Something gets under my skin and drives me crazy: a case of Sarcoptes scabiei

In this case, the non-verbal element expressed through the body motions is very important; the text mainly serves to complement the motions that lead us to the remedy.

Patient (P): I come for two things. I always have sore legs, in my muscles; my doctor thinks it’s fibromyalgia. What’s more, at night, I’ve got restless legs – I just can’t stop moving them, and that disturbs my sleep. I’ve also got problems with the menopause.

JTC: Tell me about the problems with the menopause.                                                                                 
P: I get hot flushes and night sweats from time to time – it’s not regular. I’ve also got pain in my lower abdomen and my back; my osteopath can’t find anything, and my gynaecologist says it’s hormonal. Sometimes, I can’t remain sitting. I’ve also got pain in the whole right side of my head.

JTC: What bothers you the most?                                                                                                                      
P: My legs. It’s a really old symptom. My thighs hurt in the daytime and sometimes, even my feet hurt. At night, when I am in bed for about ten minutes, I start to toss and turn. I move like this (she becomes animated, like a dance, moving her back first, then her shoulders, then her legs). I think it’s all nerves, in my legs and in my body, that keep me awake for hours. The restlessness wakes me up at night and I get up. I take a shower and I have to move. I move my legs, but at night, it’s something I can’t stand. In the morning when I get up, I’m not fit at all. It happens in the daytime, too, as though I have tics.

JTC: You make this gesture (like a crab with its pincers) and you say “it gets on my nerves.” Could you explain that a bit more?                                                                                                              
P: It is as though there is something that grabs me. It’s not me, I am overtaken by something. I don’t know what it is. It starts in my back and then. I feel it in my legs and arms. In bed, it is unbearable. I feel like I’m not myself anymore, and it is so dreadful that I have the feeling I could do something stupid when it happens. It is so strong, I feel like I can’t explain this force. I hit my head against the wall; I want it to go, to leave me. It exhausts me physically, and mentally it is unbearable. Sometimes, I say that there is something wrong in my head; there must be something wrong in my brains, something that doesn’t function right. My doctor has given me antidepressants, but it hasn’t helped, so I stopped taking them. He says I should increase the dose but I don’t feel like doing that.

JTC: You say “it’s not me.” Tell me a bit more about that.                                                                                     
P: I don’t master my body; it’s not me who is doing that, but I don’t know what it is. I don’t know where it comes from. If I could be myself, I would be able to master this, but I can’t. It is overwhelms me.

JTC: It overwhelms you?                                                                                                                                          
P: At night, I don’t see it very well, because I want to be stronger than this thing, and in the daytime, I don’t think about it. In the daytime, it bothers me, but at night, I do all sorts of things, hitting, tossing and turning. That’s why I say “it’s not me.” I don’t have that temperament, it’s not like how I usually am; it is something that comes in the night but I don’t know what it is.

JTC: How long has this been happening?                                                                                                          
P: For a long time, with ups and downs. Ever since 1995-96, I’ve been having sleepless nights. This wakes me up at night. I lost my brother, and I thought that that was the end of it, but it continued. I was sleepless before the illness of my brother, but only from time to time, and I was given medication.

JTC: So, even before the illness of your brother, you were having this problem?                                    
P: Yes, but not as bad as it is now, and only from time to time. When I was small and it overtook me, my mother used to say: “You see? The moon is changing.” When I was young, I couldn’t fall asleep. I had periods of being really restless, or I would wake up. There always seemed to be a reason, either the full moon, or I had worms…

JTC: What do you experience in that state?                                                                                                          
P: It’s as though I have bugs (she scratches her arms). It starts in my spine and it goes down. It goes everywhere, as though I have something between my skin and my flesh; something that is there, like an alien. I don’t like to watch films like that. And then, it goes everywhere, and I have to move (she wriggles in her chair). It is as though something wants to enter me. I don’t know what it is, maybe scabies. It is something that makes me scratch, it excites me. It is as though something says: “I am here, I don’t know why I am here, but I am here to pester you.” It starts at my back, then it goes to my head, and then through my whole body. I say to myself: “I am not quite normal.” I have to move, something in me tingles. The most bothersome is what happens in my head, it is unbearable, and I start to hit my head against the wall. It is as though something wants to take my place, something that wants to become “me”. In the morning, I hurt everywhere. It feels terrible to not be able to master myself.

JTC: What do you experience when you feel like that?                                                                                   
P: It feels like someone is trying to harm me, but I don’t know who. At first, I thought it had to do with my brother, and I felt guilty. Was there something I hadn’t done for him? Maybe he was waiting for something? I thought I had done all I could, but because it was already there before he got sick, I thought it might have to do with someone else. Finally, I stopped thinking like that – it didn’t seem to be the right track. This problem comes back as soon as I am relaxed.

JTC: Tell me what happens at times like that.                                                                                                         
P: I will show you with gestures: it is something that penetrates me, it is difficult to explain. It is like electric tension, and it makes me move (frenetic gestures with her hands). It is really strong, and when I move like that, it releases the tension  (she makes movements like kicking a ball). It is like I want to unblock something, like a channel that is blocked. It doesn’t come into me all at once, it takes its time, it comes and goes. I think that my body tries to resist this thing, and it keeps trying a different route instead. “If you do that, I’ll do this.” It is looking for an entrance, and it tries everything imaginable, like a searching head.

JTC: What does that mean for you? You frown when you talk about it.                                                                             
P: It is such a bother, and it’s difficult to describe. I can’t expulse it. I grit my teeth, I swallow. When there are problems in the family, I hold myself together, I close up and grit my teeth. When I wake up, I have sore jaws.

JTC: What sort of medical problems have you had?                                                                                             
P: I’ve had depression in 1984 and 1995 that lasted a long time. I go beyond my limits. These last years, I’ve had fibromyalgia. When I was 12, I saw everything “black”; it was a severe depression, after moving house.

(She talks of her childhood, and of feeling inferior. Her mother was depressive and suffered from anorexia. “I was close to my mother, and to my little brother.”)

JTC: You say you feel like you have something under your skin?                                                                          
P: It feels like scabies. My son had it.

JTC: Are you chilly?                                                                                                                                                 
P: I am often very chilly. Sometimes, I can’t warm myself up, even if it is 50 degrees F. I could put on heaps of clothes and still be freezing. The only thing that helps is to have a hot water bottle on my back. Sometimes, I am icy cold to the touch.

JTC: What do you like to eat?                                                                                                                                          
P: Sweet things. I don’t have any aversions.

Prescription: Psorinum 200K, with remedy X in mind as well.

Follow-ups
Second consultation, three weeks later (abbreviated): there is a general improvement. The crises return just before going to sleep, and they wake her up, but are less strong and they are shorter.

P: “I feel less “eaten up” than before. It still bothers me, but it does not go as deep into my skin. My legs are not moving as much. I am still full of tics. I feel like there is a burning in my legs, like needles in there, a fire in my legs, with cold legs; inside it is hot, and my skin in cold. I have pains in my heels, too. I am not questioning myself as much. I used to say to myself “you can’t just let yourself be taken over like that,” otherwise I could panic.

JTC: You talk about a “little thing that could enter you. Tell me more about that.                                  
P: It is a little thing, it tries to get in, wriggling. It penetrates. It looks like an octopus, with lots of arms and a little head, a head that searches. It is a black bug with big jaws, and it tries to get in. It is not big, but it has lots of legs (she makes a movement to show the legs moving). The worst thing is that I feel like I am helping it to enter me and that I am yielding to it. When it reaches my head, I bang my head against the wall. It’s terrible, I feel like I’m going demented. I could really hurt myself. When I feel like that, my tongue gets swollen, it doubles in volume and I feel like I could suffocate. The first time it happened, I thought I had an allergy. It is something that tingles in my mouth. I move my tongue around. It feels like my head could explode, it makes me frightened and I panic. I am afraid of doing something really stupid, of not being able to control myself.

JTC: What would be the worst?                                                                                                                                
P: In my dreams, I see myself murdering someone when I am angry.

JTC: What else?                                                                                                                                                           
P: I feel like I am going into another world that I don’t know at all. I don’t feel like I’m going crazy, but I have crises of madness. There is something in me that is disjointed. My head is boiling, (makes circles around her head), it is like a whirlwind.  Sometimes it happens at night, when I am not even aware of it, and in the morning, I am sore everywhere. It comes quickly and goes quickly. I don’t really believe in those little pills of yours…

Third consultation, six weeks later

There has been a repeat of the crises. In summary, the following points are of importance: annual periodicity, especially worse in spring (February-March) and autumn (October-November). Periodicity during the day: worse around 22:00 and at night. Better from rocking herself, from hot showers, from movement. Worm infestation (oxyures) as a child.

Prescription: Sarcoptes scabiei 200K

Fourth consultation, two months later

JTC: How is it going?                                                                                                                                                  
P: Not bad at all. I have periods where it is like this (she makes a horizontal line with her hand, with some ups and downs at the end.) It might be going in the right direction. Sometimes, I wake up at night, but it doesn’t last for long and it is not unbearable. It doesn’t prevent me from sleeping, so in that sense I’m satisfied.  It is much less strong. The crises are less frequent, and they don’t last as long, maybe fifteen minutes now, whereas they used to last up to three hours. It is not regular; sometimes, I don’t have it at all. These days, I wake up but I go back to sleep straight away, and I don’t get up like I used to. It is just very short. Something in me is changing for the positive.

JTC: How do you experience that change?                                                                                                                      
P: I live from day to day. I don’t tell myself that I need to be doing something good. I say “tonight, it will be good. I’ve taken something good, we’ll see.” I’ve tried lots of things that went well at first, and then afterwards, it went very badly.

JTC: You say it goes quickly, in fifteen minutes?                                                                                                
P: I tend to go to bed early now. I’m tired in the evenings and I go to sleep easily; in the past that wasn’t the case. Then, I wake up at night. It’s a bother, but it doesn’t last long. I massage myself, scratch and wriggle, tossing myself around in bed, and then get back to sleep easily. In fact, it’s quite short.  It is still quite intense, but not so long. It has a crescendo; it gets worse and worse and it used to be almost unbearable but now, it is not so terrible. It is a bother, it wakes me up, but it is much less intense and it is shorter. It is nothing like it used to be. It is still a bother at night, but it does not affect me the next day in the sense that I am tired and sore everywhere.

JTC: What about the pain in the legs and the muscles?                                                                                         
P: At the moment, it’s fine.

Follow up over six years

The feeling is still there, but much less intense and less frequent, and the patient does not want to talk about it anymore. I treat her husband, who tells me about his wife’s situation. He says that there are profound changes, and that she has become optimistic. She sleeps much better, and has no problems with restless legs anymore, so they can share a bedroom again. The pains in her muscles have completely disappeared. The only symptom that remains is the hot flushes, which were resolved with Sepia. She has had no more signs of depression.

Sarcoptes scabiei is known as the human itch mite; it bores into the skin of mammals and causes scabies.

Photos: Wikimedia Commons
Scabies ; public domain
Sarcoptes scabiei ; Alan R Walker