PSORIASIS

PSORIASIS – HOLISTIC APPROACH TO A COMMON CHRONIC SKIN DISORDER

Psoriasis (sore-EYE-ah-sis) is a chronic (long-lasting) disease. Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin. It typically affects the outside of the elbows, knees or scalp, though it can appear on any location. Some people report that psoriasis is itchy, burns and stings. Psoriasis is associated with other serious health conditions, such as diabetes, heart disease and depression.

CAUSES

Many researches and scientists do not know what exactly causes psoriasis; we do know that the immune system and genetics play major roles in its development. Usually, something triggers psoriasis to flare. The skin cells in people with psoriasis grow at an abnormally fast rate, which causes the buildup of psoriasis lesions.

Men and women develop psoriasis at equal rates. Psoriasis also occurs in all racial groups, but at varying rates. Psoriasis often develops between the ages of 15 and 35, but it can develop at any age. About 10 to 15 percent of those with psoriasis get it before age 10. Some infants have psoriasis, although this is considered rare.

Psoriasis is not contagious. Psoriasis lesions are not infectious.

TRIGGERING FACTORS

Psoriasis typically starts or worsens because of a trigger, Factors that may trigger psoriasis include Infections, such as strep throat or skin infections, Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn, Stress, Cold weather, Smoking,

Heavy alcohol consumption, Certain medications — including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers; antimalarial drugs and iodides.

RISK FACTORS

Anyone can develop psoriasis, but these factors can increase risk of developing the disease

Family history. - Perhaps the most significant risk factor for psoriasis is having a family history of the disease. Having one parent with psoriasis increases risk of getting the disease, and having two parents with psoriasis increases risk even more.

Viral and bacterial infections -  People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.

Stress -  Because stress can impact immune system, high stress levels may increase risk of psoriasis.

Obesity - Excess weight increases the risk of psoriasis. Plaques associated with all types of psoriasis often develop in skin creases and folds.

Smoking -  Smoking tobacco not only increases  risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.

CLINICAL MANIFESTATIONS

Psoriasis signs and symptoms can vary from person to person but may include one or more like Red patches of skin covered with silvery scales, Small scaling spots (commonly seen in children), Dry, cracked skin that may bleed, Itching, burning or soreness, Thickened, pitted or ridged nails, Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.

Classifications

Several types of psoriasis exist. These include:

Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques itch or may be painful and can occur anywhere on body, including genitals and the soft tissue inside mouth, may have just a few plaques or many.

Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.

Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. The red or scaly areas often extend beyond the hairline. There may notice flakes of dead skin in hair or on shoulders, especially after scratching scalp.

Guttate psoriasis. This primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. There may have a single outbreak that goes away on its own, or may have repeated episodes.

Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's worsened by friction and sweating. Fungal infections may trigger this type of psoriasis.

Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.

Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover entire body with a red, peeling rash that can itch or burn intensely.

Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.

DIAGNOSIS

In most cases, diagnosis of psoriasis is fairly straightforward.

Physical exam and medical history. Physician itself usually can diagnose psoriasis by taking medical history and examining skin, scalp and nails.

Skin biopsy. Rarely, physician may take a small sample of skin (biopsy) that's examined under a microscope to determine the exact type of psoriasis and to rule out other disorders.

Other conditions that may look like psoriasis or may occur at the same time as psoriasis include:

Seborrheic dermatitis. This type of dermatitis is characterized by greasy, scaly, itchy, red skin. It's often found on oily areas of the body, such as the face, upper chest and back. Seborrheic dermatitis can also appear on the scalp as stubborn, itchy dandruff.

Lichen planus. This is an inflammatory, itchy skin condition that appears as rows of itchy, flat-topped bumps (lesions) on the arms and legs.

Ringworm of the body (tinea corporis). Ringworm is caused by a fungal infection on the top layer of your skin. The infection often causes a red, scaly ring or circle of rash.

Pityriasis rosea. This common skin condition usually begins as one large spot (herald patch) on your chest, abdomen or back, which then spreads. The rash of pityriasis rosea often extends from the middle of the body, and its shape resembles drooping pine tree branches.

MANAGEMENT

Lifestyle Remedies

Although self-help measures won't cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you:

Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats.

Use moisturizer. Blot your skin after bathing, then immediately apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable — they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day.

Expose your skin to small amounts of sunlight. A controlled amount of sunlight can significantly improve lesions, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer.

Avoid psoriasis triggers. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis.

Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments.

Natural home remedies

Aloe vera: Applying aloevera gel to the affected area will reduce the rashes and scaling of skin. It has been tested by many dermatologists. Aloevera gel needs to be applied 3 times everyday to reduce the lesions. If you do this for three to four weeks, you will notice a major change on your skin.

Banana peel is the vital ingredient to cure skin ailments. You can use a banana peel and rub the inner area of the peel to your lesions. It will soothe your skin and remove the rashes.

Cayenne pepper also holds anti-inflammatory properties, that help in healing the skin. It reduces the redness and scaling. Try to get a Capsaicin cream, that is available in medical stores. It is made from hot peppers and is simply great to reduce the lesions. Make sure you do not apply it on broken skin.

Castor Oil - Applying Castrol oil to small, thick and wellcircumscribed lesions will help to improve your skin. Mix coldpressed castor oil with 1 teaspoon of baking soda. Apply this mixture on the lesions before going to bed. You will notice a complete healing of that area after a few weeks. Do not apply this on open skin.

Chamomile contain anti-inflammatory flavonoid compounds. This will help to treat psoriasis and is widely used in Europe for this purpose.

Turmeric -  This herb is being frequently studied for its powerful anti-inflammatory and antioxidant properties. Curcumin, the active ingredient in turmeric also has the ability to alter gene expression.

Coconut Oil -  Applying tepidly warm coconut oil on the affected areas for half an hour will prevent dryness and reduces the chances of aggravation.

Fish Oil -  The fatty acids present in Omega 3 have proved to cure the problem of scaly and patchy skin. Creams based with fish oil can be applied to the affected area to reduce the problem.

Epsom Salt Bath - Fill your bath tub with luke warm water. You can add a cup of milk & Epsom salt. This soothing shower will help you to get rid of the itchiness and it will gradually reduce the plaques and scales on your body.

Baking Soda & Water - Take 1 teaspoon of baking soda and 4 teaspoons of water. Mix them together and apply it to the affected area. Apply this with a sterilized cotton or cloth, to prevent bacteria. Leave it on till it dries and fall off. this mixture will help to reduce the itchiness of these areas.

HOMOEOPATHIC MANAGEMENT

From the homoeopathic point of view physician can approach treatment in different ways. Homoeopathy treats the person as a whole and tries to find a constitutional remedy with the aim of strengthening the organism generally. This means looking at not only the patient’s psoriasis symptoms, but also his or her general health and way of reacting to the environment, as well as what drives him or her on an emotional level. But homoeopaths can also treat symptomatically, meaning treating the psoriasis symptoms specifically. Usually aim for constitutional treatment but sometimes combine the two approaches, giving a more symptomatic skin remedy for flare ups, while treating the person as a whole with a constitutional remedy. Homoeopathic medicines for Psoriasis act on the body at the level of immunity and restore the deviated function. They also help to control the symptoms of Psoriasis without any side-effects. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. Please consult a qualified homoeopath before taking any homoeopathic remedy.

Indicated Remedies	Indications
Graphites:	Skin becomes rough, hard and persistent dryness. Psoriasis especially at the bend of joints, groins, neck, behind ears, and even nails. The skin gets cracked. Along with psoriasis joints get involved. Psoriasis with lot of burning and stinging. Psoriasis along with eczema. This remedy executes positive influence over digestive system, female reproductive system, etc. This remedy is suited more to obese individuals who are sensitive to cold and are usually constipated.
Kali arsenicum	The patient complains of intolerable itching that aggravates on undressing. Itching more in warm room or warm season. Cuts and fissures in bends of elbow and knee joint. Psoriasis associated with arthritis. The remedy is more suitable to individuals who are restless, nervous, and anemic.
Arsenic Album	Excellent psoriasis remedy in which psoriasis, worse by cold application and wetness, better by warmth.
Kali Brom	remarkable psoriasis remedy in which there is syphilitic psoriasis. Skin cold, blue, spotted corrugated, large, indolent, painful pustules.
Thyrodinum	one of the best psoriasis remedy for chilly and anemic subjects. Dry impoverished skin; cold hands and feet.
Radium Brom	psoriasis of penis, itching eruptions on face oozing, Patchy erythema on forehead.
Apis melliaca	for skin rashes that feel hot and dry and are sensitive to touch. Symptoms improve with cool baths and worsen with heat. This remedy is most appropriate for individuals who often feel sad, disappointed, or evendepressed. They tend to cry easily but may also be irritable and envious by nature.
Calendula	used topically, particularly if the affected area becomes inflamed. This remedy will soothe but not cure the skin condition.
Rhus toxicodendron	used for psoriatic arthritis and for skin disorders accompanied by intense itching that worsens at night and improves with the application of heat. This remedy is most appropriate for individuals who are generally restless and unable to get comfortable at night.
Sulphur	for skin disorders that are accompanied by intense itching. This remedy is most appropriate for individuals who are thirsty, irritable when not feeling well, uninspired and messy under ordinary circumstances, and who describe a sensation of internal heat and burning. Symptoms tend to improve with open, cold air and worsen with warmth
Kali Arsenicosum	It has marked action on skin disorders like eczema, psoriasis and ulcers. There are dry, scaly eruptions with itching worse from warmth, walking and undressing. It is also useful in chronic eczema. There are ãssures in bends of arms and knees. There are numerous small nodules under the skin. Intolerable itching worse while undressing in psoriasis.
Kali Sulphuricum	It has marked action on psoriasis. There are burning, itching, papular eruptions. Skin is dry, hot and burning. Itchy eruptions in nettle rash in children. Kali Sulph also helps in seborrhoea or dandruff and ringworm of scalp or beard with abundant scales. Sores on skin with thick, profuse, yellow watery secretion.

MENTAL STRESS

MENTAL STRESSFUL LIFE – CAUSE OF ALL DISEASES? MANAGEMENT WITH HOLISTIC APPROACH

Stress, an unpleasant state of emotional and physiological arousal that people experience in situations that they perceive as dangerous or threatening to their well-being. The word “Stress” means different things to different people. Some people define stress as events or situations that cause them to feel tension, pressure, or negative emotions such as anxiety and anger. Others see the stress as the response to these situations. Stress is a common experience. We may feel stress when we are very busy, have important deadlines to meet, or have too little time to finish all of our tasks.

Often people experience stress because of problems at work or in social relationships, such as a poor evaluation by a supervisor or an argument with a friend. Some people may be particularly vulnerable to stress in situations involving the threat of failure or personal humiliation. Others have extreme fears of objects or things associated with physical threats-such as snakes, illness, storms, or flying in an airplane and become stressed when they encounter or think about these perceived threats.

Stress produces numerous symptoms which vary according to persons, situations, and severity. These can include physical health decline as well as depression.

Physical Signs and Symptoms: Increased heart rate, Pounding heart, Elevated blood pressure, Sweaty palms, Tightness of the chest, neck, jaw, and back muscles, Headache, Diarrhea, Constipation, Urinary hesitancy, Trembling, Twitching, Stuttering and other speech difficulties, Nausea, Vomiting, Sleep disturbances, Fatigue, Shallow breathing, Dryness of the mouth or throat, Susceptibility to minor illness, Cold hands, Itching, Being easily startled, Chronic pain and Dysponesis

Emotional signs and symptoms of stress:  Irritability, Angry outbursts, Hostility, Depression, Jealously, Restlessness, Withdrawal, Anxiousness, Diminished initiative, Feelings of unreality or over-alertness, Reduction of personal involvement with others, Lack of interest, Tendency to cry, Being critical of others, Self-deprecation, Nightmares, Impatience, Weakened positive emotional response reflexes, Changes in eating habits and, Insomnia, Reduced self-esteem, Obsessive rumination, Narrowed focus, Experience opportunities, Decreased perception of positive.

Cognitive/Perceptual Signs and Symptoms of Stress: Forgetfulness, Preoccupation, Blocking, Blurred vision, Errors in judging distance, Diminished or exaggerated fantasy life, Reduced creativity, Lack of concentration, Diminished productivity, Lack of attention to detail, Orientation to the past, Decreased psychomotor reactivity and coordination, Attention deficit, Disorganization of thought, Negative self-esteem, Diminished sense of meaning in life, Lack of control/need for too much control, Negative self-statements and negative evaluation of experiences

Behavioral Signs and Symptoms of Stress : Increased smoking, Aggressive behaviors (such as driving - road rage, etc.), Increased alcohol or drug use, Carelessness, Under-eating, Over-eating, Withdrawal, Listlessness, Hostility, Accident-proneness, Nervous laughter, Compulsive behavior and Impatience.

Signs of Stress in the Workplace

Stress Arousal Stage - Persistent irritability and anxiety, Bruxism and/or Insomnia, Occasional forgetfulness and/or inability to concentrate

Stress Resistance Stage - Absenteeism or tardiness for work, Tired and fatigued for no reason, Procrastination and indecision, Social withdrawal with cynicism, Resentful, indifferent, defiant, Increased use of coffee, alcohol, tobacco, etc.

Severe Exhaustion Stage - Chronic sadness or depression, Chronic mental and physical fatigue, Chronic stress related illnesses (headache, stomach ache, bowel problems, etc.), Isolation, withdrawal, self-destructive thoughts

Long Term Implications of Stress

Exposure to stress on a long-term basis can be debilitating both physically and mentally. Under stress, the body produces an increase in the hormones adrenaline, noradrenaline and corticosteroids. In the short-term these hormones produce tense muscles, queasiness and an increase in breathing and heart rates.

Long-term complaints that are stress related include: Allergies, Anxiety and depression, Digestive disorders , Fatigue, Headaches and migraine, Heart disease, High blood pressure, Impotence and premature ejaculation in men, Insomnia, Irritable bladder, Irritable bowel syndrome, Menstrual problems in women, Mouth and peptic ulcers, Muscular aches and pains, Palpitations, Panic attacks, Eczema, Ulcerative colitis

POSSIBLE STRESS DISORDERS

Possible Physical Disorders Caused By Or Exacerbated By Stress are Hypertension, Cardiovascular disorders, Migraine and tension headaches, Cancer, Arthritis, Respiratory disease, Ulcers, Colitis, Muscle tension problems

Possible Emotional Disorders Caused By Or Exacerbated By Stress are Anxiety, Panic attack, Depression, Adjustment disorders.

Possible Behavioral Disorders Caused By Or Exacerbated By Stress are Eating disorders, Conduct disorders, Alcoholism, Hyperchondricism.

Stress and Aging

Recent research results suggest that long-term exposure to adrenal stress hormones may boost brain aging in later life.

Writing in the journal “Nature Neuroscience”, scientists at the University of Kentucky in Lexington looked at the results of memory tests taken by elderly patients with high levels of the stress hormone cortisol, released by adrenal glands when the body is stressed. That high-level group scored lower than others with reduced levels of the hormone, researchers say.

The level of hormone released apparently affects the total volume of the brain's hippocampus -- a major source of recall and memory function -- in later life. Those with high levels had a hippocampus volume 14 percent less than those with lower levels, researchers found.

The study results suggest "chronic stress may accelerate hippocampal deterioration," said the researchers.

GENERAL MANAGEMENT

If we think about the causes of stress, the nature of the stress response, and the negative effects of some types of stress (prolonged, unexpected, or unmanageable stress), several healthy management strategies become clear.

Diet - A well balanced diet is crucial in preserving health and helping to reduce stress. Certain foods and drinks act as powerful stimulants to the body and hence are a direct cause of stress. This stimulation, although quite pleasurable in the short term, may be quite harmful in the long run. We will look at a few of them:

Foods to Eat - Whole grains promote the production of the brain neurotransmitter serotonin, which increases your sense of well-being. Green, yellow, and orange vegetables are all rich in minerals, vitamins, and phytochemicals, which boost immune response and protect against disease.

Foods to Avoid - Coffee and other caffeinated beverages: If you are currently addicted to coffee, drink black tea; it has less than a third of the caffeine of coffee, and none of the harmful oils. Fried foods and foods rich in fat are very immune-depressing, especially when stress is doing that, as well. Reduce animal foods. High-protein foods elevate brain levels of dopamine and norepinephrine, both of which are associated with higher levels of anxiety and stress.

Caffeine - This is found in coffee, tea, chocolate, Coke, etc. It causes the release of adrenaline, thus increasing the level of stress. When taken in moderation, coffee can increase your alertness, increased activity in the muscles, nervous system and heart. Consuming too much caffeine has the same effect as long term stress.

Smoking - Many people use cigarettes as a coping mechanism. In the short term, smoking seems to relieve stress. But in the long term smoking is very harmful. Its disadvantages far outweigh its short-term benefits.

Alcohol - Like caffeine, taken in moderation, alcohol is a very useful drug. It has been shown to benefit cardiovascular system.

Exercise - Research has shown that physical exercise is the best tension reliever. It is a very important remedy for stress. Nothing eases stress more than exercise. Exercise, when property done, gives our body time to operate in the efficiency mode. Nature is one of the best soothers of stress. Taking a quiet walk in a park or watching a beautiful sunset can do wonders.

Physically, exercise improves our cardiovascular functions by strengthening and enlarging the heart, causing greater elasticity of the blood vessels, increasing oxygen throughout our body, and lowering our blood levels of fats such as cholesterol and triglycerides. All of this, of course, means less chance of developing heart conditions, strokes, or high blood pressure.

Mentally, exercise provides an outlet for negative emotions such as frustration, anger, and irritability, thereby promoting a more positive mood and outlook. Exercise improves mood by producing positive biochemical changes in the body and brain. Regular exercise reduces the amount of adrenal hormones your body releases in response to stress. 

Recommended  Exercises are Aerobic exercise daily like Walking in the woods, at the beach, or in a park, Participate in a sporting event, such as tennis, basketball, volleyball, racquetball, softball, and many others, Ride a bicycle and yoga.

Chewing gum helps release stress & improves one's mood.

Water - In addition to exercise, it is important that your body gets enough water.  Drink plenty of water , it will help you to flush out toxinsWater is necessary for our body to operate efficiently. Water is vital to the body in temperature regulation, nerve impulse conduction, circulation, metabolism, immune system, eliminative processes, sensory awareness and perceptive thinking.

Meditation and Relaxation Response can help combat stress and revitalize the mind. Smile more! Being depressed affects ur immune system & raises blood pressure.

Deep breathing infuses the blood with extra oxygen and also stimulates the body to release tranquilizing endorphins. It is one of the simplest yet most effective stress management techniques. You can do it anywhere, anytime, and it becomes even more effective with practice.

Aromatherapy : Plant and flower extracts are infused with base oils to create a palette of aromas that when inhaled, or experienced as part of a massage can bring relief to muscular tension and stress in the body. Essential oils such as lavender and bergamot are popular, and one can even enjoy a cup of chamomile tea to ease tension before bed.  

Craniosacral Therapy - This treatment is similar to massage, except that it uses more gentle techniques and has the head, spine and pelvis as its primary area of focus.  As this area is the source of the nervous system, gentle manipulation of this zone results in an alleviation of muscular and nervous tension. 

Emotional Freedom Technique -  Emotional Freedom Technique uses aspects of Traditional Chinese Medicine, specifically acupressure to relieve a wide range of issues including stress, tension and anxiety. 

Hypnotherapy - This treatment uses hypnosis to unlock the power of the unconscious mind and effect positive changes in the life of the individual.  People who are hypnotised generally feel very relaxed, which is why it is often successful in relieving stress and anxiety. 

Yoga - Yoga is a discipline that combines the mental and physical, with controlled breathing and precise poses used to unify the mind, body and spirit.  It is useful in easing stress as the meditative aspect of it aid in lowering blood pressure and heart rate. 

Massage - Massage is perhaps one of the more widespread natural treatments available, with a range of techniques and styles to choose from. Gentle or more vigorous deep tissue massage stimulates circulation and often leads to a reduction in muscular tension

HOMOEOPATHIC MANAGEMENT:

Homoeopathy is a rational therapeutical system with its holistic, integrated, multi-disciplinary and totalistic approaches the subject of stress in a convincing rational way. Homoeopathy has long been used to relieve mental and emotional disorders, including stress and anxiety. The system has a huge range of remedies for practically every ailment and condition, including stress and anxiety.  The best way to investigate the benefits of homeopathy is to consult an accredited practitioner who is bound by a professional code of conduct and standards of practice. 

The speed of action, safety and lack of interaction with drugs have made Homoeopathic medicines a popular means of dealing with many health issues. Mental and emotional stress and anxiety are very common conditions, and scientific stud­ies have confirmed that homoeopathy is an effective means of treating these disorders''. - Rober T Medhurst

Following is a list of frequently used homoeopathic remedies for these conditions, and the factors that may help to narrow down the choice of the remedy.

Medicine	Indication
Aconite	Panic disorders, restlessness and anxiety following a fright or shock. Worse for heat and worse after exposure to cold dry winds. A great remedy for 'never well since' a shock.
Aethusa	Anxiety accompanied by vomiting, diarrhoea and extreme prostration. Especially useful in children. Worse in the open air and early mornings, better out in the open air, around other people and animals.
Anacardium	Anxiety when walking, and anxiety tends to be accompanied by violent language. Absent minded with a poor memory and suffers from nervous exhaustion from overstudy. Symptoms are improved by eating and aggravated by the application of hot water
Argentum nitricum	Arg nit in an excellent medicine for anticipation anxiety. Exams, driving tests, auditions, weddings, and impending competitions can all be made much easier to deal with by the action of this remedy. Those who hold unreasonable concerns for their health have also benefited from Arg nit. Symptoms are aggravated by warmth, from being alone, and eating sweet foods, and improved by company, cold and fresh air.
Arnica	Normally thought of as a remedy for shock and physical injury, Arnica is also a very useful remedy for the long term effects of acute stress, shock or trauma. Worse for jarring, cold or damp and better for lying down with head low.
Arsenicum album	Anxiety, unreasonable fear, fear of disease or death and restlessness in those of a fastidious nature characterise this remedy. Panic attacks in the very early hours of the morning may also call for Arsenicum. Worse when alone or exposed to wet or cold weather, cold food or drink and better for com­pany, heat and warm drinks.
Aurum Metallicum	Anxiety leads to severe depression, often to the point of suicide and often with outbursts of anger. Symptoms are often relieved by music, and aggravated by cold weather. It is not uncommon to see those suffering from seasonally affective disorder (SAD) or seasonal bipolar disorder, a depressive condition predominant in autumn and winter, being pre­scribed Aurum.
Chamomilla	Stress, sensitivity, restlessness and great irritability often lead to the prescription of chamomile. An excellent remedy for stressed or anxious children, chamomile is worse mid-morn­ing or at night, worse for heat and better for being carried or held.
Coffea cruda	Anxiety accompanied by a great restless of the mind, Coffea is often the answer to stress induced insomnia. Drinking coffee or consuming stimulants often aggravate the symptoms for this remedy, as does any strong emotion such as joy or surprise. Symptoms are generally improved by warmth and lying down.
Gelsemium	Gelsemium is often very useful for stress associated with anticipation of an event (examinations etc) and ailments that occur after a fright or shock. Stress is often associated with shaking and fatigue. Complaints are often aggravated mid morning, damp weather and are better after urination.
Ignatia amara	Ignatia is an excellent remedy for ailments that follow grief, and are often chronic or long standing. Anxiety is often associated with alternating moods, sighing and great sensitiv­ity. These symptoms may be aggravated by coffee and expo­sure to open air, and ameliorated by eating.
Kali ars	Stress and anxiety related to fear of disease, particularly heart disease, or fear of death are good indicators for this remedy. Worse for cold air, cold food or cold drink.
Lycopodium clavatum	The symptoms that call for this remedy often revolve around anxiety about health. and career as well as anticipation anxiety. Symptoms are often worse in the mid afternoon to early evening, worse from heat and better for motion and warms drink or food.
Natrum muriaticum	Anxiety leading to severe depression in those of a fastidious nature are often brought back to a happier disposition by the action of Nat mur. Efforts to console the Nat mur often make their symptoms worse, as does heat, and symptoms are ameliorated by open air and cold bathing
Nitricum acidum	Extreme irritability and fears of death by things such as cancer associated with stress are often indicative of the need for Nit ac. Symptoms are aggravated by hot weather and improved by travelling in a car.
Nux vomica	Nux vomica is associated with anxiety with extreme anger, frustration and irritability in those of a fastidious or compulsive nature. Those who respond best to this remedy are often intolerant to noise, odours and lights and their symptoms are worse in the morning, worse for mental exertion and better while at rest.
Phosphoric acid	Anxiety and depression with mental weakness, apathy and indifference, often as a result of grief or disappointed love, are good pointers to Phos ac. The condition improves with warmth and is aggravated by exertion or anything that's likely to restrict the circulation of blood.
Phosphorous	Phosphorous is often of benefit with anxiety worse when alone, in the dark or during thunderstorms and fear that something bad is about to happen. Worse for touch, physical or mental exertion, better for sleep, eating, cold food and cold, open air.
Pulsatilla nigricans	Anxiety with weeping, sadness and changeable moods often resolve under the influence of Pulsatilla. They are generally worse in a warm room, worse for rest and rich foods, and better in cold, open air and after a good cry.
Silicea	Stressed and anxious about noise, imminent event and trivial things may indicate the need for Silica. Silica is sensitive to all impressions and may appear to lack self-confidence. Worse for cold air and drafts, better for warmth.
Staphysagria	Staphysagria frequently suits those suffering from anxiety from grief, suppressed anger or suppressed emotions. They may be prone to weeping, depression and appear to have a low self esteem, but may become violent when angry. Worse for cold drinks and touch better for warmth, rest and breakfast.
Stramonium	Anxiety characterised by fear of death, water, and darkness, and often extreme violence brings Stramonium to mind. Symptoms are worse after sleep and better for warmth and company.
Tarentula hispanica	Those who are most likely to respond to this remedy suffer from anxiety with impatience, restlessness. often to the point of chorea — they have to keep moving although motion such as walking often aggravates. Music and dancing soothe this savage beast. Worse for touch, cold and damp conditions.