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  • Can Depression Symptoms Be Related to a Physical Condition?

    Often it is thought that the diagnostic possibilities of depression, a rather common mental health issue, would include dysthymia (mild and chronic depression not meeting the full criteria of major depression), adjustment disorder (excessive reaction to life stress), and bipolar disorder, to name a few. However depression symptoms can also be a sign of a major medical illness, which if properly treated would resolve the mood symptoms, in some cases without the need for any mental health interventions. It’s important to distinguish between depression and mood changes that are a result of the knowledge of and dealing with the physical symptoms of a medical disorder. What we are discussing here is that depressed mood or mood change can primarily be caused by a physical condition as a result of change in physiology.

    It should be mentioned that a majority of depression cases will in fact be primarily psychiatric in nature, and not a manifestation of a medical illness. Without any physical signs or symptoms of an illness, and a very typical presentation of a psychiatric illness, the probability of a contributing undiagnosed medical disorder is even lower. Still the concept of considering all possibilities including physical illness is an important part of a comprehensive psychiatric examination. The list of medical disorders that can present with depressed mood is extensive, here I highlight three examples.

    Adrenal insufficiency is a lack of production of cortisol from the adrenal hormone gland, lowering the body’s ability to respond to stresses such as infections. Subdural hematoma is a brain bleed that requires a neurosurgeon to drill holes in the skull to relieve the pressure. Both conditions can present with depressed mood as a symptom (adrenal insufficiency will likely present with other physical signs of the disease along with depressed mood including chronic fatigue and joint pains among others). It is even possible that the first symptoms of certain types of cancer, a condition known as paraneoplastic syndrome, would be a change in the mood, landing the patient in the office of a psychiatrist. The recognition of these medical disorders is imperative as time spent treating mood symptoms that are solely caused by a physical condition will be futile and a delay in diagnosis of a medical condition can affect the prognosis for the patient.

    These examples illustrate that extensive medical knowledge, a thorough general and neurologic examination, and the skills, background and training of a physician are required to recognize when a mood or behavior symptom is in fact part of a physical illness. The medical disorder may not be apparent on initial examination, requiring serial exams over a period of time to recognize.

    © Neevon Esmaili 2016

    Neevon Esmaili, MD
    Child Adolescent, & Adult Psychiatrist
    Dual Board Certified

    The information on this blog is not intended to be used to diagnose or treat a medical or psychiatric illness. It is for informational purposes only. Diagnosis and treatment of medical and psychiatric illness can only be done by a licensed clinical professional, and recommends consulting with a qualified healthcare provider for any questions or issues you may have. This blog cannot be used as a substitute for consultation with a qualified medical professional.