70% of Hypochondriacs Can Be Cured with Drug Treatment

People should not add more burdens and pain to patients and their families out of ignorance and misunderstanding. ˝The suspect in the subway fire is not like other hypochondriacs,˝ said psychiatrics. “We hope people will show more interest in understanding the disease after this tragic accident so that more patients can be treated.”

▽Arson Suspect and Depression = Kim Dae-hwan, the suspect in Daegu subway arson, has been suffering from many mental problems. According to studies at home and abroad, more than 20% of stroke patients develop symptoms of depression. And more than 30% turn more impulsive in character.

If the patient has already problems in personality, the impact on the mental health is likely to increase.

Experts point out that Kim has developed `anti-social personality disorder` characterized by complaints against the society and disregard to public goods and interests, and his conditions further deteriorated when the disease was compounded with depression, anger and impulsiveness.

He also developed what is called `boundary personal disorder` by being extreme in how he feels and judges himself and others. Most depression patients, however, hardly blame others for their unhappiness. They tend to blame themselves and sometimes end up with self-inflected wounds and suicide attempts.

Many people think that hypochondriacs commit crimes out of impulse, but in fact, the rate of crime among them is lower than healthy people. They tend to be more cautious and wary than healthy people.

▽Causes and Symptoms = Depression is a brain disease that develops when the brain fails to secrete signal-carrying chemicals such as Norepineprine and Serotonin. Patients grow slow physically and indifferent about things, feeling helpless. They become violent like Kim only when there are other factors.

When patients first experience the symptoms, they get unease, worrisome and fretful increasingly. They become slow in thinking and speaking. When their conditions aggravate, they turn self-inflicting or suicidal by thinking ˝I will never make it˝ or ˝I am nothing and useless.˝

They also have hard times sleeping well. They either hardly sleep or sleep too much. They lose appetite and weight and feel suffocated when breathing. Other symptoms include belching, diarrhea, headache, dizziness, fatigue, joint ache, muscle ache and sexual disinclination. They feel most unhappy when waking up in the morning, and get better in the afternoon.

▽Depression can be treated = As you go to a dentist when having a toothache, you can see a psychiatrist when you suffer from depression. It is one of mental illnesses that can be treated easily at the hospital. Like other illnesses, the earlier you see a doctor, the higher the effect of treatment is.

When patients suffering from depression visit hospitals and are put on medication, 70% can get effect. In the past, there were some side effects such as dilated pupils and running saliva, but nowadays medication accompanies few side effects.

Because effects show up after two to six weeks on medication, however, patients should continue to take medicines steadily. And though it looks like their conditions improve, they should not stop taking medicines.

In line with the drug treatment, psychiatrists help patients get rid of depression through counseling.

Patients’ family members play an important role in depression treatment. They should remind the patients often that it is a treatable illness and encourage them. In addition, they should help the patients take medicines.

Depression patients hurt from trivial things, so blame should be strictly forbidden. If the patients say, "I want to kill myself," go see a psychiatrist at once. Encouraging the patients to have some hobbies or religious activities is good, but they should not be forced into those activities.

(Advice - Dr. Kwon Jun-soo, Neuropsychiatry, Seoul National University Hospital and Dr. Kim Do-kwan, Phychiatry, Samsung Medical Center of Medical college, Sungkyunkwan University)

Seong-Ju Lee stein33@donga.com