Have you ever felt anxious, fatigued, or irritable and wondered if it might be a mental health issue? While mental illness is a common and important area of health, sometimes the body itself may be the culprit. Many medical conditions can mimic the symptoms of mental illness, leading to delayed or incorrect diagnoses. Understanding these "medical mimics" is key to ensuring that both your mind and body receive the care they need. This blog will explore seven common medical conditions that often masquerade as mental health issues and provide actionable tips for identifying and addressing them.

The overlap between physical and mental health symptoms can often lead to misdiagnoses. Conditions like fatigue, mood swings, and cognitive difficulties are shared by both mental health disorders and many medical illnesses. Stigma can also play a role, with mental health symptoms often being dismissed or overly attributed to emotional causes, especially in stressed individuals. Additionally, limited awareness among patients and healthcare providers may result in physical causes for mental health-like symptoms being overlooked. Recognizing the importance of a holistic evaluation is critical for avoiding these pitfalls.

Thyroid disorders such as hypothyroidism and hyperthyroidism, involve dysfunction in the thyroid gland, which regulates metabolism. Symptoms like fatigue, weight changes, irritability, mood swings, anxiety, depression, and difficulty concentrating can arise. Hypothyroidism often resembles depression and cognitive impairment, while hyperthyroidism may mimic anxiety or bipolar disorder due to heightened nervousness and mood instability. Blood tests for TSH, T3, and T4 levels are used for evaluation. Treatment typically includes medications like levothyroxine for hypothyroidism or antithyroid drugs for hyperthyroidism, with surgery being an option in some cases.

Diabetes Mellitus, a chronic condition where the body cannot regulate blood sugar effectively, presents symptoms such as fatigue, mood swings, irritability, confusion, and, in severe cases, hallucinations during hypoglycemia. Fluctuating blood sugar levels can resemble mood disorders, cognitive impairment, or psychosis. Evaluation includes fasting blood glucose, HbA1c, and glucose tolerance tests. Management involves lifestyle changes, medications like metformin, insulin therapy, and regular monitoring.

Vitamin B12, folate, and vitamin D deficiencies, can significantly impact neurological and mental health. Symptoms like depression, anxiety, fatigue, irritability, memory loss, and psychosis may occur. Vitamin B12 deficiency can resemble dementia, while vitamin D deficiency may contribute to depression. Blood tests for specific vitamin levels help diagnose these deficiencies, and treatment includes dietary adjustments, supplements, and, in severe cases, injections.

PMDD is a severe form of premenstrual syndrome (PMS) with significant mood and behavioral symptoms. Severe depression, anxiety, irritability, mood swings, and difficulty functioning during the luteal phase of the menstrual cycle are common. PMDD is often mistaken for major depressive disorder or generalized anxiety disorder due to its cyclical nature. Evaluation involves symptom tracking across multiple cycles, and treatment includes SSRIs, hormonal therapies, and lifestyle changes like exercise and dietary adjustments.

OSA is a condition where breathing repeatedly stops during sleep, disrupting rest. Symptoms include fatigue, irritability, memory problems, and difficulty concentrating. Chronic fatigue and cognitive impairment from sleep apnea can be mistaken for depression or ADHD. A sleep study (polysomnography) is typically used for diagnosis. Treatment options include CPAP therapy, weight loss, and, in some cases, surgical interventions.

Delirium is characterized as sudden onset of confusion often caused by underlying medical issues or substance use, manifests as hallucinations, agitation, confusion, and mood changes. Acute delirium can resemble psychosis or severe mood disorders. A comprehensive medical assessment, including lab tests and imaging, is necessary to identify the underlying cause. Treatment focuses on addressing the root cause, such as infections or medication adjustments, and providing supportive care.

CFS is a long-term condition characterized by extreme fatigue that isn’t improved by rest. Symptoms include exhaustion, cognitive impairment ("brain fog"), mood swings, and depression. CFS is often confused with depression or anxiety due to overlapping symptoms. Diagnosis is one of exclusion, ruling out other conditions first. Symptom management through graded exercise therapy, cognitive behavioral therapy, and medications for associated symptoms is the usual course of treatment.

consider keeping a symptom diary to track physical and mental health changes, including their frequency and intensity. Don’t hesitate to ask healthcare providers, "Could there be a physical cause for my symptoms?" Seeking second opinions and researching potential conditions can also be beneficial, though self-diagnosing should be avoided.

Integrated care models that combine mental health professionals with primary care physicians can help bridge the gap between physical and mental health. For instance, a collaborative team approach might identify thyroid issues in someone presenting with depression or address sleep apnea in someone labeled with ADHD. Such models highlight the importance of treating the whole person.

Mental and physical health are deeply interconnected, and understanding how physical conditions can mimic mental illness is crucial. By advocating for thorough evaluations and seeking holistic care, you can achieve better health outcomes. Remember: it’s okay to ask questions and seek the support you need—both for your mind and your body.

Sources:

1. American Thyroid Association. (2024). "Understanding Thyroid Disorders." Retrieved from thyroid.org.
2. American Diabetes Association. (2024). "Diabetes and Mental Health." Retrieved from diabetes.org.
3. National Institutes of Health (NIH). (2024). "Vitamin Deficiencies and Mental Health." Retrieved from nih.gov.
4. International Association for Premenstrual Disorders (IAPMD). (2024). "What is PMDD?" Retrieved from iapmd.org.
5. American Academy of Sleep Medicine (AASM). (2024). "Obstructive Sleep Apnea and Cognitive Function." Retrieved from sleepeducation.org.
6. Alzheimer's Association. (2024). "Delirium vs. Dementia: Understanding the Differences." Retrieved from alz.org.
7. Centers for Disease Control and Prevention (CDC). (2024). "Chronic Fatigue Syndrome: Symptoms and Management." Retrieved from cdc.gov.

By :Talia Nelson, MSN, FNP-C, PMHNP-BC

Keywords Physical conditions misdiagnosed as mental health issues, How medical issues affect mental health, Thyroid disorders and mental health, Diabetes mental health symptoms, Vitamin deficiencies and depression