Many medical conditions can have depression associated with them, ranging from endocrine ( hormonal ) disorders, cardiac conditions, cancers, and vitamin deficiencies. Most often, depression occurs independently of another medical disorder, but if physical signs and symptoms exist other than those typically found in depression, a medical/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 deter-mine 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 coexisting depression vigorously. For example, postrecovery 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 per-son 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.