Causes of Depression - Chronic
Medical Conditions
About 10-15 percent of depressive symptoms can be caused by medical conditions (US Department of Health and Human Services). This includes, but is not limited to, concurrent use of certain medications, substance abuse, chronic medical conditions and other psychiatric disorders or dementias.
General medical conditions can cause depression, it can trigger a depression to one who is vulnerable, or it can psychologically precipitate a depression. According to the US Department of Health and Human Services, clinically significant depressive symptoms are identified in 12 - 36 percent of patients with a non-psychiatric medical condition.
Many medical conditions are risk factors for major depression, some conditions, at higher rates than others. Because not all medical conditions result in depression, doctors treat the depression as a separate entity and requiring special treatment. This is done in two ways, by optimizing the treatment of the medical condition and by starting anti-depressant treatment in the form of medication and or psycho- social-environmental interventions.
It is common that when the medical treatment is optimized, the depressive symptoms resolve. If you suspect depression related to a general medical condition, contact your primary health provider so he/she may make an assessment so appropriate treatment begins. It is necessary to distinguish between what is the medical condition and what is the depression.
A doctor may include the following in the evaluation: (this list is not all inclusive)
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History and physical exam | |
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Complete blood count | |
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Serum electrolytes (sodium, glucose, calcium...) | |
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Renal function tests | |
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Liver function tests | |
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Thyroid function tests | |
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Various X-rays, ultra sounds, MRI | |
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Electrocardiogram, stress test, echocardiogram | |
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Pulmonary function tests | |
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CT scan | |
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EEG |
General medical conditions
associated with depression
(US Department of Human Health and Services, 1993).
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Stroke 10-27% (especially left frontal cortex or left basil ganglia) | |
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Dementia 30-40% in the Alzheimer’s disease patients | |
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Parkinson’s disease 40% with dementia symptoms experience depression in illness course | |
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Diabetes, depression is 3 times more common in diabetic adults than the general public | |
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Coronary Artery Disease 40-50%, higher mortality rate 4 times higher than expected | |
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Cancer 25% (75% of patients with cancer of the pancreas) | |
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Chronic Fatigue Syndrome (life time rates 46-75%) | |
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Fibromyalgia 20-71% | |
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Hypothyroidism 80-90% | |
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Vitamin deficiency (B 12) | |
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Anemia | |
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Metabolic disturbances (dehydration, hypoxia, hyponatremia, hypercalcemia) | |
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Infections (viral or bacterial) | |
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Hepatitis |
