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Maybe It's Not Depression

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Updated January 17, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Imagine that you have the following complaints:

  • You are tired all the time
  • You have no motivation for things you once enjoyed
  • You've had a change in your eating habits (either eating more or lost your appetite)
  • You are lacking energy
  • You are sleeping a lot (or you have trouble sleeping)
  • You are depressed and/or anxious

While these symptoms are often caused by depression, they could be caused by several other conditions. For example, thyroid problems and chronic fatigue syndrome can also result in these symptoms. It's even possible (although probably less likely) that you have fibromyalgia, sleep apnea, or an autoimmune disorder, such as rheumatoid arthritis or lupus.

Thyroid Problems

Thyroid problems can lead to either weight loss and feelings of anxiety, or weight gain and feelings of depression. They can can also result in a complex mix of symptoms that don't seem to make sense. The traditional model of thyroid function suggests that hypothyroid (low thyroid) results in depression and weight gain; while hyperthyroid (high thyroid) results in anxiety and weight loss. The traditional treatment involves medications that bring your body chemistry under control.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a condition that is characterized by severe fatigue that interferes with your everyday life, as well as several other symptoms, such as memory problems, headaches, and muscle and joint aches. The underlying cause of chronic fatigue syndrome hasn't yet been discovered, and treatment may involve certain medications and/or alternative therapies.

Fibromyalgia

Fibromyalgia seems to overlap with chronic fatigue, but people with this disorder also have chronic pain all over their bodies. The disorder is usually diagnosed by tender points in certain muscles, which respond with pain when touched a certain way. Sleep disturbance is common in chronic fatigue and in fibromyalgia. Research is ongoing into the causes of fibromyalgia, and treatment often involves a multi-pronged approach.

Autoimmune Disorders

Autoimmune disorders involve the immune system attacking the body. Rheumatoid arthritis and lupus are examples of autoimmune disorders. Autoimmune processes have also been implicated in diabetes and multiple sclerosis (MS). These disorders almost always involve a complex symptom picture, which can include depression. They aren't nearly as common as depression, but they can present with some similar symptoms.

Sleep Disorders

Sleep disorders, such as obstructive sleep apnea, can also many symptoms similar to those of depression. If you snore, or if you are feel that your sleep is disturbed, you may want to speak with your doctor about the possibility of further testing.

Bottom Line

Depression remains the more common cause of most of these symptoms. It is important to remember that people can have more than one diagnosis at a time, too. There are certainly people who have both clinical depression and hypothyroidism, for example.

Some symptoms are more common in one disorder than the other and help in clarifying the diagnosis. People with hypothyroidism, for example, frequently gain weight. This can happen in depression, of course, but it is even more common with low thyroid. People with chronic fatigue can be depressed, but it is also common for them simply to be very tired (and not the least bit sad).

Your best bet is to work with your health care provider in exploring your symptom picture. Lab tests can help make a definitive diagnosis in some cases.

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