May 2014

Panic attacks: a case of Latrodectus mactans

by So?a Koyšová

A 62 year old business woman came into the office. She is pleasant, nice looking, dressed in black and white. She talks and moves very quickly. She says: “I don’t like chemicals, I can’t cope with them. Only sometimes, I take Magnesium, Lexaurin or Xanax.”

So?a Koyšová (SK): What is your problem?

Patient (P): I have internal cramps, anywhere in my body. I have a cramp in my chest which shoots to my axillae. I feel a tingling, then cramps in my stomach, as if constricted by a very strong belt. I also feel a constriction in my throat as if I was going to suffocate.

I have had a business together with my husband for 27 years. I am never tired and I can’t sleep properly. I am the one who does everything, my husband only stands by. I have to work a lot. I am always afraid of what will happen – I don’t know what the future will bring. It’s like this since I survived our accident. At that time, my heart tightened for the first time and my whole body went numb.

SK: What accident did you have?

P: It happened on 8.3.1981. I was in the car with my mother, my sister, two children, and my brother in law who was driving. We had just been on the road for a short time when it happened. My mother died on the spot and the passengers of the other car all died. Since that day, I started to suffocate at night; my whole body became numb and I had a terrible fear of dying, which was always worse at night. I was treated by Radepur. I started to work very soon after the accident. I felt I would die if I stayed at home; I needed to move! I always felt worse if I had to rest. I was afraid that I was going to die, that it would be the last moment of my life, and my heart was continuously pounding.

I’ve almost died once: when I was two years old, I almost drowned. They had to pull me out of the water and resuscitate me. When I lie down, I have to find a good position, otherwise I get this cramp in my chest: it shoots from the lower part of my chest to my arms and back. It even contracts my eyelids. I also get cramps in my legs and a tingling sensation.

SK: The patient talks very fast, I can’t manage to write everything she is saying. When I ask her repeatedly to describe her symptoms, she repeats the same things at equally high speed, until I get the feeling that my questions are irritating her. She is very lively and she tells me that some people have problems understanding her because she speaks so fast.

SK: What type of business do you have?

P: We have a pastry shop and we also sell Balkan ice cream. I married a man from the Balkans when I was 35 years old. I never wanted children because they would have grown up in the streets; I would never have had time for them. I had to take care of everything. I woke up at 4:00 a.m, made all the ice cream, baked the pastries and cakes, and when the shop opened, I was already standing behind the counter. I even cooked the meals for our employees; they are young and can’t cook properly. I prefer to do everything myself so that I won’t have to repeat the same task a hundred times. Everyday, I work until midnight. I have a great amount of energy and I am never tired. My husband is like a rubber puppet; if I could, I would throw him away. Sometimes, I tell him that if he doesn’t like something, he is free to go. In earlier years, I cried very easily but now I tell everybody what I think. I am very sensitive.

SK: What do you like to eat?

P:  I only eat the side dishes with sauce. I eat almost no meat; it goes up my throat when I get cramps in my bronchi. I like light salads, fruit, mashed potatoes, soup, dumplings, and fresh juices. I eat a lot of sweet things; sometimes, I just stuff my mouth with a lot of sweet food.

SK: What other health issues have you suffered until now?

P: I had my gallbladder removed because of terrible pains. I thought I was going to die. I used to have very painful menses every three weeks. The blood was very dark with clots; it used to run down my legs. I had to use up to three pads at a time and it got worse at night. I was also operated for a myoma in my womb. Even when I had my period, I worked 20 hours a day; I never could rest. The doctor prescribed me oral contraceptives for the painful menses but I only took them for one month, then I told the doctor I was not going to take something like that.

As a child, I used to have nose bleeds which could not be stopped. I often had colds and I also had severe tonsillitis, which would choke me.

SK: Why didn’t you have children?

P: My husband has children from his first marriage. I don’t have contact with them. There was no time for children. It didn‘t appeal to me, who would have raised them? It is not a problem to not have children.

Work saved me. I have everything organized, otherwise I would end up in a psychiatric ward. For me its no problem, I am never tired. In our shop, there is a steep staircase with fifty-four steps to our supplies room. Some people can hardly reach the top; they tell me that it must be horrible to climb up there for supplies. But I quickly run up, take whatever I need and run back down. I do my shopping on my bike; my husband only gets the largest things by car.

SK: You don’t drive?

P: No, since the accident I haven’t sat behind the wheel, I am terribly afraid that I would kill myself.

SK: Tell me about the panic attacks.

P: I have been having them for thirty years, but they are not so severe anymore. They come and go. I don’t have time to go to the doctors.

Later, she mentioned ten different kinds of therapies she had undergone.

When I got a panic attack for the first time, I thought it was a heart attack. At night, I hardly sleep, I’m tossing and turning around in my bed. I tell myself: “I am not going to sleep tonight, I will sleep tomorrow.”

SK: Tell me more about yourself?

P: I am very sensitive. I cry when someone raises his voice. But I also know how to support other people. I have a strong personality; I know how to express my opinion. What’s in my soul is on my tongue, I don’t have any secrets. I rely on myself, I am able to take care of everything alone. I say to my husband that I can easily find another puppet like him. Men take possession of you, like cattle. My husband is a Muslim, I don’t like his faith; he is fanatic.

I am cheerful; I am able to compromise with anyone. I am sensitive about myself. If somebody offends me, I’m finished with him. I am strict with myself. People are false.

SK: Hobbies?

P: I like nice things. I am an artistic type. I love photography. I take photos of myself, of water, of birds. I like handcrafts, sewing, embroidery, and painting. I like to make artistic cakes and pastries. I like music and dancing. 

SK: Fears?

P: When my mother died, I was afraid that there might be a stranger outside. I was afraid of the dark. What if someone assaults me? My heart was beating in my ears. In the morning, at 4:15, I would run all the way to the train station. I have a phobia of heights. I feel a great responsibility; I feel anxious about every problem. When we have an audit for the company taxes, I have everything prepared; I am thorough and precise. I am always on the lookout.

SK: Are you warm or cold blooded?

P: My whole life I have been chilly but since the menopause, I am warm blooded.

SK: Tell me again about your cramps. Give me an example so that I can understand it well.

P: When I start to wash clothes, for example, it’s like the whole world starts to fall, weighing me down. I feel a pressure on my heart, a pressure in my chest, as if someone was clasping me around the heart. My throat contracts and I can’t breathe. I have cramps bellow my breasts, as if I was wearing a tightly clasped belt. Then, it shoots in nerve pathways under my axillae and to the tips of my fingers. I am drenched in cold sweat and white faced.


She is very energetic, full of life, tremendously hard working.

She has a very vivid energy; she is one of those patients you´ll never forget.

She speaks a lot and very quickly.

She is very dominant with her husband.

She has dreams of being persecuted.

These themes indicate a remedy of the animal kingdom, but of which group?

Her health problems are of neurological origin: she has cramps everywhere in her body, which extend to the extremities through nerve pathways. Her problems started during the serious car accident, where several persons lost their lives, and this scared her very much. She has panic attacks and fear of death.

Her first panic attack felt like a heart attack, her heart felt like it was in a clamp. She could not breathe and she was convinced she was going to die.

She never yearned for children.

She does not sleep much and has a lot of energy.

Her interests include sewing and embroidery. These are activities typical for spider remedies because it occupies their hands with quick movements, and there is a need for a certain precision.


These aspects of the case strongly point to a spider remedy. Which one?

Strong constriction of the chest, inability to breathe, and the sensation of suffocation are typical for the remedy Latrodectus mactans.

According to Massimo Mangialavori, this spider has a different relationship to food in comparison to the other spider remedies. It does not have the typical lack of appetite common to other spider remedies, it is more the bulimic sort. They like to be comforted by food by eating. She is stuffing herself with sweet foods.

Latrodectus is hypersensitive and has ailments of shock from the proximity of death. Together with Theridion, it is one of the most sensitive spiders. Every moment is experienced as a threat, so they stay constantly alert. This oversensitivity is connected with sudden life-threatening experiences, either real or presumed. It results in a paralytic state in the mental and physical level, similar to Aconite and Opium. They are frozen in the situation.

This remedy connects everything with the heart. This hypochondria drives them to claim constant attention and support. Latrodectus is typical also for profuse watery black bleeding, sleeplessness, and restless sleep.

Prescription: Latrodectus mactans 1M

Follow ups

After one month: the panic attacks have subsided, as did her sensation of constriction around the heart and the cramps in the body. The patient is much calmer and talks more slowly. She continues to be a bit hypochondriac. Her lively character and hard working remain unchanged but she rests more and sleeps better.

After one year: she did not need a repetition of the remedy. She does not have panic attacks anymore.

Photos: Wikimedia Commons
Ouch; Highway patrol images; CC BY 2.0
Black widow spider; Chuck Evans; CC BY 2.5


Categories: Cases
Keywords: panic attacks, fear of accidents, fear of death, palpitations, cramps, desire to move
Remedies: Latrodectus mactans


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