Why talk to your doctor about feeling blue?
Certain untreated medical conditions can cause depression. Untreated depression can worsen our overall health.
If we view our mental well-being as something separate from other physical or medical issues, we can miss important cues about our health. Our bodies and mind are not isolated from one another. When we get sick, it can affect how we think and feel. This is one reason that when you go to the doctor for your yearly check-up, they may ask if you have been feeling sad or depressed.
When feeling down, behavior changes. Our concentration may decrease, and we may become more forgetful about things like taking medicines. Feelings of fatigue and low energy, and loss of interest can make it hard to do physical activity. There can be changes in sleep schedule, with too little or too much sleep. The quality of sleep may be poor. We may eat less or find that we eat more carbohydrate-heavy, salty, or sweet foods. These changes can worsen many common medical conditions, such as high blood pressure and other cardiovascular issues, pre-diabetes, and diabetes.
Even if we don't have a medical condition, depression can worsen our overall health. It may even increase the risk of developing specific medical issues. Depression not only changes behaviors but can also affect how our endocrine (hormone) and immune systems function. Over time, depression is associated with conditions such as cardiovascular disease (heart disease and stroke), metabolic syndrome (weight gain, insulin resistance, increased risk for stroke and heart attacks), diabetes, chronic pain, osteoporosis, substance use disorders (including alcohol), dementia, and other behavioral health disorders. It also impacts our overall quality of life.
When an underlying medical condition causes depression, the best treatment is often to treat or optimize the treatment of the underlying illness, if possible. Examples include thyroid conditions, untreated sleep apnea, and some anemias. In these cases, treating the underlying condition can often be all that is needed to resolve depression symptoms, while anti-depressant medications or talk therapy alone may have limited or no effect.
It is common for patients to develop depression after a heart attack if they have an inflammatory condition or a chronic or life-threatening illness. Depression may emerge after a stroke, during the weeks and months post-partum, or during menopause. In these cases, a multifaceted approach to treatment addressing both causes and depression symptoms is often the most beneficial.
There can be a significant overlap between depression symptoms and other illnesses. Low energy, poor sleep, and appetite changes are common in depression and many other medical conditions. Your doctor can determine if a workup for an underlying illness is needed.
Some patients with depression may not immediately recognize they are "depressed." Instead, they may experience feelings of unease, fatigue, vague discomfort, or loss of interest in things they used to enjoy. Embarrassment or a belief that "I should just be able to get over it" sometimes prevents patients from getting the right treatment. Physicians, including primary care doctors and psychiatrists, are trained professionals who are there to help you optimize your health and well-being. And while starting that conversation with your doctor is not easy, it is the first step to healing.
References and Resources
The American Heart Association. “The severity of depressive symptoms over time may help predict stroke risk.” https://www.heart.org/en/news/2022/05/23/the-severity-of-depressive-symptoms-over-time-may-help-predict-stroke-risk Last accessed 6.16.23.
The American Heart Association. “The Link between depression and heart disease cuts both ways.” https://www.heart.org/en/news/2021/05/25/link-between-depression-and-heart-disease-cuts-both-ways Last accessed 6.16.23.
