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The Unrecognized Link: Depression Co-occurring with Medical Conditions

By The National Institute of Mental Health

Having a physical illness can cause you to feel "down" or sad. But if the sadness is severe or long-lasting, there may be an unrecognized link: clinical depression co-occurring with a medical condition.

Clinical depression is a serious but treatable illness; its symptoms have been estimated to occur in as many as one third of persons with any medical condition, and the rates in some specific conditions may be even higher. Depression can cause changes in eating and sleeping patterns, problems with memory and concentration, decreased energy, and feelings of hopelessness, worthlessness, and negative or pessimistic thinking. Discussing such symptoms with your doctor is important for several reasons.

First, if the depressive symptoms are part of the medical illness or side effects of medications, treatment may be adjusted or changed. Second, if clinical depression is an additional problem, it can be treated. And treatment is effective and can start to work within a few weeks.

Your doctor must first find out whether you have one diagnosis or two. This requires careful evaluation, especially in illnesses with similar symptoms.

Weight loss, sleep disturbance, and low energy occur in depression and also in diabetes, cardiovascular disease, vitamin or mineral imbalances, and endocrine disorders. Symptoms of apathy, poor concentration, and memory loss are found in depression and in Parkinson's and Alzheimer's diseases. Depressive symptoms may also include achiness or fatigue which are present in many other conditions.

Depression and medical illnesses may occur together for different reasons.

For example:

Medical disorders may contribute biologically to depression, as with an underactive thyroid or Cushing's disease. Medically ill people may become depressed as a psychological reaction to the prognosis, pain, and incapacity caused by the illness or its treatment, as in cancer. Though occurring together, depression and a general medical disorder may be unrelated.

Major depression is particularly common in persons diagnosed with cancer, stroke, and diabetes. A doctor can best make the diagnosis and prescribe the right treatment.

Treatment of co-occurring depression can have a positive effect on the course of the medical illness, particularly when it improves a person's ability to properly manage chronic illnesses such as diabetes and heart disease. In addition, it can significantly enhance an individual's quality of life.

Recognize the link: don't ignore mental health as a part of overall health. Get professional treatment for depression.

The National Institute of Mental Health of The National Institutes of Health. Depression, Awareness, Recognition, and Treatment Brochure: The Unrecognized Link: Depression Co-occurring with Medical Conditions. August, 1997.

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