Depression is a common psychiatric disorder characterized by depressive mood, anhedonia (loss of pleasure), decreased energy, and impaired daily functioning. In primary care, patients often present with nonspecific somatic complaints such as fatigue or malaise rather than overt psychological symptoms. The continuity of care and comprehensive approach in family medicine enables early recognition of psychiatric disorders and severe psychopathology, such as psychotic features.A 28-year-old woman presented to a family medicine clinic with complaints of fatigue, malaise, and hair loss. She reported no chronic illness, regular medication use, or history of surgery. Initial laboratory tests, including thyroid function tests, were normal. On examination, the patient appeared tired and inattentive. The Patient Health Questionnaire-9 (PHQ-9) was administered, yielding a score of 20, consistent with severe depressive symptoms. She denied active suicidal thoughts, and a psychiatric referral was planned. Three days later, the patient returned and reported canceling her psychiatry appointment, stating, “I believe God sent me to you.” She explained that a psychologist she spoke to by phone opposed psychiatric evaluation and suggested alternative approaches. During the consultation, she exhibited disorganized thought processes, frequently changed topics, and expressed beliefs that she was being punished by God and that her family was trying to take her property through forced marriage. These delusional beliefs indicated disturbances in thought content. A preliminary diagnosis of psychotic depression was considered, and an urgent psychiatric referral was reinstated.This case demonstrates that severe depression with psychotic features can initially present with vague somatic complaints, highlighting the importance of diagnostic responsibility in primary care that goes beyond symptom-focused evaluation.Screening tools such as the PHQ-9 are valuable for patients presenting with nonspecific complaints.Primary care physicians can recognize early signs by paying attention to behavioral changes and unusual thought patterns.Primary care plays a central role in the early recognition of complex depressive disorders. Careful assessment can reduce delays in the treatment of  depression. Keywords (MeSH): Depressive Disorder, Psychotic Depression, Primary Health Care, Patient Health Questionnaire, Somatic Symptoms, Delusions, Referral and Consultation