MSN.com Living
1/21/2013
What
feels like depression … but isn't
Depression or a Thyroid Condition?
The tiny thyroid gland
has a huge role. It regulates metabolism, which means virtually all the
chemical reactions in the body, including those involving hormones. If
metabolism is out of whack, a person doesn't function right -- or feel right --
usually without realizing why. Resulting symptoms like changes in mood, weight,
and energy levels can be mistaken for many other conditions. As many as half of
all thyroid disorders are therefore misdiagnosed or undiagnosed.
In a 2004 Spanish
study, 34 percent of older adults with hypothyroidism (underactive thyroid) and
half of those with hyperthyroidism (overactive thyroid) reported feeling
depressive symptoms. Women are at higher risk for thyroid disorders, possibly
because they experience more hormonal changes.
What to watch: Other common symptoms of thyroid disorders
include weight changes, dry skin, sensitivity to cold, tingling or numbness in
the hands and feet, new constipation or loose stools, puffy skin, and bulging eyes. Hypothyroidism sometimes follows childbirth (a period when
postpartum depression may also strike).
What
to do: Don't ignore
depressive symptoms, whether you think you know the cause or not. A thyroid test can measure thyroid function. Hormone treatments are used to
restore proper thyroid functioning.
Depression or Drug
Side Effects?
When personality and
behavioral changes strike in teens or young adults, we're quick to think of
drugs. In adults, though, it's often overlooked that prescription drugs can
have similar effects. Beta-blockers used to treat hypertension, angina, and
other conditions, for example, can cause symptoms that appear to be
depression-like, including lack of energy, changes in sleep, lack of sexual
interest, and mood changes. Research shows that beta-blockers don't cause
depression; rather, they can bring effects that look and feel like it.
Other medications that
can sometimes cause depressive symptoms include corticosteroids (for autoimmune
diseases), which can alter serotonin levels, and drugs for Parkinson's disease
that affect dopamine levels, such as levodopa. Serotonin and dopamine are both
linked to mood. Also beware common antianxiety drugs, such as Xanax, Ativan,
and Valium.
What to watch: Ask whether the person has recently begun a
new prescription or had a dosage change. Abuse of illicit drugs or alcohol can
also cause depressive-like effects; be alert to these warning signs of addiction.
What
to do: When seeing a doctor
about worrisome symptoms, be sure to bring a list of all medications or, better
yet, all the medication bottles themselves. A different drug or an adjustment
to the dosage may ease the unwanted side effects.
Depression or Sleep
Problem?
Say there's no obvious
stressor or health symptom -- at least by day -- and yet you feel tired,
lethargic, and "off." The problem may be something that's happening
at night. Any kind of sleep problem can cause mood and energy problems by day. For example, those
who suffer insomnia due to stress, a bladder problem, or caregiving for someone
with dementia who doesn't sleep well are at higher risk for depression.
Sleep apnea, a dangerous condition that causes a person to briefly stop
breathing during sleep, is often a surprising cause. In sleep apnea, the soft
tissues of the throat temporarily close the airway. As many as 80 percent of
sufferers go undiagnosed or are treated for the wrong problem.
A 2012 study by the
Centers for Disease Control and Prevention of 10,000 adults found that people
with sleep apnea have a higher risk of depression. Men, diabetics, and those
who are obese are at greater risk of sleep apnea. Other risk factors include a
large neck size or being over 40.
What to watch: Someone with sleep apnea usually snores
loudly or sounds like he or she is struggling to breathe. A companion may
notice actual gaps in breathing. Other symptoms of sleep apnea include restless sleep, plus tiredness and napping during the
day.
What
to do: Don't ignore sleep
problems, whether you notice them during the day or night. For sleep apnea,
treatments include special sleep masks. A 2012 Cleveland Clinic Sleep Disorders
Center study found that patients who used them to treat sleep apnea experienced
fewer symptoms of depression, even if they didn't follow the Depression or
Dementia?
When a loved one
becomes withdrawn and uninterested in activities that once brought pleasure,
loved ones are apt to think, "He's depressed" more often than,
"He has cognitive impairment." But seeming apathy is a common early
sign of dementia, as the person struggling with cognitive changes focuses more
thought and energy on everyday behaviors, sometimes to the exclusion of
anything else.
Depression and
dementia can occur separately, but they're also often found together. The risk
of depression is higher in people diagnosed with dementia (of which Alzheimer's
disease is the most common cause), though there are other causes.
What to watch: There's a great deal of overlap in dementia and depression symptoms. With both, for example, someone may have
trouble concentrating, seem apathetic, show personality changes, or withdraw
socially. Other common early warning signs of Alzheimer's include making mistakes with money, having
trouble finding the right words, having difficulty with abstract thinking, and
being disoriented about time or place. Not everyone with early dementia will
have all these signs, but some of them may appear along with the changes in
focus and personality that look like depression.
What
to do: No single test will
distinguish between dementia and depression. A clinical assessment is the best way to diagnose Alzheimer's.
treatment exactly as
prescribed.
Depression or Burnout?
You can feel emotions
like sadness, or feel overwhelmed because you're dealing with chronic stress,
without having actual depression, which is a physical disorder. But it's a
slippery slope from stress to burnout, and burnout often leads to depression.
What to watch: Ongoing stress (such as the demands of
caregiving) is often compared to the proverbial frog in a pot of water on a
stove -- the temperature rises so gradually that the frog gets used to it, and
by the time he's being boiled away, it's too late. Check in with your stress level to get a sense of how advanced your stress
is. One rule of thumb: The longer a stressful situation goes on, the more at
risk for burnout you may be.
What
to do: Whatever the source
of your stress, you've got to look out for Number One even as you struggle with
the burden at hand. Among the keys of beating caregiver stress syndrome, for example, are tapping into more practical
and emotional support, finding physical outlets for stress, and focusing on
self-care as much as possible.
Depression or
Traumatic Brain Injury (TBI)?
Traumatic brain
injuries (whether caused by falls, sports, accidents, or acts of violence) are
commonly known as concussions, and they affect individuals differently. Often
they create changes to mood, memory, attentiveness, and energy levels. A
sufferer's personality may seem to change, and dramatic mood swings can be mistaken
for depression. Making things more complicated, half of those who suffer head
trauma will experience clinical depression, according to a 2010 study reported
in the Journal of the American Medical Association. So the two
conditions can overlap, or one may be mistaken for the other.
What to watch: Usually the cause of a traumatic brain injury
is obvious -- but people don't always understand that the associated cognitive
and mood effects can persist for several months after the incident. They can
include listlessness, anxiety, paranoia, fear, irritability, difficulty
beginning or completing tasks, and changes in concentration and attention.
What
to do: Encourage someone who
hit his or her head in a fall or other accident to get checked out afterward.
(See what to tell the doctor when someone with dementia falls).Tell the doctor about ongoing depressive
symptoms and encourage the person with the concussion not to be embarrassed or
ashamed about sharing these symptoms
Depression or Grief?
As with stress and
burnout, the intense emotional and physical experience of grieving can be
profoundly depressing. These very natural emotions aren't usually the same
thing as the physical condition doctors call clinical depression, however. Grief and depression can overlap -- or be mistaken for one another.
There is an acute
subset of grief, affecting 10 to 20 percent of mourners, known as prolonged grief disorder or complicated grief. (The term prolonged grief disorder
was proposed for the 2013 diagnostic manual of mental disorders, DSM-5.)
Psychological distress is so intense in these cases as to interfere with
everyday functioning. People with this kind of grief are at dramatically
increased risk for clinical depression.
What to watch: Everyone grieves differently. But a sign that
someone may benefit from additional support is when there's difficulty managing
everyday life. Among the other worrisome symptoms of acute grief are emotional
numbness, a sense of meaninglessness, difficulty accepting the loss, and
suicidal thoughts. Suicidal thoughts, in particular, should be taken seriously
and brought to the attention of a clinician. Symptoms may persist a year or
more after the loss, or they may not go into full swing until six months after
the death.
What to do: A doctor or mental health professional can
help advise on treatment for grief-related depressive symptoms. Realize, too, that grief isn't limited to
mourning those who have died. Alzheimer's caregivers, in particular, often
experience what's called anticipatory grief -- feelings of loss for someone who is still alive. (They don't
call Alzheimer's the "long good-bye" for nothing.)
