Nausea, abdominal pain, weight loss, and a family history of cancer..These factors add up to a high degree of suspicion that "malignant tumor" is not an exaggeration, but after repeated examinations, the doctor's conclusion is unexpected: it is not cancer, it is depression! This surprised the patient, MrZhangis a very well-known disease for modern peopleWhen you or someone around us experience long periods of depression, especially extreme expression, we often wonder - is there depression? But if you tell you that depression is not always so "straight", often there are a lot of typical, hidden behavior, some patients do not even feel "bad mood", do you believe?case56-year-old MrZhang suddenly felt nauseous after lunch four months ago, which was not serious, so he didn't care too muchBut then the nausea doesn't ease over time, it persists, and it's good and badReferring to his brother's death from bowel cancer just a few months ago, MrZhang suspected he had cancer, especially after his stomach began to acheso, MrZhang went to the hospital, has done blood routine, blood biochemistry, tumor markers and other examinations, gastroscopy, enteroscope scans have also done againCuriously, although he felt very uncomfortable and lost his eyes, the results of the tests did not show any abnormalitiesUneasy he went to several hospitals, repeated examinations, there is still no clear diagnosisthis did not reassure MrZhang, but let him live in "serious problems but can not find out" anxiety Family members saw the original cheerful extrovean Mr Zhang all day sad face, eat bad sleep, do nothing and feel tired, so persuaded him to go to the psychiatric clinic to see again In his conversation with the psychiatrist, Mr made it clear that he did not feel depressed and that the current lack of interest and energy was caused by physical discomfort But to his bewilderment, after a series of tests and evaluations, the psychiatrist's diagnosis was: depression Half-convinced that he took the doctor prescribed antidepressants, did not expect, after the prescribed course of treatment, troubled him for many days nausea, abdominal pain and other symptoms really improved, he also restored the past cheerful emotion sourcing is not the only measure of depression
when it comes to depression, what we may think about is a persistent bad mood But in fact, the mood is far from the whole of depression Even without a subjective experience of persistent depression, there may be depression The patient, Mr Zhang, did not feel subjectively depressed, indicating that his depressive symptoms were hidden depression bothers many people According to the World Health Organization, there are about 350 million people with depression worldwide, with an average of one in 20 people suffering from or suffering from depression This year, the latest epidemiological investigation results reported by Professor Huang Yueqin's research team at Peking University's Sixth Hospital show that the annual prevalence of depression in China is 3.59% This means that one in 25 people in our country will have a depressive episode in a year This figure is lower than the global average published by the World Health Organization, but represents an increase in the prevalence rate of our past surveys (meta-analysis in 2013 showed that the current prevalence of Chinese mainland depression was 1.6 per cent, compared with 2.3 per cent annual) rapid social change may lead to an overall increase in stress and stress levels Like people in many countries, Chinese face challenges associated with the pace of life and lifestyle, which may also lead to an increase in the incidence of emotional disorders What is depression ? Depression, generally referred to as depression, is characterized by a single or multiple depressive episodes Depressive episodes include depression, loss of interest, changes in appetite, sleep changes, irritability/slowness, fatigue/lack of energy, feeling worthless, difficulty concentrating, suicide and other 9 symptoms, in more than 2 weeks, the above symptoms persist 5 and more, need to consider the diagnosis of depression Like most mental illnesses, the risk factors for depression involve biological, psychological and social aspects, and there are more studies, but the neurobiological and pathological basis of depression is not conclusive , why is depression "hidden" often there? Clinically, those physical symptoms highlighted and masked emotional symptoms, depression symptoms are not typical of the situation called "hidden depression." In the 10th edition of the International Classification of Diseases, hidden depression is attributed to other depressive episodes studies suggest that hidden depression accounts for 6% to 7% of all depression, while 30% to 40% of patients in general hospitals may have hidden depression Many doctors estimate that there are no fewer patients with hidden depression than those with obvious emotional symptoms people of all ages are , with the highest number of people at the age of the elderly This is consistent with the often atypical depressive symptoms of the elderly and the prominent features of physical symptoms hidden depression is easy to be misdiagnosed
hidden depression is an atypical depression, its clinical manifestations are mainly repeated and persistent physical discomfort and plant neurological symptoms, such as headache, dizziness, palpitations, chest tightness, shortness of breath, anorexia, abdominal discomfort, diarrhea, constipation, weight loss, body pain, libido loss, insomnia, body weakness, etc Among the symptoms, the pain is most common with lack of evidence of instrumentality clinical experience, we believe that hidden depression can lead to several major problems one is two "injuries" to people's wealth Patients with prominent persistent physical discomfort, resulting in them will be repeated lying on a variety of adverse examinations, which will not only cause the family financial burden, the patient's own health is also detrimental the second is to create family conflicts Many family members see the results of the hospital examination and often feel relieved, but the patient's physical symptoms make it difficult to accept the conclusion that "no disease" Over time, patients will think that their families do not understand and do not care about themselves, while their families think that the patientist is purely psychological and does not understand the hard work of others This conflict of understanding often leads to disharmony in the family third and most important problem is that the hidden nature of depressive symptoms has caused problems for a definitive diagnosis and treatment Clinically, it is also a disease that is prone to misdiagnosis For diagnosis, emotional symptoms are not the most difficult to cover up by a large number of physical discomforts, and the trickier thing is that patients often resist linking their physical symptoms to emotional problems and passively or actively ignore emotional problems In addition, patients will also think that emotional problems are caused by physical discomfort, the result is that even if they admit to having emotional problems and do not want to go to the psychiatric department, they still tend to double check and deal with physical discomfort We have had individual cases, so we delayed treatment, from mild depression to severe depression, and were not willing to come to psychiatric care until some extreme behaviour occurred people should have a sense of "mental illness" so how do we non-professionals deal with hidden depression? first, objective understanding of depression, do not simply understand depression as a bad mood or want to commit suicide second, understand that the body and psychology are related, depression, anxiety often cause a variety of physical discomfort Can not find abnormal but long-lasting digestive discomfort, headache, tinnitus, panic, etc , may be hidden depression warning signal, to timely identification and medical treatment, can not be taboo medical heart is one, there is a kind of disease we call "heart and body disease." It is a disease whose development is closely related to psychosocial factors, but is mainly characterized by physical symptoms Its main characteristics include psychosocial factors playing an important role in the occurrence and development of diseases, showing somatic symptoms, inductopathological changes or known pathophysiological processes In general, non-psychiatrists pay little attention to the psychological factors of patients, and rarely regard them as medical diseases related to psychiatry, so patients often receive physical therapy, psychosocial factors are rarely paid attention Patients should understand that emotional distress may cause physical discomfort, physical illness may also cause emotional barriers, this is a normal phenomenon, is not what "mistakes", do not take the initiative to cover up emotional symptoms third, to the regular hospital, actively cooperate with the treatment Patients with similar problems must choose a regular hospital If the standard inspection prompt is not abnormal, it is not recommended to repeat the same examination in different hospitals in a short period of time, so as not to increase anxiety If the doctor in the corresponding physical department recommends a psychiatric visit, he or she should cooperate with the consultation in short, do not have to fear hidden depression, as long as put aside prejudice, actively cooperate with the diagnosis and treatment, "hidden" will no longer hide, thus away from physical and mental pain (Author: Jiang Sith, Clinical Psychologist, Sixth Hospital, Peking University)
