Are You Sure That It's Depression?

Could You Have Been Misdiagnosed With Depression?

THE SYMPTOMS OF DEPRESSION ARE FAR FROM CLEAR-CUT — THEY VARY FROM PERSON TO PERSON AND OFTEN OVERLAP WITH THOSE OF OTHER HEALTH CONDITIONS. HERE ARE SOME CLUES YOU MAY NEED A SECOND OPINION ON YOUR DEPRESSION DIAGNOSIS.

By Kristen Stewart 

Medically reviewed by Lindsey Marcellin, MD, MPH

Most people shop around for a new TV or computer, but how many of us actually take the time to get a second opinion about our health? Turns out, you should — especially when it comes to a depression diagnosis.

That’s because depression can be especially difficult to diagnose. “Depression may manifest with different symptoms for different people, and those symptoms often overlap with symptoms of anxiety disorders, bipolar disorders, post-traumatic stress disorder, or even addictions,” says Christopher Willard, PsyD, a clinical psychologist in private practice in Cambridge, Mass., and author of Child’s Mind: Mindfulness Practices to Help Our Children Be More Focused, Calm, and Relaxed.

Is It Depression — or Something Else?

The classic signs of depression include feelings of sadness, hopelessness, and worthlessness, but some people with depression also feel restless or irritable, have trouble concentrating, and sleep either too much or too little. Other people may experience fatigue and dramatic changes in appetite.

To complicate things even further, many of these symptoms overlap with other mental illnesses. Take bipolar disorder, for example. People in the manic phase of bipolar disorder may feel agitated or irritated, be easily distracted, and experience binge behaviors such as eating — all things that could describe depression. In the depressed period of bipolar disorder, people may experience some or all of the same symptoms as someone with depression, like feelings of worthlessness and low self-esteem, sadness, and suicidal thoughts.

Anxiety disorders can also mimic depression, with symptoms ranging from trouble concentrating, restlessness and irritability to fatigue and difficulty sleeping. Even post-traumatic stress disorder can cause some symptoms that are similar to depression, including not being able to concentrate, being irritable or angry, and having sleep disturbances.

Finally, some physical conditions, such as hypothyroidism, can be mistaken for depression. The body needs the thyroid hormone to run smoothly — if the level gets too low, you may experience fatigue, forgetfulness, and even depression. Diabetes is another possibility. Many people have diabetes without realizing it, so symptoms such as weight loss, fatigue, and irritability can be misdiagnosed as depression.

How Often Do Doctors Make Mistakes?

The good news? Today, misdiagnoses of depression are relatively uncommon. “Depression is diagnosed based on a cluster of symptoms, which has proven to be remarkably accurate,” says Dale Archer, MD, a clinical psychiatrist in New York City and Lake Charles, La. “It’s always possible to have a medical condition as the root cause with the exact same symptoms, but in medicine we call this ‘looking for zebras’.”

But misdiagnoses are possible — and it is generally a good idea to get a second opinion, especially if you are not feeling better with your current treatment. If you aren’t responding to your prescribed regimen, a full physical and laboratory evaluation should be performed. Fatigue can be a symptom of a medical condition and/or depression, so that should be the focus of the work-up, according to Dr. Archer. If the lab tests come back normal, then odds are very likely depression is the correct diagnosis.

Another important tip? Follow your instincts. “Rely on your gut feeling,” says Russell Hyken, PhD, EdS, a therapist in St. Louis. “Depression is having the ‘blues’ for an extended period of time. If you think it is something else, such as anxiety, then it may be.”

Other issues such as an undiagnosed learning disability or attention-deficit/hyperactivity disorder, just to name a few, can cause frustration and also lead to depression. In situations like these, if the underlying problem is addressed, the depression may lift.

Finally, if you simply don’t feel a connection with your mental health professional, it may be time for a second opinion. There is help out there — it may just take a little effort for you to find it.