Patient 6: CHRONIC STRESS, DEPRESSION AND ANXIETY.
Female,
Age 35.
This is a real patient history. Their identification details have been removed to maintain the patient’s privacy.
Initial Presentation
- Presented with already made diagnosis of pyloruria, on high dose of zinc and SAM–e for years but very stressed, depressed and anxious
- Worried about her anxiety, depression and tiredness
- Runs her own business
- Mother of two daughters, both have got behavioural problems
- Lives with her husband (separated from previous husband as he was very abusive)
- Childhood was not very troublesome except for father’s depression and alcoholism and mentally ill. Abusive brother who eventually became a psychotic.
- Mum suffers from anxiety throughout her life.
- Patient reported feeling unwell, drained, depressed, and poor gut health. (Her mum was also told that she has got polyuria but found to have methylation issues.)
- Patient has been on a number of supplements when she presented to me.
- Tentative diagnoses of ADHD, Depression, Anxiety, Dyslexia, Pyloruria
- Allergies – None
- Never smoked
- Alcohol only once in 2 – 3 months
- Family History
- Mother, Father, Brother, Maternal Uncle – Depression and Anxiety
- Brother – Psychosis
- Physical Exam
- Looks Anxious. And bit agitated, pressurised speech
- BMI – 36.55
- Otherwise normal looking
- More about Life
- Mum and dad separated
- Step-dad died and the mum and patient tried to resuscitate him which was very traumatic.
- Brother was very physically abusive to the patient (He suffered from ADHD, Asperger’s Autism, Oppositional Defiance Disorder and Dyslexia)
- Assessment
- Fatigue Questionnaire
- Total Score – 70
- Responded Positive to 18/20 main fatigue questions
- Yeast symptom Questionnaire
- Score – 268
- Dysbiosis Questionnaire
- Score – 66
- Mental Health Screening Questionnaire
- Features of moderate to severe depression
- Symptoms of severe anxiety
- Beck’s Depression Scale Score – 31
- Beck’s Anxiety Scale Score – 29
- Brain Health Questionnaire
- High scores for many of the brain areas
- Severe serotonin deficiency symptoms
- Severe dopamine deficiency symptoms
- Hormone Assessment Questionnaire
- Oestrogen Dominant Symptoms
- Toxin Score – 148
- Gene Screening Questionnaire
- MTHFR, Slow COMT, Fast COMT, Slow MAOA, Fast MAOA
- Positive Symptoms for above SNPs (these are for screening purposes only and may not represent actual SNP defects)
- MTHFR, Slow COMT, Fast COMT, Slow MAOA, Fast MAOA
- Fatigue Questionnaire
Review 03/09/19
- Yeast symptom Score – 225
- Dysbiosis Score – 65
- Toxin Score – 125
- Fatigue Score – 121
Review – 20/01/20
- Patient feels much better
- Depression and anxiety symptoms are very much reduced
- More energetic
- Gut symptoms are hugely improved
- Above protocol will be continued until next review
- Lost to follow up due to COVID-19
Author
Dr. Priyanta Thotagamuwa (MBBS, FRACGP)
Dr. Priyanta Thotagamuwa (MBBS, FRACGP) is operating Wandal Medical Centre in Rockhampton with the aim and interest of treating patients in a holistic manner. As a GP he offers medical assistance to patients of all ages, seeking advice, treatment or minor procedures.
Dr. Priyanta Thotagamuwa (MBBS, FRACGP)
Dr. Priyanta Thotagamuwa (MBBS, FRACGP) is operating Wandal Medical Centre in Rockhampton with the aim and interest of treating patients in a holistic manner. As a GP he offers medical assistance to patients of all ages, seeking advice, treatment or minor procedures.