As doctors, we can understand that hyperthyroidism is associated with manic symptoms and hypothyroidism with depressive symptoms. This is due to the dysfunction of the hypothalamic-pituitary-thyroid axis of the patient, resulting in an increase or decrease in thyroxine, which ultimately leads to central nervous system lesions and a series of psychiatric symptoms. Similarly, we should also pay great attention to the mental symptoms of patients with hypothalamic-pituitary-gonadal axis dysfunction. Psychiatric disorders caused by abnormal gonadal function mainly refer to the psychiatric disorders caused by the imbalance of sex hormone balance in women under the influence of menstruation, pregnancy, labor and delivery, menopause, or under the influence of gonadal underdevelopment, etc., especially the psychiatric disorders in peri-menopausal women, because these patients usually go to the clinical departments for repeated consultations with various somatic discomforts, and the various medical examinations are more or less normal, and the doctors of our clinical departments follow the principle of symptom + sign + symptoms + symptoms. Doctors follow the pattern of symptoms + signs + test results = disease. When the patient’s signs and test results are negative, they assume that the patient does not have organic pathology, and simply treat the patient, or say some comforting words and let the patient go, which can only aggravate the patient’s suffering, knowing that the patient’s pain and swelling are real. The omission of diagnosis stems from our doctors’ insufficient understanding of “functional” mental disorders. The distinction between organic and functional is only relative and conditional. With the development of science and technology, various testing methods have become more and more advanced, and what was originally considered as functional mental disorders have been found to have brain parenchymal and ultrastructural changes, so that the so-called functional mental disorders will sooner or later be found to have brain lesions in particular. For example, a 52-year-old woman presented to the psychiatry department with the complaint of “insomnia, pain and numbness in both lower limbs for 3 years”. Before coming to the psychiatry department of our hospital, the patient had been to Xijing Hospital, Jiaotong University First and Second Affiliated Hospitals and other major hospitals in the province, and consulted many departments, such as neurology, orthopedics, traditional Chinese medicine, pain, etc., and underwent various medical examinations, such as blood tests (blood routine, liver and kidney function, blood lipids and blood glucose, anti-O, blood uric acid, CRP, a full set of thyroid function, immunology, etc.), cervical spine and lumbar vertebrae MR, EMG, Doppler and so on, which were roughly normal. The patient was diagnosed as “vegetative”. The patient was diagnosed with “phytoneurological dysfunction” and “menopausal syndrome”, and had been under treatment for three years, receiving a variety of treatments in both Chinese and Western medicine, but with little effect, with no relief of the pain and numbness, and with further aggravation of the sense of airflow and numbness in both lower limbs, as well as a sudden onset of heat and cold. The body was hot and cold. This time, I went to our orthopedic department for treatment, and the doctor said that orthopedics is not a big problem, and suggested that the patient should have physical therapy, and after two courses of physical therapy, the symptomatic relief was not obvious, and the director of the rehabilitation department, Dr. Li Junyi, suggested that the patient should come to the psychological department for adjustments. Obviously, this is a case of perimenopausal mental disorders, is due to perimenopausal estrogen levels decline, triggering a reduction in the central nervous system 5-hydroxytryptophan, resulting in mental disorders, depressed state of mind and a variety of somatic discomfort. In general hospitals, however, most of them (77.5%) had complaints of somatic discomfort rather than psychiatric symptoms, thus creating difficulties in recognizing and diagnosing depression by physicians in various clinical departments. Influenced by the biomedical model, non-psychiatrists subjectively do not pay enough attention to depression, objectively relative lack of knowledge about depression, coupled with the prominent physical symptoms of this disease, depression symptoms latent, hidden, easy to misdiagnose. In addition, even if some non-psychiatrists can recognize this disease, they are reluctant to refer such patients to psychiatry for various reasons, resulting in misdiagnosis and treatment and causing patients to repeatedly visit various clinical departments. Some patients are also reluctant to go to psychiatry because of the stigma attached to mental illness. Let’s go back to the patient above. After 2 months of treatment with antidepressant drugs (to increase the level of 5-hydroxytryptamine), the patient’s symptoms improved significantly, especially the pain in both lower limbs was completely relieved, and the swelling and numbness were also reduced by 80%. Appetite and sleep were basically normal, and the patient could also undertake some housework. There was a significant difference in HAMD and HAMA scale scores before and after treatment, very good efficacy.