Today I came across a patient whose main symptoms were anxiety and irritability, panic attacks, hand tremors, and somatic discomfort in several areas, such as feeling that the head is being held, feeling hot all over the body, feeling that living is meaningless, and having thoughts of dying. At first glance, it is simple: either an anxiety disorder or a depressive episode. However, this patient had something different: her movement was slow, she walked at a pace and moved forward slowly, which was more obvious after the onset. The hand tremors were more pronounced when he was irritable. Parkinson’s was diagnosed in Nanjing and multi-systemic muscular atrophy was considered in Shanghai and Beijing, but Parkinson’s was ruled out after repeated screening and many room discussions. Transferred to psychiatry and psychiatric treatment, took a variety of antidepressants, that initial time, the effect was very good, after that, the effect has been poor. Almost all antidepressants were taken, but the condition was generally poor. In recent years, after increasing the dose, there would be garbled speech and inexplicable words, such as feeling that someone was in the house. However, several hospitalizations and checkups in the neurology department ruled out a neurological dose and considered depression as a high possibility. Therefore, a debate arose among our doctors: if no organic problem was found after the neurology screening, can the diagnosis of cerebral organic mental disorder continue to be given based on the symptoms, and is the depression determined by the previous consultation between neurology and psychology still considered first? This reminds me of a similar patient I met many years ago with symptoms very similar to this patient, who was diagnosed with depression for 6 years and had been treated as depression, and in the last 6 months even gave the diagnosis of depression with psychotic symptoms. The diagnosis of depression was still made when I was hospitalized in a ward 2 months before I received this consultation. At that time, I was hesitant and struggled, on the one hand, I thought it should be organic brain mental disorder, but repeated examinations had no basis for organic brain lesions, and depression had always been considered in the past, including still considered after multiple specialist visits 2 months ago. At this point, am I going to make a judgment based on my own feelings? Should I make a diagnosis of organic brain mental disorder that should have been based on no basis? Later, I followed my inner feelings and made the diagnosis of organic brain disorder according to my own judgment. No one can be 100% correct, and even the most renowned experts cannot guarantee it. At this point, it is important to make a judgment based on what you have observed and what you can understand, and as long as there is a basis and reason for such a judgment, it should be understood. Fortunately, that patient, after I changed his diagnosis from depression to organic brain disorder, the head of the department and most of the doctors in the departmental consultation room also agreed, and from then on the diagnosis was completely changed from depression to organic brain disorder, and the corresponding symptomatic and etiological treatment was given, and the result was better than before.