Nine Illnesses That Look Like Depression But Aren’t

It is easy to believe depression is to fault if you or a loved one is depressed, overly exhausted, or experiencing difficulty sleeping. Experts caution that while many diseases can mimic depression, misdiagnosis is a common occurrence.

In fact, according to a Current Psychiatry paper, between 26 and 45 percent of people who are referred for “depression” do not fit the diagnostic criteria for the condition. Only 47% of cases of depression were correctly diagnosed by general practitioners, according to a study of 118 research, and they frequently diagnose depression in persons who do not actually have it.

According to psychiatrist Jonathan E. Alpert, M.D., chair of the Council on Research of the American Psychiatric Association, the difficulty facing medical professionals is that there is no one, gold standard test for depression.

“It is not possible to diagnose depression with a blood test or an MRI,” asserts Alpert, the chair of psychiatry and behavioral sciences at the Albert Einstein College of Medicine and Montefiore Medical Center.

Rather, recommendations need patients to have at least five of nine specified symptoms (see box) for longer than two weeks in order to be diagnosed with depression. According to Alpert, medical professionals should also rule out other illnesses.

Experts assert that while evaluating older persons, it’s crucial to take other potential diseases into account. Although it is true that individuals over 50 may have depression, the majority of people initially encounter the illness in their early years. Furthermore, unusual symptoms or other illnesses that can cause depression or be confused for it are more common in older persons.

“It’s often challenging to diagnose depression because the symptoms may overlap with chronic medical conditions, early dementia, hearing and vision loss, and medication side effects,” says Meredith Gillam, M.D., a geriatrician and medical director of the University of North Carolina Geriatrics Clinic in Chapel Hill. “It takes time and patience for family and clinicians to work through what is really going on.”

The greatest risk of receiving the incorrect diagnosis is that you could actually have a serious illness that needs to be treated right away, like dementia or cancer.

The following are some of the most typical illnesses that can resemble or result in depression:

A thyroid condition

General practitioner Joseph Lai of Novant Health in Charlotte, North Carolina, believes that thyroid problems are a prevalent illness that can be misinterpreted for depression.

The thyroid gland, which resembles a butterfly, controls vital bodily processes like heart rhythm and energy level. As you get older, your chances of developing a thyroid issue rise.

“The thyroid is one of those little organs that has its fingers in everything,” Lai says. “If not working properly, it can definitely mimic depression.”

Fatigue, depressive symptoms, and irritability are all signs of thyroid issues and can be confused with depression.

However, Alpert notes that an underactive thyroid rather than depression may be indicated by weight gain or swelling, susceptibility to cold, and excessive exhaustion. According to him, an underactive thyroid might cause someone to feel as though they don’t have the energy, whereas depression can cause someone to feel unmotivated or uninterested in accomplishing activities.

A separate thyroid condition called hyperactive parathyroid glands, which raises blood calcium levels, can also produce symptoms similar to sadness.

The American Thyroid Association estimates that 20 million Americans suffer from thyroid disease in one way or another, and that up to 60 percent of them are unaware of it. Consider requesting a thyroid test from a medical practitioner if you think you may have a thyroid issue.

Inadequate intake of vitamins

Sometimes symptoms of depression might be brought on by a nutritional insufficiency. Vitamin D and vitamin B12 are two basic nutrients that many older persons do not get enough of.

According to the Cleveland Clinic, about 35% of adults in the United States do not receive enough vitamin D. According to Lai, signs of a deficit include weakness, discomfort, and low energy, which might mimic depression. Being outside is the simplest way to increase your vitamin D intake since sunlight converts vitamin D in your body.

A deficiency in vitamin B12 is linked to depression, dementia, and impaired cognitive function. Vitamin B12 is required for nerve activity.

According to Lai, vitamin deficiencies are more common in older persons, thus he always looks at nutrient levels before making a diagnosis of sadness. Your doctor might suggest a supplement if there is a deficiency.

Cancer

According to Alpert, a number of symptoms commonly associated with depression, such as weariness, appetite loss, and weight loss, can also be early indicators of cancer.

Furthermore, a number of cancer patients experience depression prior to receiving a cancer diagnosis, according to recent study, which has led scientists to speculate that depression may be an early indicator of a disease process occurring in the body.

For instance, a 2016 Swedish study comprising over 3 million cancer-free patients and 300,000 cancer patients revealed that, in the ten months preceding their cancer diagnosis, the cancer patients had a higher likelihood of receiving a psychiatric disorder diagnosis than the cancer-free patients.

According to Alpert, there is a particularly substantial correlation between depression and pancreatic cancer. According to two review studies, between 33 and 45 percent of individuals with pancreatic cancer experienced psychological symptoms prior to physical signs.

Dementia

Detachment and a loss of interest in activities are early indications of dementia that can resemble depression.

“I can think of situations where a person was presumed to have depression because they stopped going to activities like dinner with friends, didn’t speak much in group conversations, or lost interest in watching movies or other activities that require concentration,” Gilliam says.

The person’s memory and processing issues would grow more obvious over time, she claims, and it would eventually become clear that dementia was the cause.

According to doctors, the primary distinction between the two illnesses is the amnesia associated with dementia. Additionally, a person suffering from depression is less likely than a person suffering from dementia to become lost or confused in familiar settings.

Parkinson’s illness

According to Alpert, Parkinson’s disease results in chemical alterations in the brain, such as the death of dopamine neurons, which impair desire, engagement, and interest. He claims that “that overlaps very much with what we see in depression.”

According to him, depressive and apathetic symptoms can occasionally manifest in Parkinson’s patients prior to the development of motor symptoms like tremors and stiffness.

Parkinson’s is typically identified by a neurological examination. The tremors, stiffness, rigidity, slowness of movement, balance issues, and loss of facial expression are what the providers will be on the lookout for.

Individuals with a Parkinson’s disease diagnosis are more likely to experience depression. According to studies, up to 50% of Parkinson’s patients will go through a depressive episode.

Low red blood cell count

You don’t have enough healthy red blood cells in your body to carry oxygen to the tissues if you have anemia. In addition to feeling weak and exhausted, you can find it difficult to focus, which are signs of depression.

According to the CDC, the risk of anemia rises with age and is more common in adults over 65. Anemia is most commonly caused by iron deficiency, but it can also be brought on by intestinal bleeding, cancer, or deficiencies in folic acid or vitamin B12.

Anemia can also result in symptoms unrelated to depression, such as chilly hands and feet, lightheadedness, and dyspnea, in addition to weakness and exhaustion. Anaemia can be identified with a straightforward blood test.

Adverse effects of medication

More than 200 medications have been connected to depressive, hopeless, and suicidal thoughts. In fact, according to a research published in the journal JAMA, roughly one-third of Americans take prescription medications that may raise their risk of depression or suicide.

Steroids, sleep or anxiety aids, anti-seizure meds, and opiate painkillers are common ones.

“We’re always wondering, did this coincide with starting a new medication?” says Alpert, who also notes that it may take weeks or months for a new medication to have a side effect like depression.

It’s crucial to avoid stopping your medicine on your own if you think it’s the source of your depression. Instead, Alpert advises discussing your worries with your healthcare physician. He or she may choose to keep you on the medication and use an antidepressant to treat your depression if it is necessary for your condition.

Prolonged grief

Grieving after the loss of a loved one is common. What you may mistake for depression, however, could be extended grief disorder if your grieving becomes so severe that it interferes with your daily activities for more than a year following the loss.

A relatively recent psychiatric diagnosis, prolonged grief disorder is defined by persistent longing for a deceased person and trouble recognizing the reality of the loss.

According to Alpert, although protracted grieving can mimic depression, there are certain, research-proven psychotherapies that can address it and restore your sense of self.