2023-07-27 08:51:01
Depression is a pathological condition that has clear criteria for an accurate medical diagnosis, just as there are clear criteria for diagnosing diabetes, high blood pressure, urinary tract infections, migraine headaches and other diseases.
But the problem is that depression has a complex relationship with other chronic diseases. In many cases, a person may exhibit multiple symptoms, including what may actually accompany depression. Including those that may accompany other physical or psychological conditions unrelated to depression, such as fatigue, sleep problems, changes in appetite or weight, difficulty concentrating, unjustified pain, and feelings of sadness and/or anger. Therefore, the mere presence of it in a person does not automatically mean that the person is depressed.
Common medical conditions
The basis in medical science is that: “The occurrence of a misdiagnosis hinders the success of treatment.” Thus, mischaracterizing these cases as depression may exacerbate the real disease that caused them to appear, and unnecessarily prolong the suffering of those symptoms. To make things worse, having a chronic organic disease can, for understandable reasons, lead to depression. Or a person may develop depression independently of other conditions they already have.
Here are four “common” conditions that may sound like depression, but aren’t:
1. Hypothyroidism. The thyroid gland is a small gland located in the front of the neck. It plays an important role in a number of bodily functions through the hormone it secretes at steady levels. The American Thyroid Association reports that 60 percent of people with actual problems of thyroid disorders, who have many symptoms of it, are actually unaware of their condition and have not yet been diagnosed.
In some cases, hypothyroidism may contribute to depression, as well as other types of mental health mood disorders, such as anxiety. In addition to a wide range of pathological physical symptoms.
Although the medical community has long recognized that there is a link between thyroid function and depression, the exact mechanisms of how they interact are not yet fully understood. Evidence also suggests that taking thyroid hormone therapies can enhance the effectiveness of medications for depression. Therefore, some doctors sometimes combine the prescription of thyroid medications with the prescription of antidepressants, to treat depression in people with normal thyroid function.
One problem that can complicate diagnosis is that depression and hypothyroidism share some of the same symptoms. Common symptoms of both are: low mood, easy fatigue, difficulty concentrating, decreased libido, and weight gain. In such cases, it may be helpful to look at some of the other symptoms that may indicate an underactive thyroid.
To be clear, if the symptoms of depression are also accompanied by either constipation, dry hair, hair loss, hoarseness, muscle stiffness, or always feeling cold, then depression is likely related to underactive thyroid.
2. Vitamin D deficiency. Many people all over the world suffer from a deficiency of vitamin D without excluding any region of the world, regardless of the level of health, nutrition and availability of sunlight. This is a doctor’s fact, the exact cause of which is not known. In a study using data from the four-year NHANES National Health and Nutrition Examination Survey, nearly 20 percent of the US population had low blood levels of vitamin D.
Vitamin D plays major roles in building bone, absorbing calcium, activating parathyroid hormone, and regulating the balance of phosphate in the body. muscle efficiency. Therefore, the symptoms of deficiency in the body appear on a large scale, and in different forms, and perhaps one of the most important of them is depression.
Increasing scientific evidence points to the role of vitamin D in causing depression, as well as in the success of its treatment. Although the mechanisms for this complex relationship are not clear, vitamin D receptors (VDRs) are elevated in regions of the brain (such as the prefrontal cortices and cingulate cortices) that are known to play a key role in regulating mood, as well as a proposed modulating role for vitamin D in the association between depression and depression. and inflammation (through a possible immune modulatory mechanism), as well as the neuroprotective role of vitamin D.
Anemia and chronic fatigue
3. Anemia. Anemia may be the reason why one suffers from a gloomy mood. A common symptom of depression is the feeling that even the simplest tasks take up more energy than one has. But on the other hand, anemia can also make one feel that way.
When a person is anemic, their blood cannot carry as much oxygen as it should to the body’s organs. Thus, anemia can affect many areas of the body, including the brain, muscles, ears, and eyes. So not only does anemia lower a person’s energy levels, but it can also affect the way they think, feel, hear and see. Thus, changes in mood, dizziness, and cognitive impairment (difficulty remembering, learning, concentrating, or making decisions).
Several medical studies from different regions of the world have linked anemia, especially caused by iron deficiency, to depression. As well as between anemia and anxiety. To be clear, the brain region called the basal ganglia contains a higher amount of iron than other brain regions. Because of this, they respond easily to changing iron levels, especially to a deficiency. This area is an important part of processing emotional stimuli.
Indeed, iron does more than just help red blood cells carry oxygen, iron is involved in many essential areas of cognition, including central nervous system enzymes and proteins, central nervous system development, DNA replication and repair, and formation of white myelin (laminar epithelium). neurons to speed up the transmission of information), and the development of neurotransmitter systems. So, if a person’s iron is not at the right level, their brain may not function effectively, and their brain may not process emotions properly.
4. Chronic fatigue syndrome. Chronic Fatigue Syndrome is more common in females than in males, and often affects young and middle-aged adults. Even today, it is not possible to ascertain the extent of chronic fatigue syndrome, although some recent British studies reported that it is in regarding 5 percent of adults.
Chronic fatigue syndrome is a very debilitating disease and its cause is not known. People with this syndrome are often unable to perform duties and practical activities normally in the workplace or at home, due to their long-term fatigue and short-term memory problems. This can lead to depression. But at the same time, depression is not a cause of this syndrome.
The scientific community still suffers from a weak ability to diagnose this debilitating disease, which hinders the medical ability to treat it. In general, the diagnosis of chronic fatigue syndrome requires the fulfillment of medically approved diagnostic criteria, the most important of which is that the person has chronic fatigue for a period of six months or more, and at the same time all other known conditions that can cause fatigue in humans have been excluded. Or the person has, at the same time, four or more of the following symptoms:
Significant problems with short-term memory or concentration abilities.
– sore throat.
Pain in the lymph nodes.
Muscle pain.
Joint pain without swelling or redness.
Headaches that differ in pattern or intensity from one’s usual headaches.
– Feeling tired and not renewed following waking up.
Extreme fatigue that lasts more than 24 hours following physical exertion or stress.
In many cases, a person may display multiple symptoms, including what may actually accompany depression, but have nothing to do with it
Negative consequences and potential causes of mental illness diagnosis difficulties
Diagnosis of mental illness is the first step on the path to correct treatment, which the patient will often benefit from.
A misdiagnosis of mental illness occurs when a person receives a diagnosis they do not actually have. This can happen during the initial evaluation by a psychiatrist, or during follow-up treatment. If this first step is wrong, and the person receives an incorrect diagnosis, it can have negative consequences, depending on the type of underlying problem they have.
For example, a misdiagnosed mental illness can confuse a patient when a recommended treatment does not improve their condition, despite their cooperation with their physician. Or he may feel that it is a personal failure from him, and he may feel guilt or shame when he does not make progress according to that diagnosis and that treatment.
Also, receiving a drug to treat a condition that a person does not have is already negative, as this can lead to the person suffering from all the side effects of the drug, without any benefits. It may also cause new symptoms to appear, or exacerbation of symptoms he already has, in addition to the possibility of a person’s condition deteriorating if it is misdiagnosed or not diagnosed at all, especially if it is treated with drugs that are known to be slow-acting and take a long time to improve. The patient’s condition, such as selective serotonin reuptake inhibitor medications for depression.
It is true that misdiagnosis can happen to any medical condition, organic or psychological. But in psychological cases it may be more likely. One of the reasons for the difficulties in accurately diagnosing mental illnesses is that mental illnesses often do not have accurate analyzes or examinations to indicate their existence. That is, it is not as available in blood sugar analysis, cholesterol and fat analysis, blood pressure measurement, coronary artery imaging, or x-rays for bone fractures and so on. Rather, psychiatry relies exclusively on the symptoms reported by the patient, and the medical history he recounts. Obtaining a good clinical history requires a lot of time and a good doctor-patient relationship. Both are not always available at the start of treatment. It is also important to collect previous history, including obtaining previous medical records. And also, sometimes, talking to family members to get accurate and correct information that appoints a doctor. Therefore, these and other reasons interfere with the doctor’s attainment of accurate diagnosis, when important information that leads to a correct diagnosis of mental illness is lost.
Therefore, the description of the medical history is essential. Thus, doctors are more likely to reach incorrect conclusions when there is not enough or correct information provided by the patient. For example, the patient may not always want to talk regarding topics such as substance abuse, childhood trauma, academic failures, or poor functioning, and may not realize how important they are in forming the correct diagnosis. Other times, he may not feel that some aspects of his experiences and emotional states are worth talking regarding.
The best that the patient can do for himself, following he is keen to receive treatment with a specialized doctor, is to cooperate and be clear with his doctor.
* Consultant in internal medicine
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