Depressive Disorder Due To Another Medical Condition

The symptoms of depressive disorder caused by another medical condition can vary from person to person. However, some common signs and indicators are consistent. 

One of the main symptoms experienced by individuals with this disorder is a depressed mood or a decreased interest or pleasure in activities. In some cases, the affected person may also show significant weight changes, such as weight loss or weight gain. Sleep disturbances, such as insomnia or hypersomnia, are also frequently reported. 

The criteria for a diagnosis, according to the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition (DSM-5), include:

• Difficulty concentrating or making decisions
• Fatigue or loss of energy
• Thoughts of worthlessness or excessive guilt
• Restlessness or slowed movements

These symptoms alone may not be enough to diagnose a depressive disorder due to another medical condition. The underlying cause of the depressed mood must be linked to a separate medical condition, such as hypothyroidism, heart disease, Parkinson's disease, or cancer. Treatment of the underlying medical condition often leads to an improvement in depressive symptoms.

The criteria for a diagnosis, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), include:

• Persistent depressed mood or reduced interest in activities dominates the clinical picture
• Evidence that shows depression is directly caused by another medical condition
• Symptoms that are not better explained by another mental disorder
• Symptoms that do not solely occur when the individual is extremely confused or disoriented (delirium)
• Depressive symptoms that cause significant distress or impairment in daily life activities like work or social interactions

The symptoms can vary but must be distinguished from those of depressive disorder not caused by another medical condition. In addition, the disorder may need to be distinguished from the depressive side effects of some medications, such as corticosteroids. 

Once these signs and symptoms are recognized, it may be recommended to seek appropriate treatment for both the depressive symptoms and the related medical condition. Early treatment may improve the outcomes for those with the disorder.

A depressive disorder may occur due to various medical conditions. Some medical conditions that may lead to depressive symptoms include the following. 

Endocrine disorders

• Hypothyroidism
• Hormonal imbalances (e.g., menopause)

Neurological conditions

• Parkinson's disease
• Multiple sclerosis
• Stroke
• Traumatic brain injury
• Alzheimer's disease
• Epilepsy

Cardiovascular conditions

• Heart disease
• Congestive heart failure

Metabolic conditions

• Diabetes
• Obesity

Autoimmune diseases

• Lupus
• Rheumatoid arthritis
• Sjögren's syndrome

Chronic pain conditions

• Fibromyalgia
• Arthritis
• Back pain

Infectious diseases

• Hepatitis C
• HIV/AIDS

Organ-related conditions

• Kidney disease
• Liver disease
• Respiratory diseases, such as COPD

Cancer

• Various types of cancer

Risk factors 

Certain factors may increase the likelihood of developing depression due to another medical condition, such as:

• Genetics: A family history of depression or other mood disorders may make individuals more prone to depressive episodes.
• Age: Older adults may be at increased risk due to the higher prevalence of chronic medical conditions in this age group.
• Severity of the medical condition: More severe, chronic, or terminal medical illnesses may increase the risk of developing depression.

Inciting events for depressive episodes may vary from person to person. A healthcare provider can evaluate the potential causes of depressive symptoms based on the individual’s complete medical history. Once the possible causes and risk factors² are identified, the appropriate treatment can be recommended.

The main goal of treatment for this condition is often to reduce depressive symptoms and improve the individual's overall quality of life. The treatment will typically depend on the underlying condition causing depressive symptoms. Common treatments may include therapy, medication, and self-care strategies.

Medication

Medications may also be recommended for managing depressive symptoms. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are often prescribed to relieve symptoms and improve mood. 

Depending on the underlying medical condition, other medications may be required to resolve other symptoms contributing to depression. For example, if the underlying medical condition is hypothyroidism, thyroid replacement hormones may be prescribed. Similarly, if the root cause is a chronic pain condition, pain relievers or anti-inflammatory medications may be given to manage pain and improve a depressed mood. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. In addition, the above information is not a replacement for medical advice or diagnosis. 

Self-care

Specific self-care strategies may be added to daily routines to help manage depressive symptoms. Some self-care practices might include:

• Regular exercise: Engaging in physical activity may improve mood, increase energy levels, and reduce distress that may accompany depressive disorders caused by underlying medical conditions. For some people, however, it may be difficult to exercise due to the nature of their condition. In these cases, consult a healthcare provider and physical therapist for support. 
• Adequate sleep: Proper sleep hygiene aimed at seven to nine hours of sleep per night may improve mental and emotional well-being. Consistent, quality sleep may boost focus and mood while reducing stress. 
• Balanced diet: Consuming a nutritious diet may support overall health. A balanced diet is often rich in fruits, vegetables, lean proteins, and whole grains, which may support the production of neurotransmitters involved in mental health and well-being. 
• Stress management: Relaxation techniques, such as deep breathing exercises or mindfulness meditation, may help individuals manage stress related to depressive disorder and underlying medical conditions. Meditation may also be beneficial for managing chronic pain, which can contribute to depressive symptoms.
• Social support: Interpersonal relationships and connections with others can give emotional support to those struggling with chronic medical conditions.

Depressive disorder due to an underlying condition often requires a comprehensive approach, which may include therapy, medication, and self-care strategies combined. Therefore, working closely with healthcare professionals to find the most suitable treatment plan may be recommended. The right treatment can depend on the overall condition of the individual.

For individuals experiencing depression alongside chronic medical conditions, various resources are available to help. One option may be online therapy platforms, such as BetterHelp, which may make it easier for individuals to find professional assistance from home. Licensed professionals can guide clients in managing depressive symptoms due to a chronic medical condition. 

Mental health organizations may also offer support for individuals with depression or other mental health disorders. The National Institute of Mental Health (NIMH) provides information on recognizing and treating depression in the context of chronic illness. The American Psychiatric Association is a professional organization that may also offer valuable resources for understanding and treating this specific type of depression.

Support groups can be helpful for connecting with others experiencing similar challenges. Organizations such as the Depression and Bipolar Support Alliance (DBSA) offer both online and in-person support groups for individuals living with bipolar disorder, major depressive disorder, and other types of depression. Support groups provide an environment for individuals to support one another as they address mental health challenges and other medical conditions.

Research has sought to understand treatment options for depression due to another medical condition and how various medical conditions can impact depression and overall mental health. One study looked at how effective antidepressant treatment can be for depression alone and alongside other general medical conditions. The study found that although all participants improved with treatment, those with depression alongside other health conditions did not experience as significant of an improvement. 

A review of studies was performed to evaluate if mindfulness can reduce anxiety, distress, and depression in people with chronic conditions. The researchers looked at more than 1,500 articles published from 2014 to 2019. The results showed that mindfulness could improve psychological symptoms in individuals with chronic illnesses.

Another recent study reviewed the effectiveness of internet-delivered cognitive behavioral therapy (CBT) for treating depression in individuals with chronic conditions like heart disease, diabetes, and chronic pain. The study suggests that internet-based CBT is an effective method for reducing depressive symptoms in patients experiencing depression and chronic diseases. This approach may also decrease the stigma associated with seeking therapy.

65% of cases of depression may be caused by obsessive-compulsive disorder, which are highly treatable together using exposure therapy interventions

In a study published in the International Journal of Psychiatry and Clinical Practice, exposure and response prevention therapy (ERP) was found to be effective in reducing symptoms of both OCD and depression in cases where depression was caused by OCD. Participants reported increased daily functioning after the study.¹

¹The International Journal of Psychiatry and Clinical Practice

Below are more statistics on depressive disorder due to another medical condition:

• A significant number of people with multiple sclerosis (MS) may experience depression or anxiety. Around 27% of all MS patients, 16% with relapsing-remitting multiple sclerosis and 19% with progressive multiple sclerosis, experience depression.
• A recent meta-analysis of 71 studies found that globally, 30.2% of women with breast cancer experience depression. This rate varies significantly by region, with the highest prevalence in Pakistan at 83% and the lowest in Taiwan at 8.3%.
• There may be increased rates of mental health problems among people with heart problems. Depression may occur in around 31% of people with heart conditions, anxiety in approximately 33%, and stress in around 58%, highlighting the benefit of mental health support for people experiencing heart problems.
• American adults diagnosed with diabetes are found to have a higher prevalence of depression at 29.2% than those without diabetes at 17.9%. The prevalence of depression is consistently over 10% higher in those with diabetes, with states like Kentucky, West Virginia, and Maine showing the highest rates.
• The American Psychological Association (APA) reports that depression is highly treatable with a combination of lifestyle changes, therapy, and medication.