Depressive Symptoms

Is It Really Depression? 

4 Conditions That Can Fool You

Depression is a health threat you don't want to ignore. Growing populations at risk include caregivers looking after frail elders, PEOPLE WITH DEMENTIA, and people living alone. 

Yet not all sadness, apathy, low energy, and low mood should be considered depression at work. Sometimes, depressive-type symptoms can flag a different condition.

It's good to know the warning signs of clinical depression -- but if you're worried about someone, also consider whether any of the following situations might APPLY.

1. 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.

2. 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 SYMPTOMSinclude 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.

3. 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 treatment exactly as prescribed.

4. 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.