A simple diagnosis that can change lives

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A simple diagnosis that can change lives

Published: 14 Mar. 2025, 00:03

Audio report: written by reporters, read by AI

Oh Sang-woo

The author is a professor of family Medicine at Dongguk University Ilsan Hospital.

Though rare, there are times when I hear patients call me a “distinguished doctor.” It's not because of my exceptional medical knowledge or because I possess the remarkable skills and talent of Baek Kang-hyuk, the protagonist in the popular series “The Trauma Code: Heroes on Call.”(2025) I'm just an ordinary physician. So why do I receive such praise? The reason is surprisingly simple.

There is a female patient who visits my clinic like clockwork when the weather turns cold. At our first consultation, she complained of persistent abdominal and chest pain that had lasted for years. Fearing she might have cancer, she had undergone numerous expensive tests. She had visited renowned hospitals and spent over 10 million won annually on diagnostic procedures, only to receive the same response each time: “No abnormalities detected.” Even her family began to suspect she was feigning illness, making her suffering even more unbearable.

During our consultation, she described her symptoms in detail. However, their connection was unclear, making it difficult to pinpoint a specific illness. As our conversation progressed, I suspected depression (major depressive disorder), as her symptoms closely aligned with its manifestations. She was experiencing somatic symptoms of depression. I prescribed antidepressants and monitored her response. Fortunately, she reacted quickly to a low dose, and most of the symptoms that had plagued her for years vanished. It was the moment her prolonged suffering came to an end. Though her depressive symptoms still recur seasonally, they are now well-managed with appropriate medication.

This is the story behind why she called me a “distinguished doctor.” The secret? It was simple — I merely considered the possibility of depression and checked for it. That small step significantly improved her quality of life. Anyone who had taken the time to assess her for depression could have earned the same praise.

Teenager girl sitting alone on the floor in the dark room. [SHUTTERSTOCK]

Depression is a disorder caused by an imbalance of neurotransmitters such as serotonin, dopamine, and norepinephrine. These chemicals influence not only emotions but also pain perception, bowel movements, and sleep regulation. Additionally, depression disrupts the autonomic nervous system and increases stress hormone secretion. As a result, it can lead to chronic fatigue, lethargy, sleep disturbances, headaches, indigestion, constipation, diarrhea, muscle pain, joint pain, palpitations, chest tightness, dizziness, and impaired concentration.

Because these physical symptoms commonly appear in other medical conditions, focusing solely on treating physical illnesses can lead to the oversight of underlying depression. Regrettably, I too have once failed to recognize depression in a loved one — my own mother, who lives far away in my hometown. She complained of heart palpitations, shortness of breath, and sleep disturbances. However, since we were physically distant, all I could do was suggest over the phone that she visit different hospitals. Fortunately, a skilled doctor eventually identified and treated her hidden depression, and all her symptoms disappeared.

Just as depression can manifest as physical symptoms, physical illnesses can also trigger depression. It’s a classic “chicken-or-egg” dilemma — did the depression cause the physical symptoms, or did a medical condition lead to depression? Determining which came first isn't always necessary, but checking for the coexistence of both is crucial. Treating depression often accelerates and enhances the recovery from physical ailments.

To effectively address depression, we must first discard common misconceptions about it. Depression should not be dismissed as a condition affecting only weak-minded individuals. It is a biological disorder caused by an imbalance in neurotransmitters, not a reflection of personal willpower or capability.

We must also abandon prejudices against antidepressants. Many people associate them with scenes from movies or dramas, imagining that they induce numbness and mental decline. Some fear dependency, worrying they might never be able to stop taking them. However, modern antidepressants have been significantly improved, with reduced side effects and enhanced efficacy. Concerns about medication are often exaggerated and unfounded.

A mobile counseling service booth set up near City Hall Station in Seoul on July 11, 2024, following a fatal wrong-way traffic accident that killed nine people. The Jung District Office provided the service to support witnesses of the accident and residents experiencing trauma. [NEWS1]

People suffering from depression often send out signals for help — not just through words but also through physical symptoms and behavioral changes. It is essential to recognize these signs and offer support rather than dismiss them.

Korea holds the unfortunate distinction of having the highest rates of depression and suicide among OECD countries. The frequent news of celebrities taking their own lives is a heartbreaking reminder of this crisis. Yet, depression is a treatable condition, and with proper care, it can be overcome. Seeking help should never be a source of hesitation.

Depression is not a battle to be fought alone — it is a struggle we must face together. A little attention and empathy can change someone's life.

Translated using generative AI and edited by Korea JoongAng Daily staff.