DEPRESSION AND HOMOEOPATHIC MANAGEMENT

DEPRESSION – LOSING TOUCH WITH REALITY

Depression is a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), withdrawal from social contact, and vegetative states such as loss of appetite and insomnia.

Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate or attempt suicide.  Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains, or digestive problems that are resistant to treatment may also be present. Depressed mood is not necessarily a psychiatric disorder. It is a normal reaction to certain life events, a symptom of some medical conditions, and a side effect of some medical treatments.

Forms of Depressive disorders:

Major depressive disorder (Major Depression) - Major depressive disorder is also known as major depression. The patient suffers from a combination of symptoms that undermine his ability to sleep, study, work, eat, and enjoy activities he used to find pleasurable. Experts say that major depressive disorder can be very disabling, preventing the patient from functioning normally. Some people experience only one episode, while others have recurrences.

Dysthymic disorder (dysthymia) - Dysthymic disorder is also known as dysthymia, or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. However, the symptoms are not as severe as in major depression, and the patient is not disabled by it. However, he may find it hard to function normally and feel well. Some people experience only one episode during their lifetime, while others may have recurrences. A person with dysthymia might also experience major depression, once, twice, or more often during his lifetime. Dysthymia can sometimes come with other symptoms. When they do, it is possible that other forms of depression are diagnosed.

Psychotic depression - When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression.

Postpartum depression (postnatal depression) - Postpartum depression is also known as postnatal depression or PND. This is not to be confused with 'baby blues' which a mother may feel for a very short period after giving birth. If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed PND. Experts believe that about 10% to 15% of all women experience PND after giving birth. Sadly, many of them go undiagnosed and suffer for long periods without treatment and support.

SAD (seasonal affective disorder) - A person who develops a depressive illness during the winter months might have SAD. The symptoms go away during spring and/or summer. Light therapy works for about half of all SAD patients. In addition to light therapy, some people may need antidepressants, psychotherapy, or both. Light therapy is becoming more popular in other countries, such as Canada and the United Kingdom.

Bipolar disorder (manic-depressive illness) - Bipolar disorder is also known as manic-depressive illness. It used to be known as manic depression. It is not as common as major depression or dysthymia. A patient with bipolar disorder experiences moments of extreme highs and extreme lows. These extremes are known as manias.

Causes:

Experts say depression is caused by a combination of factors, such as the person's genes, his biochemical environment, his personal experience and psychological factors, but still not sure what causes depression. 

There are a number of other factors that may increase the chance of depression, like

Abuse  - Past physical, sexual, or emotional abuse can cause depression later in life.

Certain medications - For example, some drugs used to treat high blood pressure, such as beta-blockers or reserpine, can increase risk of depression.

Conflict - Depression may result from personal conflicts or disputes with family members or friends.

Death or a loss - Sadness or grief from the death or loss of a loved one, though natural, can also increase the risk of depression.

Genetics - A family history of depression may increase the risk. It's thought that depression is passed genetically from one generation to the next. The exact way this happens, though, is not known. According to geneticists, depression risk is influenced by multiple genes acting together with environmental and others factors. 

Major events - Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring.

Other personal problems - Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression.

Serious illnesses - Sometimes depression co-exists with a major illness or is a reaction to the illness.

Substance abuse - Nearly 30% of people with substance abuse problems also have major or clinical depression.

Folate and B12 deficiency associated with some depression symptoms - scientists from Finland, reported in the Journal of Affective Disorders that people with low levels of folate and vitamin B12 have a greater risk of developing melancholic depressive symptoms.

Changes in Depressive Individuals

Researchers have noted differences in the brains of people who are depressed as compared to people who are not. The hippocampus, a small part of the brain that is vital to the storage of memories, appears to be smaller in people with a history of depression than in those who've never been depressed. Scientists do not know why the hippocampus is smaller in those with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or poisonous effect on the hippocampus. Some experts theorize that depressed people are simply born with a smaller hippocampus and are therefore inclined to suffer from depression.

MRI (magnetic resonance imaging) has shown that the brain of a person with depression looks different, compared to the brain of a person who has never had depression. The areas of the brain that deal with thinking, sleep, mood, appetite and behavior do not appear to function normally. There are also indications that neurotransmitters appear to be out of balance. Neurotransmitters are chemicals that our brain cells use to communicate. 

Symptoms:

According to the National Institute of Mental Health, symptoms of depression may include the following:

·         Difficulty concentrating, remembering details, and making decisions

·         Fatigue and decreased energy

·         Feelings of guilt, worthlessness, and/or helplessness

·         Feelings of hopelessness and/or pessimism

·         Insomnia, early-morning wakefulness, or excessive sleeping

·         Irritability, restlessness

·         Loss of interest in activities or hobbies once pleasurable, including sex

·         Overeating or appetite loss

·         Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

·         Persistent sad, anxious, or "empty" feelings

·         Thoughts of suicide, suicide attempts

Warning signs of suicide with depression include:

·         A sudden switch from being very sad to being very calm or appearing to be happy

·         Always talking or thinking about death

·         Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse

·         Having a "death wish," tempting fate by taking risks that could lead to death, such as driving through red lights

·         Losing interest in things one used to care about

·         Making comments about being hopeless, helpless, or worthless

·         Putting affairs in order, tying up loose ends, changing a will

·         Saying things like "It would be better if I wasn't here" or "I want out"

·         Talking about suicide (killing one's self)

Diagnosis:

DSM-IV criteria for diagnosing depression: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM -IV), a manual used to classify and diagnose mental disorders, depression can be diagnosed in a particular case if at least five of the following nine symptoms are present at the same time for most of the days a week:

·         A depressed mood for major part of the day, particularly in the morning

·         Fatigue or loss of energy

·         Feelings of worthlessness or guilt that persist

·         Inability to concentrate on tasks, indecisiveness

·         Insomnia (inability to sleep) or hypersomnia (excessive sleeping)

·         Markedly diminished interest or pleasure in almost all activities (including those which were pleasurable earlier)

·         Recurring thoughts of death or suicide

·         Restlessness (psychomotor agitation) or being slowed down (retardation)

·         Weight loss or gain of more than 5% of body weight in a month's time

Management:

Home Remedies - St. John's wort is a common herbal supplement that is used.St. John's wort has been used for medical purposes in other parts of the world for thousands of years. 

Yoga - There is some evidence to suggest that yoga may be helpful for depression, but the evidence is not conclusive. Yoga involves meditation with physical postures, breathing techniques, and relaxation. Yoga practices vary, and some may not be recommended to people with certain medical conditions. In addition to meditation and yoga, on can use a number of other approaches such as progressive muscle relaxation, guided imagery, or music therapy.

Massage - Massage uses touch to help provide relaxation. Most touch therapies are based on the premises that the mind and body are interconnected and that physical health and emotional well-being are closely linked. The belief is that, when the body is relaxed, the mind contributes to better health, less depression, and overall well-being. There are also reports that mind/body exercises used with various types of bodywork can boost feelings of calmness. 

Different forms of exercise can lower stress, relax and help reduce symptoms of depression. Exercise can also increase energy, balance, and flexibility. In general, exercise is a safe, effective, and easy way to improve well-being. Check with your doctor before starting a new program.

Diet - Eat a Diet High in Nutrients include vitamins, minerals, carbohydrates, protein, and even a small amount of fat. Add more antioxidants, Eat "Smart" Carbs for a Calming Effect, Eat Protein-Rich Foods to Boost Alertness, Eat a Mediterranean-Type Diet(The Mediterranean diet is a balanced, healthy eating pattern that includes plenty of fruits, nuts, vegetables, cereals, legumes, and fish), Get Plenty of Vitamin D, Select Selenium-Rich Foods, Include Omega-3 Fatty Acids foods like fatty fish, flaxseed, and nuts.

Medical -  The kind of depression treatment that's best is depends on the type of depression. For example, some patients with clinical depression are treated with psychotherapy, and some are prescribed antidepressants. Others are prescribed antidepressants and psychotherapy. Still others may undergo electroconvulsive therapy (ECT), also called electroshock therapy. This treatment may be used with patients who do not respond to standard depression treatment options.

HOMOEOPATHIC MANAGEMENT:

Homoeopathy is a rational therapeutical system with its holistic, integrated, multi-disciplinary and totalistic approaches the subject of deprssion in a convincing rational way. Homoeopathy has long been used to relieve mental and emotional disorders, including depression etc. Homoeopathy can effectively treat most forms of depression with very good success rate. Early treatment is more effective and helps prevent the likelihood of serious recurrences. With adequate counseling and psychotherapy as an adjunct to homoeopathy, patients can be effectively helped out of their depression to lead a normal, joyful and satisfactory life.  The system has a huge range of remedies for practically every ailment and condition.  The best way to investigate the benefits of homoeopathy is to consult an accredited practitioner who is bound by a professional code of conduct and standards of practice. 

Indicated Remedies	Indications
Arsenicum album:	Anxious, insecure, and perfectionistic people who need this remedy may set high standards for themselves and others and become depressed if their expectations are not met. Worry about material security sometimes borders on despair. When feeling ill, these people can be demanding and dependent, even suspicious of others, fearing their condition could be serious.
Aurum metallicum:	This remedy can be helpful to serious people, strongly focused on work and achievement, who become depressed if they feel they have failed in some way. Discouragement, self-reproach, humiliation, and anger can lead to feelings of emptiness and worthlessness. The person may feel worse at night, with nightmares or insomnia.
Calcarea carbonica:	A dependable, industrious person who becomes overwhelmed from too much worry, work, or physical illness may benefit from this remedy. Anxiety, fatigue, confusion, discouragement, self-pity, and a dread of disaster may develop. A person who needs this remedy often feels chilly and sluggish and easily tires on exertion.
Causticum:	A person who feels depressed because of grief and loss (either recent or over time) may benefit from this remedy. Frequent crying or a feeling of mental dullness and forgetfulness (with anxious checking to see if the door is locked, if the stove is off, etc.) are other indications. People who need this remedy are often deeply sympathetic toward others and, having a strong sense of justice, can be deeply discouraged or angry about the world.
Cimicifuga:	A person who needs this remedy can be energetic and talkative when feeling well, but upset and gloomy when depressed—with exaggerated fears (of insanity, of being attacked, of disaster). Painful menstrual periods and headaches that involve the neck are often seen when this remedy is needed.
Ignatia amara:	Sensitive people who suffer grief or disappointment and try to keep the hurt inside may benefit from this remedy. Wanting not to cry or appear too vulnerable to others, they may seem guarded, defensive, and moody. They may also burst out laughing, or into tears, for no apparent reason. A feeling of a lump in the throat and heaviness in the chest with frequent sighing or yawning are strong indications forIgnatia. Insomnia (or excessive sleeping), headaches, and cramping pains in the abdomen and back are also often seen.
Kali phosphoricum:	If a person feels depressed after working too hard, being physically ill, or going through prolonged emotional stress or excitement, this remedy can be helpful. Exhausted, nervous, and jumpy, they may have difficulty working or concentrating—and become discouraged and lose confidence. Headaches from mental effort, easy perspiration, sensitivity to cold, anemia, insomnia, and indigestion are often seen when this remedy is needed.
Natrum carbonicum:	Individuals who need this remedy are usually mild, gentle, and selfless—making an effort to be cheerful and helpful, and avoiding conflict whenever possible. After being hurt or disappointed, they can become depressed, but keep their feelings to themselves. Even when feeling lonely, they withdraw to rest or listen to sad music, which can isolate them even more. Nervous and physically sensitive (to sun, to weather changes, and to many foods, especially milk), they may also get depressed when feeling weak or ill.
Natrum muriaticum:	People who need this remedy seem reserved, responsible, and private—yet have strong inner feelings (grief, romantic attachment, anger, or fear of misfortune) that they rarely show. Even though they want other people to feel for them, they can act affronted or angry if someone tries to console them, and need to be alone to cry. Anxiety, brooding about past grievances, migraines, back pain, and insomnia can also be experienced when the person is depressed. A craving for salt and tiredness from sun exposure are other indications for this remedy.
Pulsatilla:	People who needs this remedy have a childlike softness and sensitivity—and can also be whiny, jealous, and moody. When depressed, they are sad and tearful, wanting a lot of attention and comforting. Crying, fresh air, and gentle exercise usually improve their mood. Getting too warm or being in a stuffy room can increase anxiety. Depression around the time of hormonal changes (puberty, menstrual periods, or menopause) can often be helped with Pulsatilla.
Sepia:	People who feel weary, irritable, and indifferent to family members, and worn out by the demands of everyday life may respond to this remedy. They want to be left alone and may respond in an angry or cutting way if anyone bothers them. They often feel better from crying, but would rather have others keep their distance and not try to console them or cheer them up. Menstrual problems, a sagging feeling in internal organs, sluggish digestion, and improvement from vigorous exercise are other indications for this remedy.
Staphysagria:	Quiet, sensitive, emotional people who have difficulty standing up for themselves may benefit from this remedy. Hurt feelings, shame, resentment, and suppressed emotions can lead them to depression. If under too much pressure, they can sometimes lose their natural inhibition and fly into rages or throw things. A person who needs this remedy may also have insomnia (feeling sleepy all day, but unable to sleep at night), toothaches, headaches, stomachaches, or bladder infections that are stress-related.

 

OSTEOPOROSIS

BUILD STRONG BONES AND PREVENT OSTEOPOROSIS WITH ENERGY OF HOMOEOPATHY
     
Good health of the individual is mostly depend on strong bone and healthy skeletal makeup. There are totally 206 bones present in human body which are exquisitely and perfectly placed to keep skeleton in appropriate shape and in a healthy manner. Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bone has hard and solid outer shell surrounding the connecting plates and rods of bones within which lies the bone marrow, internally they are soft and spongy and thus bones are light, strong and flexible.
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

AETIOLOGY & RISK FACTORS

The leading cause of osteoporosis is a lack of certain hormones, particularly oestrogen in women and androgen in men. Women, especially those older than 60 years of age, are frequently diagnosed with the disease. Menopause is accompanied by lower oestrogen levels and increases a woman's risk for osteoporosis. Other factors that may contribute to bone loss in this age group include inadequate intake of calcium and vitamin D, lack of weight-bearing exercise, and other age-related changes in endocrine functions (in addition to lack of oestrogen).
Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certain genetic disorders, use of certain medications, and problems such as low calcium in the diet.
Women are at a greater risk than men, especially women who are thin or have a small frame, as are those of advanced age. Women who are white or Asian, especially those with a family member with osteoporosis, have a greater risk of developing osteoporosis than other women.
Women who are postmenopausal, including those who have had early or surgically induced menopause, or abnormal or absence of menstrual periods, are at greater risk.
Cigarette smoking, eating disorders such as anorexia nervosa or bulimia, low amounts of calcium in the diet, heavy alcohol consumption, inactive lifestyle, and use of certain medications, such as corticosteroids and anticonvulsants, are also risk factors.
Rheumatoid arthritis itself is a risk factor for osteoporosis.
Having a parent who has/had osteoporosis is a risk factor for the offspring.

CLINICAL FEATURES

Early in the course of the disease, osteoporosis may cause no symptoms. Later, it may cause height loss or dull pain in the bones or muscles, particularly low back pain or neck pain.
Later in the course of the disease, sharp pains may come on suddenly. The pain may not radiate (spread to other areas); it may be made worse by activity that puts weight on the area, may be accompanied by tenderness, and generally begins to subside in one week. Pain may linger more than three months.
People with osteoporosis may not even recall a fall or other trauma that might cause a broken bone, such as in the spine or foot. Spinal compression fractures may result in loss of height with a stooped posture (called a dowager's hump).
Fractures at other sites, commonly the hip or bones of the wrist, usually result from a fall.

DIAGNOSIS

A routine X-ray can reveal osteoporosis of the bone because the bones appear much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30% of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density. Thus, the appearance of the bone on X-ray often is affected by variations in the degree of exposure of the X-ray film.
The National Osteoporosis Foundation, the American Medical Association, and other major medical organizations recommend a dual-energy X-ray absorptiometry scan (DXA, formerly known as DEXA) be used for the diagnosis of osteoporosis. DXA typically measures bone density in the hip, the spine, and the forearm. The test takes only five to 15 minutes to perform, exposes patients to very little radiation (less than one-tenth to one-hundredth of the amount used on a standard chest X-ray), and is quite precise.
The bone density of the patient is compared to the average peak bone density of young adults of the same sex and race. This score is called the "T score" or T-score, and it expresses the bone density in terms of the number of standard deviations (SD) below peak young adult bone mass.
Osteoporosis is defined as a bone density T score of -2.5 or below.
Osteopenia (between normal and osteoporosis) is defined as bone density T score between -1 and -2.5.
It is important to note that while osteopenia is considered a lesser degree of bone loss than osteoporosis, it nevertheless can be of concern when it is associated with other risk factors that can increase the chances for developing vertebral, hip, and other fractures. In this setting, osteopenia may require medication as part of the treatment program.

BONE MINERAL DENSITY TESTING

The National Osteoporosis Foundation guidelines state that there are several groups of people who should consider DXA testing for proper diagnosis of bone health:
All postmenopausal women below age 65 who have risk factors for osteoporosis
All women aged 65 and older
Postmenopausal women with fractures, although this is not mandatory because treatment may well be started regardless of bone density
Women with any of more than 50 medical conditions associated with osteoporosis; a primary care physician can scan a patient's list of medical illnesses to determine if one of these conditions is present (see causes above)
Women whose decision to begin treatment for osteoporosis might be aided by bone density testing to determine the presence or absence of osteoporosis or osteopenia
The National Osteoporosis Foundation guidelines state that bone-density testing does not need to be performed if a person has a known osteoporotic fracture because the patient will be treated for osteoporosis with or without a bone-density study. In addition, bone-density testing is not appropriate if the person undergoing the test is not willing to take treatment based on the results. Therefore, if bone-density testing is done, it should be performed on people willing to take some specific action to improve their bone health based on the results.
Bone biopsy may be useful in unusual forms of osteoporosis. It provides information about rate of bone turnover and presence of secondary forms of osteoporosis. Patient with high bone turnover usually respond to antiresorptive drugs.


MANAGEMENT

General
Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D
Exercise has a wide variety of beneficial health effects. However, exercise does not bring about substantial increases in bone density. The benefit of exercise for osteoporosis has mostly to do with decreasing the risk of falls, probably because balance is improved and/or muscle strength is increased. Research has not yet determined what type of exercise is best for osteoporosis or for how long it should be continued. Until research has answered these questions, most doctors recommend weight-bearing exercise, such as walking, preferably daily for optimal health.
Building strong and healthy bones requires an adequate dietary intake of calcium beginning in childhood and adolescence for both sexes.

Home Remedies
Some of the most effective home remedies for osteoporosis include the use of beans, vinegar, spinach, milk, pineapple juice, salmon, tofu, red clover, black   cohosh, yogurt, and calcium supplements, as well as behavioral modifications, including quitting smoking, cutting back on alcohol, maintaining a healthy weight, exercising, and reducing protein intake.
Milk - Arguably the most famous substance to help “build strong bones”, the calcium found in milk is a wonderful way to work a daily bone-boost into your diet and health regimen. A single glass of milk can represent one-quarter of the recommended daily amount.
Lower Protein Intake - Research has suggested that human beings actually consume more protein than is necessary for a healthy life, and the excretion of protein often includes excreting [13]calcium, which compounds the problems of osteoporosis
One of the newest findings concerning osteoporosis has to do with manganese deficiency, so ensuring a high level of that mineral can seriously help fend off bone degradation. Freshly squeezed pineapple juice is a rich source of manganese.
Excessive consumption of calcium to prevent osteoporosis can cause other problems, like calcium deposition that leads to gout, gall stones etc. Long-term treatment with calcium supplements is not recommended because some patients develop bone spurs, kidney and gall bladder stones due to calcium deposits. Discuss with trained medical professional about diet which is suitable for age before adding any major home remedies for osteoporosis.

HOMOEOPATHIC MANAGEMENT
The aim of homeopathy is not only to treat osteoporosis but to address its underlying cause and individual susceptibility. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. As far as therapeutic medication is concerned, several well-proved medicines are available for osteoporosis treatment that can be selected on the basis of cause, sensation and modalities of the complaints.
Homoeopathic remedies used in low potency doses can be a great part in the quest to nourish, build, and maintain strong, healthy, vitally intelligent and flexible bones.  Homoeopathically prepared minerals in particular help us to engage the energy of the foods, herbs, and exercise we also use to build and strengthen bone. Homoeopathics used in this way might be seen as reminders to our body’s intelligent foundation which directs nourishment and growth, Homoeopathy can also be a most useful bridge when even the best lifestyle efforts are failing to work well enough and you find yourself tempted to take calcium supplements. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Some important remedies are given below for osteoporosis treatment:

Indicated Remedies
Indications

Calcaria Phos
it is an excellent remedy for osteoporosis. Delicate and easily breakable bones. The bones of the head are deficient in quality and quantity. This will promote the absorption of calcium from the food that the patient takes. The bones of the neck are too small and weak to support the head which is normally large. The bones of the extremities are also weak and fragile. Stools green, undigested and offensive. No appetite, it is a bone builder and creates new blood cells. It gives general tone to the entire organism.

Calcaria Carb
remarkable medicine for osteoporosis. Promotes the absorption of calcium

Calcaria Iod
should be thought of when there is deficiency of muscles and fat in addition to deficiency of bones. Unhealthy condition of glands is always present when this remedy is indicated.

Silicea

People who need this remedy are often nervous, easily tired, very chilly, and tend to sweat at night. They have a refined or delicate appearance, and often have weakness in the spine. Their injuries are slow to heal, and they tend to have a low resistance to infection. Moderate exercise often warms the person up and improves energy.

Phosphorus


This remedy is often helpful to people who are sensitive, suggestible, imaginative, but easily tired or weakened physically. Bones may be less strong than normal, or be slow to heal after fractures. Weakness is often felt in the spine, with burning pain between the shoulder blades. People who need this remedy are often tall and thin with an easily-flushing face. A desire for refreshing foods (especially ice cream) and strong thirst for cold or carbonated drinks are other indications for Phosphorus

Symphytum
When osteoporosis is a problem, fractures often occur from mild trauma. This remedy can be useful for strengthening and healing bones when new fractures occur, and also helpful when pain persists in old, healed fractures (see Fractures).

Osteocynesine
Homoeopathic calcium tablets
French and Czech teams reported beneficial effects of a complex homeopathic medicine Osteocynesine in osteoporosis in menopausal women. Women got bone density tests before and after 3- and 6-month treatment with Osteocynesine that contains homeopathic dilutions of Calcarea carbonica, Calcarea phosphorica, Calcarea fluorica and Sulphur iodatum. The follow-ups showed increase of bone density.

HIGH BLOOD PRESSURE (HYPERTENSION) - ITS MODERN UNDERSTANDING AND HOMOEOPATHIC APPROACH

                                                                                               

Hypertension or high blood pressure, sometimes called arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is elevated. Hypertension, or abnormally high blood pressure, is often referred to as the “silent killer.” This is because it does not usually manifest any symptoms while causing damage to the heart, brain, kidneys, and eyes. By hearing the word Blood Pressure, People himself thinks that it’s a serious disease likewise but fact is that increased blood pressure than its normal range is not merely a disease by itself, but a sign or manifestation of a pathological process.

According to the World Health Organization, “Hypertension affects 600 million people worldwide. Yet many are unaware that they have the disease and are at risk of developing a stroke, heart disease, blindness and kidney failure. Hypertension causes five million premature deaths per year, yet there is no proper solution for curing hypertension.”

High blood pressure seems to be more common in modern times. Intensive struggle for existence associated with continual anxiety, greed, ambition, artificial methods of living, want of faith in religion, intemperance, irregular hours, adulterated and unwholesome food and many vices peculiar to modern civilization do play an important part in its causation. With the advancement of medical sciences and the invention of sphygmomanometer, the detection of hypertension become very easy and patient myself inclined to check there blood pressure in frequent intervals and more cases are brought to the notice of the physicians.

Normal blood pressure at rest is within the range of 100– 140mmHg systolic and 60–90mmHg diastolic. High blood pressure is said to be present if it is often at or above 140/90 mmHg.

Causes of Hypertension

Hypertension is classified as either primary (essential) hypertension or secondary hypertension; about 90–95% of cases are categorized as "primary hypertension" which means high blood pressure with no obvious underlying medical cause. The remaining 5–10% of cases (secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart or endocrine system. In females the prevalence is closely related to age, with a substantial increase occurring after age 50. This increase is presumably related to the hormonal changes of menopause. The ratio of hypertension frequency in women versus men increases from 0.6 to 0.7 at age 30 to 1.1 to1.2 at age 65.

Primary (essential) hypertension - For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

Secondary hypertension - Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

Kidney problems, Adrenal gland tumors, Thyroid problems, Certain defects in blood vessels congenitaly, Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs, Illegal drugs, such as cocaine and amphetamines, Alcohol abuse or chronic alcohol use, Obstructive sleep apnea.

Risk Factors

Strong familial and genetic predisposition and a number of modifiable predisposing factors have also been identified. Several studies have demonstrated the influences of Weight gain, Insulin resistance, Salt intake, Physically inactive, Mental stress, Tobacco Smoking Alcohol use, Elevated haematocrit, Hypertriglyceridaemia and Rapid heart rate. Sometimes pregnancy contributes to high blood pressure, as well. Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to high blood pressure.

Clinical manifestations

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms usually don't occur until high blood pressure has reached a severe or life threatening stage.

American Heart Association, Recommended Blood Pressure Levels are

1.      Optimal Level < 120 / 80, it should be rechecked in every 2 years.

2.      Normal Level < 130 / 85, it should be rechecked in every 2 years.

3.      High Normal Level <130 – 139 / 85 – 90 it should be rechecked in every 1 years.

Diagnosis

Blood pressure measurements fall into four general categories:

Normal blood pressure - blood pressure is normal if it's below 120/80 mm Hg. Once blood pressure rises above 120/80 mm Hg, the risk of cardiovascular disease begins to increase.

Prehypertension - Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.

Stage 1 hypertension - Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.

Stage 2 hypertension - More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Both numbers in a blood pressure reading are important. But after age 60, the systolic reading is even more significant. Isolated systolic hypertension — when diastolic pressure is normal but systolic pressure is high — is a common type of high blood pressure among people older than 60.

White coat high blood pressure

A single elevated blood pressure reading in the doctor's office can be misleading because the elevation may be only temporary. It may be caused by a patient's anxiety related to the stress of the examination and fear that something will be wrong with his or her health. The initial visit to the physician's office is often the cause of an artificially high blood pressure that may disappear with repeated testing after rest and with follow-up visits and blood pressure checks. One out of four people that are thought to have mild hypertension actually may have normal blood pressure when they are outside the physician's office. An increase in blood pressure noted only in the doctor's office is called 'white coat hypertension.' The name suggests that the physician's white coat induces the patient's anxiety and a brief increase in blood pressure. A diagnosis of white coat hypertension might imply that it is not a clinically important or dangerous finding. However, caution is warranted in assessing white coat hypertension. An elevated blood pressure brought on by the stress and anxiety of a visit to the doctor may not necessarily always be a harmless finding since other stresses in a patient's life may also cause elevations in the blood pressure that are not ordinarily being measured. Monitoring blood pressure at home by blood pressure cuff or continuous monitoring equipment or at a pharmacy can help estimate the frequency and consistency of higher blood pressure readings. Additionally, conducting appropriate tests to search for any complications of hypertension can help evaluate the significance of variable blood pressure readings.

Borderline high blood pressure

Borderline hypertension is defined as mildly elevated blood pressure higher than 140/90 mm Hg sometimes, and lower than that at other times. As in the case of white coat hypertension, patients with borderline hypertension need to have their blood pressure taken on several occasions and their end organ damage assessed in order to establish whether their hypertension is significant. People with borderline hypertension may have a tendency as they get older to develop more sustained or higher elevations of blood pressure. They have a modestly increased risk of developing cardiovascular disease. Therefore, even if the hypertension does not appear to be significant initially, people with borderline hypertension should have continuing follow-up of their blood pressure and monitoring for the complications of hypertension.

If, during the follow-up of a patient with borderline hypertension, the blood pressure becomes persistently higher than 140/ 90 mm Hg, an antihypertensive medication is usually started. Even if the diastolic pressure remains at a borderline level (usually less than 90 mm Hg, yet persistently above 85) treatment may be started in certain circumstances.

Complications of hypertension:

In the beginning hypertension is labile, but in due course, it becomes established hypertension. The complications are more common in higher blood pressures. The accompanying arteriosclerosis may be the reason for cardiovascular diseases in uncontrolled hypertension; Ischemic heart diseases like angina pectoris, myocardial infarction or congestive heart failure. 50% of patients die, 33% get cerebral strokes, 15% get renal failure. Renal failure is more common in hypertension with diabetes as the patients suffer from proteinuria, which is an evidence of nephropathy.

The complications are classified into two types-

Hypertensive complications like Malignant hypertension, Congestive cardiac failure Aortic dissection and aneurysm, Nephrosclerosis, Cerebral hemorrhages and infarctions

Atherosclerotic complications like Ischemic heart diseases like angina pectoris and myocardial infractions, Sudden death, Arrhythmias, Cerebral thrombotic strokes, Peripheral vascular diseases

Home Remedies for High Blood Pressure:

• Bananas are one fruit that people with high blood pressure can eat regularly to control it. Bananas are a rich source of potassium, which helps control blood pressure levels. At the same time, they are low in sodium and have no cholesterol, both of which also are good for people with this problem.
• Coconut Water - People with high blood pressure must keep their bodies well hydrated. It is a good idea to drink eight to 10 glasses of water daily. Coconut water is particularly beneficial for lowering blood pressure.
• Black seed oil contains a number of active ingredients that have been shown to help reduce cholesterol and control high blood pressure. Therefore, to reduce excess blood pressure simply take one teaspoon of Black Seed oil daily. Black Seed Oil can also be mixed into juice or tea if you don't like the taste of the raw oil.
• Garlic has also been known to help reduce high blood pressure. Although the exact reasons are still not clear, studies have shown that eating just a single clove a day (either raw or cooked) has a beneficial effect. An added bonus for eating garlic is that it is also known to reduce cholesterol. Therefore, regularly consuming garlic, either fresh or in capsule form, is a great way to reduce your risk of heart disease.
• Lemons help keep blood vessels soft and pliable and by removing any rigidity, high blood pressure will be reduced. In addition, you can help lower your chance of heart failure by consuming lemon juice regularly, due to its vitamin B content.
• Ginkgo Biloba is an herb which helps increase blood circulation in our bodies by dilating our blood vessels. Therefore, asimple remedy to lower blood pressure is to take 120mg of Ginkgo Biloba extract daily before any meal.
• Watermelon seeds contain a compound called cucurbocitrin, which helps widen the blood capillaries. At the same time, it also helps improve kidney functioning. This in turn reduces blood pressure levels and also helps a lot with arthritis.

HOMOEOPATHIC MANAGEMENT

Homoeopathy considers health as a state indicating harmonious functioning of the life force. Disease is a deviation from health, which develops when the life force is unable to overcome obstructions to its smooth functioning. Being a chronic disease, it requires constitutional, antimiasmatic treatment. It is the totality of symptoms which guides the homoeopath to the indicated remedy. A constitutional remedy chosen by an experienced prescriber is the most appropriate way to treat deep-seated, serious, or chronic conditions. Some remedies may be useful as first-aid in intense situations, but medical care should also be sought immediately. Remedies below have been helpful to some people with hypertension.

Indicated Remedies	Indications
Argentum nitricum	If blood pressure rises with anxiety and nervousness, this remedy may be indicated. “Stage fright” or anticipation of a stressful event can bring on dizziness, headache, diarrhea, and a pounding pulse. People who need this remedy are typically warm-blooded, imaginative, impulsive, claustrophobic, and have strong cravings for sweets and salt.
Aurum metallicum	This remedy is sometimes indicated for serious people, focused on career and accomplishment, with blood pressure problems related to stress. Worry, depression, or anger may occur, especially when these people feel they have made a mistake or failed in some way. A general tendency to feel worse at night, and a strong desire for alcohol, sweets, bread, and pastries are other indications for Aurum.
Belladonna	This remedy is indicated when symptoms come on suddenly, with great intensity and heat. The person’s face is flushed, with dilated pupils, and pulsations and throbbing may be felt in various parts of the body. Despite the general heat, the person’s hands and feet may be cold. Vertigo and pounding headaches, worse from jarring and worse from light, may also occur.
Calcarea carbonica	This remedy is often helpful to people with high blood pressure who easily tire and have poor stamina. They are typically responsible types, who feel overwhelmed when ill and fear a breakdown. Palpitations and breathing problems can be worse from walking up a slope or stairs, and also when lying down. A general chilliness with clammy hands and feet (the feet may heat up in bed at night) and sweat on the head during sleep are other indications. The person may have cravings for sweets and eggs, and tend toward weight problems.
Glonoinum	A flushed face with a pounding headache and visible throbbing in the blood vessels of the neck may indicate a need for this remedy. The chest can feel congested or hot, with a pounding or irregular heartbeat. The person is worse from moving around, after heat and sun exposure, and after drinking alcohol. A feeling of “being lost in a familiar place” is a strong indication for this remedy.
Lachesis	A person who needs this remedy typically is intense and talkative, with inner passion and agitation that need an outlet—a “pressure-cooker.” The person may have a strong fear of disease, and feelings of suspicion, revenge, or jealousy are common. The person may also have heart or artery problems, look flushed or purplish, and feel constriction in the chest, with pulsations in many areas. Feeling worse after taking a nap or on waking in the morning, and a strong intolerance of clothing around the neck (or any kind of restriction) are other indications for Lachesis.
Natrum muriaticum	A person who needs this remedy seems reserved and responsible, but may have very strong feelings (of grief, disappointment, anger, lingering grudges, a fear of misfortune) inside. Headaches and palpitations are common, as well as a feeling of tension (even coldness) in the chest. The person feels worse from being in the sun, worse around midmorning, and better from being alone in a quiet place. A craving for salt and strong thirst can help to confirm the choice of this remedy.
Nux vomica	A person who needs this remedy is usually impatient and driven—easily frustrated, angered, and offended. A strong desire for coffee and other stimulants, sweets, strong foods, and alcohol or drugs may aggravate blood pressure problems. Palpitations, constricting feelings in the chest, constipation, and hemorrhoids are often seen. The person is typically sensitive to light, noise, odors, and interference.
Phosphorus	A person who needs this remedy usually is sensitive, suggestible, and sympathetic, with a tendency toward weakness, dizziness, a “spaced-out” feeling, and fearfulness. Nosebleeds, facial flushing, palpitations, and a feeling of heaviness or pain in the chest, and left-sided problems are often seen. A strong desire for cold drinks and refreshing things, and a marked improvement after eating and sleeping are other indications for Phosphorus.
Plumbum	This remedy is indicated for people with degenerative problems of the nerves and hardening of the arteries. Chest tightness and palpitations are often worse when lying on the left side. Contractures, paralysis, and nerve or muscle problems are also likely. The person may have a history of heavy drinking and “high living”—becoming apathetic or depressed when physical debility and memory problems develop.
Sanguinaria	A feeling that blood is rushing to the head, with flushed red cheeks and pulsing in the neck, may indicate this remedy. The person may have headaches or migraines (usually on the right and worse from light and noise). Right-sided neck and shoulder problems, allergies, heartburn, and digestive problems are often seen, and burning pains are typical. Symptoms are worse from motion, and relief may come from being in the dark and sleeping. A craving for spicy food, and a tendency to feel worse from eating sweets are other indications for Sanguinaria.
Terminalia Arjuna	A great remedy for heart maladies. Highly effective in cases of high blood pressure with vertigo, palpitation and a sense of mental and physical exhaustion. It is a good remedy for diseases of the heart, both organic and functional, angina pectoris, weakness and pain in the heart.
Viscum Album	Feeling of suffocation when lying on the left side. Stertorous breathing. Spasmodic cough. Arterial hypertension with valvular insufficiency. Unable to rest in a reclining position. Oedematous swelling of the extremities. Teeth chatter. Eyes sleepy, difficult to open, lids heavy. Bowels obstinately constipated. Urine milky-white after standing. Palpitation during coitus. Heart gives a throb and then a pause. Pulse small, quick and very irregular, slow, full and bounding. Low tension due to dilated blood vessels.
Ignatia Amara	Indicated in high blood pressure due to emotions, disappointed love and/or grief. Fluttering of the muscles of chest. Throbbing cardiac hyperaesthesia. Anxious feeling in precordia. Difficult respiration, as if there is some weight on the chest, shortness of breath when walking. Feeling of suffocation on running. Palpitation of the heart at night. Strong disposition to be frightened. Sadness and concentrated sorrow with sighing. Loves solitude.