Are there medical conditions that could cause depression
Many medical
conditions can have depression associated with them, ranging from
endocrine (hormonal) disorders, cardiac conditions, cancers, vitamin
deficiencies, etc. Most often, depression occurs independent of another
medical disorder, but if physical signs and symptoms exist other than
those typically found in depression, a medical or physical examination to
exclude physical causes for depression is warranted. Because of their
medical background, psychiatrists routinely consider medical conditions
as possible causes for depression and thus will assess a person's medical
history. Your psychiatrist may consider obtaining laboratory tests as
part of screening for medical conditions or may defer this evaluation to
your primary care physician. If a medical condition exists, it may be
difficult to determine with certainty whether the depression is
physiologically related or merely co-occurring with the illness.
Treatment of the medical disorder may or may not result in resolution of
the depression, but resolution of the depression would support the
physiologic connection. Even if so connected, it is possible that
treatment for depression will still also be needed. Depression can have
adverse effects on the body and its recovery from illness; thus, it is
very important to treat co-existing depression vigorously. For example,
post-recovery cardiac patients do more poorly when depressed, and thus,
depression is usually treated more vigorously now in this population than
it had been in years past.
More often, depression worsens existing medical conditions or is the
cause itself for physical symptoms. Depression and anxiety can be
associated with several physical ailments for which there are no physical
cause associated with them. Sometimes, a symptomatic person does not
endorse depressed mood, or there is denial of a depressed or anxious mood
(perhaps because of negative associations with the idea of mental
illness). Instead, the emotional distress is expressed through physical
symptoms. Such persons may see many different doctors seeking a "medical"
cause of their symptoms. Missing a mood disorder in such cases can result
in an overuse of healthcare services - not to mention persistent
morbidity and decreased productivity in the person. Afflicted persons
often show improvement in the physical symptoms with an antidepressant or
therapy.
