Clinical Depression and Anxiety with Severe Sleep Disturbance

Abstract

Background

Depression and anxiety may present with disturbances of sleep, restlessness, somatic symptoms, excessive worry and impaired functioning. Depression is a clinically significant disorder that can involve disturbed sleep, appetite changes, low energy, impaired concentration, guilt, hopelessness and anxiety.

Case Presentation

A 35-year-old woman presented with a documented diagnosis of clinical depression and anxiety, with a history of approximately 73 months. The prominent initial symptoms included severe insomnia, marked restlessness, inability to remain in bed, repeated getting up and going to the window, claustrophobic sensations, a strong desire for company, loneliness, excessive concern regarding her son, gastrointestinal complaints with bloating and fear of loose motions, palpitations, guilt, helplessness and heightened emotional sensitivity.

Her psychosocial history revealed early marriage during class 10, difficulty adjusting after marriage, perceived lack of acceptance from in-laws because of limited formal education, prolonged emotional dependence on her family of origin, and significant psychological distress related to her son's vitiligo. She also experienced bereavement following her father's illness and death and ongoing concerns regarding her son's education and future.

The homeopathic case analysis recorded Pulsatilla as the constitutional prescription, with Belladonna 200C, Magnesia phosphorica 6X, Arsenicum album 200C and Natrum muriaticum 1M also documented during the course of management.

Outcome

The longitudinal record from 2020 to August 2026 documents substantial improvement in anxiety, restlessness, sleep and depressive symptoms, with progressive reduction in conventional psychiatric medication. However, the record also demonstrates periods of relapse or symptom fluctuation and intermittent continued use of psychiatric medication. In March–June 2026, the patient was documented as taking substantially reduced clonazepam and had discontinued Prodep, while reporting that she was doing well. By August 2026, she was documented as having almost stopped allopathic depression medication and wished to continue homeopathic treatment.

Conclusion

This case demonstrates a long-term, individualized approach to a complex presentation of anxiety, depressive symptoms, insomnia, somatic anxiety and psychosocial stressors. The extensive longitudinal follow-up provides clinically useful documentation of symptom trajectories and medication changes. However, because this is a single uncontrolled case with concurrent conventional psychiatric treatment and no standardized depression/anxiety outcome scales, the improvement cannot be attributed causally to homeopathic treatment alone.