Health and Psychology

The prevalence of anxiety or depression in people with physical illness ranges from estimates as low as 10% to as high as 70%.  When people continue to have physical symptoms and no diagnosis the rates rise.  The same is true with chronic illness after about the 8 week point. 

Support symptoms are able to adequately manage acute illness.  Everyone has an idea about what to say and do.  "Oh I hope you get better soon."  They send candy and flowers, get well cards, and come to visit.  But after the illness has persisted, people don't know what to do or how to provide support.  Difficulties start after about the sixth medical visit without a diagnosis, or at about the 8 week point for a physical illness.  "When I first got sick, people stopped by with food.  Now they don't stop by any more.  They seem to think I should be over it [the illness] by now."  That's a common reason for the increased rates of anxiety and depression.  Some of the illnesses themselves cause anxiety and depression.  Chronic pain, fatigue, and impaired sleep contribute to problems with depression.  Chronic infection or chronic anemia can lead to depression.  Cardiac, renal and endocrine problems can lead to anxiety disorders.  Autoimmune disorders can lead to both anxiety and depression.  Head injuries can lead to either anxiety or depression or both.

Frequently patients with presenting complaints of anxiety or depression presenting for psychiatric or psychological treatment are not evaluated for medical conditions prior to starting treatment for mental problems.  Treatment will continue without significant symptom relief and patients will be erroneously diagnosed as treatment resistent.

If a patient with psychiatric symptoms or medical symptoms is not improving with standard evidence-based treatment, it might be appropriate to do a more thorough assessment to determine if the initial diagnosis is correct.  For an assessment please feel free to contact our office.