Depression “hidden” behind physical symptoms

Dr. Nguyen Khac Dung, lecturer of the Department of Psychology and Educational Sciences, Dai Nam University, Deputy Head of the Clinical Department, Mai Huong Daytime Psychiatric Hospital, once admitted a 9th grader in Nghe An who came to see a doctor for symptoms of dizziness, poor appetite, and frequent stomachaches. The family took him to many hospitals for examination, and the results of blood, urine, and stool tests were all normal.

Parents said their son often complained of fatigue, often lost his appetite, and skipped meals, causing his weight to drop. He had little concentration in class, which weakened his studies, even during the final exam preparation period.

When he went to the psychiatric hospital for examination, Dr. Dung, through questioning and psychological tests, determined that the patient had moderate depression. After further investigation, he said he felt pressured by schoolwork and often tried to study late at night, which caused him to have insomnia.

The doctor determined that the child was experiencing stress, but the physical symptoms were manifested as an eating disorder that caused weight loss, which in turn caused abdominal pain, weakness, and dizziness - making diagnosis difficult. If not detected promptly, psychological symptoms may appear later and worsen, such as loss of interest in hobbies, fear of communication, and negative thinking.

Another male patient in grade 7, on the outside is a cheerful person but at night he often has nightmares, can't concentrate on studying, causing his results to decline. Recently, his teacher reported that he often bullies his friends, hangs out with bad friends, and uses tobacco.

When parents complained, the child became irritable and agitated. At first, parents thought it was "the stubborn nature and natural curiosity of puberty", however, when taking the child to a psychologist, the parents were surprised to receive a diagnosis of depression. After further investigation, the doctor found that the parents often compared the child to the good-studying sister, which could cause psychological instability but was hidden inside, manifesting in the above behavior.

"This makes it very difficult for parents to detect that their child has the disease. Because depression is characterized by signs of sadness, but the male student still has signs of happiness and vivacity on the outside," said Mr. Dung.

Brain MRI of a patient. Illustration photo

Dr. Dung said that depression has diverse manifestations, in which in addition to common symptoms such as sadness, crying, fatigue, loss of interest, isolation, and anger; many cases are revealed through physical signs, called masked depression.

Some patients sleep more, have difficulty waking up, and experience nutritional and appetite effects such as loss of appetite leading to weight loss or overeating leading to abnormal weight gain. These disorders lead to pathological symptoms such as abdominal pain, constipation, malnutrition, dizziness, and cramps - which they mistake for physical illness.

Depression can also cause headaches, chronic body aches, and pain that does not respond to medication. In adolescents, it can cause changes in school performance, bad company, drug use, risky behavior, over-the-top behavior, or clinging to friends, irritability, and negative behavior.

Behaviors like bullying are also thought to mask feelings of sadness and loneliness caused by depression. Depression and stress can negatively affect your immune system, making you more susceptible to infections and other illnesses.

Research on NCBI shows that 69% of depressed patients who come to the clinic have many signs of physical abnormalities. The more severe the physical symptoms, the more severe the depression. A high rate of patients with suicidal thoughts is found in patients with persistent pain. Experts explain that when depressed patients have neurotransmitter disorders, they may have an imbalance of serotonin and norepinephrine, causing physical and mental pain symptoms.

Similarly, according to the NHS, the symptoms of clinical depression can be complex and vary from person to person. The condition causes a lack of energy, low or no sex drive, changes in menstrual cycles, and sleep disturbances. In addition, there are social symptoms such as poor academic performance, less participation in activities, and neglect of personal interests.

Depression may only happen once in a lifetime, but it often goes through many episodes, long-term treatment, costs time and money, spreads negative psychology to people around, causing "double" harm, according to psychologist Nguyen Thi Huong Lan. Therefore, early detection and timely treatment are very important, according to experts. A study from the Ministry of Health in 2023 showed that 21.7% of adolescents (10-17 years old) in Vietnam have mental health problems, of which anxiety disorders and depression are the most common. However, only about 5% of parents identify their children as needing help with emotional and behavioral problems.

Patients need to be treated for all symptoms, including physical and mental, with psychotherapy and medication. This dual effect is powerful in combating depression and preventing its persistence or relapse.

Dr. Dung advises that changes in adolescent psychology are a normal part of growing up but should never be taken lightly. Parents need to spend time with their children to detect warning signs in time and take them to the hospital early.

Duong Chung (According to vnexpress.net)

Source: http://baovinhphuc.com.vn/Multimedia/Images/Id/126848/Tram-cam-“an”-dang-sau-trieu-chung-the-chat