Potential Bach Flower Remedies For Psychological Stress Due To Lockdown Measures: A Literature Review

Authors: Dr Ruchi Singh¹, Dr Astha Mathur²

1. Associate Professor, Dept of Organon of Medicine & Homoeopathic Philosophy, Dr. MPK Homoeopathic medical College, Hospital & Research Centre, Homoeopathy University, Jaipur
2. Assistant Professor, Dept of Pharmacy, Dr. MPK Homoeopathic medical College, Hospital & Research Centre, Homoeopathy University, Jaipur

Abstract:
Social distancing and lockdown measures, the most essential and effective preventive measures for COVID-19, have put millions of people in confinement for over a month. Fear of disease coupled with psychosocial issues related to family and occupation is creating psychosocial distress on the society. Various measures like diet, exercise, well- regulated lifestyle have been advised for maintaining and improving health, physical and psychological. Bach Flower medicines are flower essences that help to provide a positive emotional state. This literature review presents BFR’s and their potential indications for emotional distress.
Keywords- Bach Flower Remedies, Emotions, Stress, Anxiety
Introduction: Humanity today is facing a worldwide medical as well as psychological threat from COVID 19 pandemic. Social distancing and lockdown measures have emerged as the most important preventive measures against the spread of this pandemic. People all over the world are coping with medical as well as psychosocial impact of this pandemic, directly and/or indirectly. General public has faced psychosocial stress of over 2 months. Various studies have reported on psychological impact of the present scenario.^1-4 Anxiety, fear and depression seem to pervade humanity. These emotional states negatively impact health and immunity in themselves.

Bach Flower Remedies deal with states of mind and emotions. Edward Bach, a medical doctor and one of the earliest homoeopaths at the beginning of 20^th century, discovered flower remedies also known as Bach flower remedies (BFRs) which are a widely-available, popular form of complementary and alternative medicine (CAM) consisting of 38 remedies that correspond to negative emotional states5,6 and are commonly recommended by practitioners for psychological problems and pain. 7

Bach Flower Remedies (BFRs), according to Bach, provide “a positive emotional state that is conducive to the restoration of a healthy equilibrium and by acting to catalyze an individual’s own internal resources for maintaining balance^“.They are believed to assist the body in healing itself by restoration of balance. They are commonly used for psychological problems and stress.⁸

BFRs are considered safe, however few controlled prospective trials of BFRs for psychological problems and pain exist and some report that there is no evidence of benefit compared with a placebo intervention. ⁹ However the BFE Rescue Remedy has shown effectiveness in reducing high levels of situational anxiety.¹⁰

There are 38 Bach flower remedies. There are no known side effects. Upto three Bach flower remedies can be given in chronic diseases and can be repeated as often as upto three to five times daily^{. 8}

Methodology: Literature on Bach flower remedies was searched for medicines with indications suitable for fear of diseases and effect of solitude and confinement and their corresponding emotional states, Further differentiating factors of BFR’s were listed and tabulated for easy comparison.
Discussion:
Psychological impact of lockdown measures for COVID 19 on general public showed prominent common mental symptoms as^1-4:

• Anxiety- anxious reactions
• Depression
• Post traumatic stress syndrome
• Fear of disease- for self, family and friends
• Insomnia
• High perceived stress

A review of Bach flower remedies^11-12, helped to understand their indications which were tabulated as follows:
Bach flower remedy is mentioned in the last column.

Symptom
Anticipation	Of vague fears, unknown reason	Aspen
Of failure	Larch, Mimulus
Of unfortunate things that may happen to others	Red Chestnut
Anxiety / worry	For extremely capable people who feel suddenly unable to cope	Elm
For a feeling of inadequacy	Elm
For anxiety about the welfare of others	Red Chestnut
For no apparent reason	Aspen
For anxiety attacks	Rescue Remedy
For having to make a choice between two things	Scleranthus
Anxious to please Centaury-Over one’s life direction	Wild Oat
Broken	By news	Star of Bethlehem
By exhaustion	Olive
By overwork	Vervain, Oak, Centaury
By stress	Vervain, Elm, Agrimony
In crisis situations	Rescue Remedy
Claim	Responsibility for others	Pine
Desires, with irrational desperation	Cherry Plum
Desires, as means of escape	Agrimony, Clematis
Morbid obsession with	Clematis, Mustard, Sweet Chestnut
Depression stages	After a physical or emotional shock	Star of Bethlehem
For being overworked and feeling frustrated	Oak
For dark feelings without any apparent reason	Mustard
For emotional tensions kept hidden from others	Agrimony
For feelings of hopelessness	Gorse
For longing the past	Honeysuckle
For mild depression caused by setback and disappointment	Gentian
For the lack of faith in one’s ability	Larch
For the lack of faith in oneself	Cerato
For those who are resigned	Wild Rose
For being unhappy in present circumstances	Clematis
When feeling anguished beyond endurance	Sweet Chestnut
When feeling that people take advantage of us, that the world is unfair	Willow
Depression	For known reason; due to set-back	Gentian
For unknown causes	Mustard
Hopeless	Gorse
Feeling like a dark cloud suddenly descending	Mustard
Introspective	Willow
Feels task too hard to undertake	Elm
Pessimistic	Gorse, Gentian
Utter dejection	Sweet Chestnut
Despair	No hope of change in outer circumstances	Gorse, Gentian
Due to terror	Rock Rose
Pessimistic hopelessness	Gorse
Helpless, heartbroken	Sweet Chestnut
Cause unknown	Mustard
Self blame/guilt	Pine
Shock	Star of Bethlehem
Of living	Cherry Plum
Despondency	Through lack of confidence	Larch
From self-reproach/guilt	Pine
Through feeling of inadequacy	Elm
From shock, bad news	Star of Bethlehem
Through limitation of illness	Oak
From feeling of uncleanness	Crab Apple
Due to embitterment	Willow
Cause unknown	Mustard
Due to frustration	Vervain
Through over work	Vervain, Oak, Elm
Through tiredness	Hornbeam, Olive
Complete anguish	Sweet Chestnut
Despondency after setback	Gentian.
Dissatisfaction	Due to not finding right way in life	Wild Oat
Due to frustration and restriction	Walnut, Vervain
Emergency	For no hope	Rock Rose
Home sickness		Honeysuckle
Illness	Frustrated by	Oak
Simulates illness	Chicory, Heather, Willow
Fear of	Mimulus
When depleted energy	Olive
Loneliness	Enjoys and often prefers to be alone	Water Violet
Prefers to work alone	Impatiens
Is reluctant to be alone	Agrimony, Heather, Chicory, Mimulus, Vervain
As an escape	Clematis
Because of intense sadness	Star of Bethlehem
Seeks companionship constantly	Heather
Phobias	For the everyday fears of known things- (snakes, spiders, being late…)	Mimulus
For unknown fears, vague and dark	Aspen
For fear turning to terror and perhaps panic	Rock Rose
For fear that the mind is going to fall apart	Cherry Plum
Fear of someone’s safety	Red Chestnut
For the pre- or post-treatment of any kind of shock, physical or mental, for emergencies,emotional upsets, panic attacks	Rescue Remedy
Tension	By nature	Beech, Impatiens, Rock Water, Vervain, Vine
Due to shock	Star of Bethlehem
Due to fear	Mimulus, Aspen ,Rock Rose,Cherry Plum
Fearful for others	Red Chestnut
Constantly worried for others	Chicory, Red Chestnut
Tiredness and Fatigue	For those who feel physically and mentally exhausted	Olive
When feeling unable to cope with the day	Hornbeam
From being so anxious to do well and please others	Centaury
From a lack of interest in life, dreamy type	Clematis
From resignation to an unsatisfactory life	Wild Rose
Generally strong, but momentarily stressed and despondent	Oak
When feeling overwhelmed by responsibilities	Elm
When constantly bothered by inner arguments	White Chestnut
	Through a lack of flexibility for oneself (high expectations)	Rock Water
Uncleanliness	Feeling of uncleanliness	Crab Apple
Unsatisfied	With one self if ill	Oak
Unsatisfied with own actions	Pine
Unstable-Generally	Walnut
Overwhelming thoughts	White Chestnut
Because of indecision	Scleranthus
Because of guilt	Pine

Discussion & Conclusion: As humanity faces this monstrous threat, there is a need for finding safer alternative measures to maintain psychosocial health. Importance of general measures like meditation, healthy diet and lifestyle needs to be understood and adequately applied. Each patient suffering from psychological distress needs a comprehensive evaluation for effective case management.

Remedy profiles of Bach flower remedies present various symptomatology which may be felt by people under lockdown. BFRs when indicated by symptoms of patient can offer a safe way of treating emotional conditions associated with psychosocial impact of lockdown measures. The effect of these medicines needs to be further explored in clinical research.

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