with grass and lots of rain clouds, with a small sun and a small rainbow. One little straight house was on the hillside, with lots of smoke. I asked her to tell me about this picture. She said that there are lots of rain clouds but that every once in a while there is the sun or a rainbow, but not often. I prompted her to explain the house. It was a house that no one wanted to be near at all, she reported. As for the smoke, it was very busy inside; someone is trapped in there. When associating the picture with her feelings, she agreed that she felt trapped in her own body. She wants to let her body sleep and to go outside of her body. When she returns to her body, she wants it to be all healed. Mom concurs that her daughter will tell her that she wants to get out of her body and to fly. The patient likes rain and mountains. When asked, she is scared of spiders but not of snakes. She loves animals and has 3 birds, 2 dogs, and a hermit crab. She dreams of having a horse.
Tell-Tale Tripartite Cycle
My initial assessment was dysbiosis, and the viral history was significant for this patient. Homeopathically, she displayed the following tripartite cycle: (1) sensitivity (with the main complaints starting after being rejected and not welcomed; physically, she does not feel normal, and the sensitivity leads to her perception of being trapped), (2) a feeling of being trapped (desiring to get outside of her skin; this is also illustrated in the drawing of her house), and (3) powerlessness (a feeling of being trapped that is expressed by fear, anxiety, and a burning or squeezing sensation). These descriptors were used by the patient several times and could be likened to her picture of lots of smoke pouring from the house and the tight walls, as if she was trapped. Her love of animals and possibly consolation helped her move to the final stage of rainbows and sunshine, until the rejection was triggered again.
Little is known about homeopathic Chocolat, but I remembered this remedy from discussions in medical school. The case involved an adult with family-of-origin emotional trauma and the overwhelming understanding that she was despised. I dug back into the pile of medical school notes to find the cycle that was presented by Dr Will Taylor. It involved an excitement or impulsiveness that would lead to a restlessness or confusion, then an irritable and isolated feeling, followed by anxiety that something will or will not happen. Duty or weakness will convert to sensitivity and finally to a euphoria, in which the person may fall in love with simple concepts such as sunshine and rainbows. The cycle seemed to mimic my patient’s condition but did not fit my radar remedies very well. I recalled that somewhere during the visit, without prompting on the topic, she mentioned how she had eaten chocolate at school and had become so sick that her mom had to come pick her up.
I prescribed Chocolat 200C and some basic naturopathic treatments, with instruction to follow up in 4 weeks. They did not return for the follow-up visit, so I phoned them. Conditions had changed dramatically for the patient, for the good. The parents were so dumbfounded by the response that they had chalked it up to weather change or the passing of time. They considered that all of their concerns, both emotional and physical, were resolved. Despite encouragement to return for a visit, they did not see a reason to. I recently checked in with the family, 7 months after treatment, and the patient continues to thrive and to be well, without the previous concerns.
Shannyn Fowl, ND began her service to the medical community by exploring midwifery and working as a nurse’s aid for 13 years. When she learned of naturopathic medicine, she pursued a bachelor of biomedical sciences degree at Western Michigan University, Kalamazoo, and was privileged to participate in their neuroimmunoendocrinology laboratory. She earned her doctorate from National College of Natural Medicine, Portland, Oregon, and continued to be active in research during medical school. Dr Fowl has a private practice and is an adjunct faculty member at San Diego Community College, San Diego, California. She resides in San Diego with her 5-year-old son. Her website is www.journeyofhealth.org.