Persistent physical symptoms—for example, a chronic dry cough—can cause anxiety and depression.

Before treating anxiety and depression, it is important to find the cause of the persistent physical symptom.

A common class of medications can trigger persistent dry cough months or even years after treatment begins.

Careful medication review can solve medical mysteries and prevent misdiagnosis.

Sometimes physicians encounter symptoms that remain unexplained despite extensive testing. When no clear medical explanation is found and symptoms persist, patients often develop anxiety and/or depression as a consequence of living with an unresolved health problem.

In such situations, treatment frequently focuses on the emotional consequences while the underlying medical mystery remains unsolved.

Yet occasionally, the right question can reveal a surprisingly simple explanation—and an equally simple solution.

Case study: A chronic cough

Linda was 54 years old when she came to see me with a persistent dry cough that had lasted 14 months.

The cough was relatively mild during the day but became relentless at night. She described a constant tickling sensation in her throat. Coughing would briefly relieve the sensation, but within seconds, the tickle would return, triggering another coughing spell.

She tried drinking cold water, warm water, and various home remedies, but nothing provided lasting relief. The chronic cough disrupted her sleep night after night, leaving her exhausted during the day.

As the months passed, Linda became increasingly anxious and depressed.

Apart from her cough and being treated for high blood pressure, she was healthy, exercised regularly, and ate a balanced diet.

Linda had never smoked and had no history of asthma. Her physical examination was normal. Blood tests and chest X-rays were unremarkable.

Over........

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