Chapter 1: The Startling Signs of Mental Disorders

What physical indicators of mental illnesses can be identified by medical professionals?

This extraordinary story will captivate you.

In 2012, during my internship, a striking incident occurred. At about 1:30 a.m., a 23-year-old woman arrived at our hospital's emergency room, suffering from intense abdominal pain.

Upon conducting a thorough examination and taking her medical history, I discovered that she had underlying psychiatric issues that had gone unrecognized by her family. Naturally, it was imperative for me to inform my supervisors about my observations regarding her condition.

A series of diagnostic tests—including an abdominal X-ray, ultrasound, and several blood tests—were performed to identify the source of her pain. In the interim, we initiated symptomatic treatment; however, it was peculiar that nothing seemed to alleviate her discomfort.

Typically, various types of pain respond to analgesics, but this case was different. After careful assessment, my supervisor diagnosed her with trichobezoar, a condition associated with severe clinical depression, where individuals consume and ingest their own hair. This phenomenon is also referred to as "Rapunzel syndrome."

It later emerged that this woman had been grappling with depression for two years and had been ingesting her hair for the past eight months. Consequently, a hairball had developed in her stomach, leading to a blockage and causing excruciating cramps.

At this juncture, we had two potential paths to consider: performing an abdominal surgery to remove the hairball or attempting to extract it using an endoscope. Given the patient's young age and her psychiatric condition, we opted to reserve the surgical intervention as a last resort.

We then contemplated a third, unconventional approach that astounded me. Though I had only read about it in literature, I was now witnessing it firsthand. My supervisor instructed me to procure two large 2-liter Coca-Cola bottles. We inserted a tube through her nose into her stomach, connected it to the bottle, and inverted it to rapidly flush the liquid into her stomach.

I was taken aback, but all she could do was burp. We attempted the second bottle, yet again, there was no change. It became clear we would need to take her into the operating room.

At that moment, she expressed a desire to sit up. Before I could intervene, she began to vomit violently. To our astonishment, she expelled hair—hair, and more hair. For the next 20 minutes, she continued to vomit hair before finally falling into a deep sleep.

She was kept overnight for monitoring and released the following day with medication for her depression. Today, she is a delighted mother of two and visits my practice regularly, humorously attributing her recovery to "a few Cokes."

This strange illness and its unusual treatment yielded an incredible result, illustrating the wonders of medicine: the ability to save lives and foster hope.

Story Credit to Dr. Farman Ali

Chapter 2: Understanding Mental Health and Its Physical Manifestations

A comprehensive overview of mental illness, including its causes, symptoms, diagnosis, and treatment options as presented in the Merck Manual Consumer Version.

Learn to recognize the signs of mental illness in this informative video from Healthsource 10.