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The Globe and Mail

Depressed? Psychotic? The culprit could be a physical condition


Imagine believing you suffer from depression, only to find out it's actually a side effect of your blood pressure pills. Or thinking you have anxiety, when what you really have is a thyroid condition.

According to Harvard psychiatrist Barbara Schildkrout, there are more than 100 medical disorders that can be mistaken for psychological conditions. She tells The Wall Street Journal that even experienced clinicians can have a hard time determining when one causes the other, and since busy primary-care doctors and psychiatrists spend so little time with patients, the risk of misdiagnosis is all the greater.

With her new book, titled Unmasking Psychological Symptoms, Dr. Schildkrout hopes to help clear up some of the confusion.

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The Wall Street Journal notes that studies have shown as many as 25 per cent of psychiatric patients may actually suffer from physical conditions.

What seems like depression, for example, may actually be sign of an under-active thyroid, Lyme disease, lupus, diabetes, a deficiency of vitamin D or B-12, or a host of other medical conditions.

Hallucinations may be an indicator of epilepsy, fever or a brain tumor, while psychosis could be a result of venereal disease, brain tumors and cysts, or stroke.

Substance abuse and the side effects of many medications could also be the real culprits of certain psychiatric symptoms.

While some underlying medical conditions are treatable, The Wall Street Journal notes that others, like Alzheimer's and Parkinson's disease, are not.

And in some cases, patients could require both psychiatric and medical treatment. Regardless, finding the proper diagnosis could alleviate a lot of frustration.

Are psychiatric side effects of physical conditions more common than we think?

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