Friday, July 10, 2009

Mental illness - it's not all in your head

Many people diagnosed with mental illnesses seek the help of psychiatrists and other mental health care providers. It seems the obvious treatment. What many people with depression, anxiety and phobias, do not do, is seek out consultations to find a possible medical cause for their symptoms.

There are many endocrine,neurological and cardiac diseases that present symptoms of depression, anxiety and even
intermittent bouts of rage. Proper treatment of these disorders can reduce and often times resolve the psychiatric symptoms. Some patients will benefit from both psychiatric and medical interventions. This is not to say that every person with a mental illness is misdiagnosed, but many are.

The endocrine system, is a complex group of glands. These glands make hormones which help to control activities in
your body. Along with growth, metabolism,reproduction and development, hormones control the way you respond to your
surroundings. Diseases that alter the hypothalamic -pituitary-axis may produce anxiety-like states. It important to differentiate between medically induced and primary anxiety disorders. Treatment with psychotropic medications alone may not significantly improve the emotional symptoms and may, in some cases, contribute to the hormonal imbalances.

Anxiety frequently occurs in endocrine patients with adrenal dysfunction, Cushing's Disease, Carcinoid syndrome, hyperparathyroidism, pseudohyperparathyroidism, hyperglycemia, hyperinsulinemia, pancreatic tumors, pheochromocytoma and thyroid diseases including hyperthyroidism, hypothyroidism and thyroiditis. These diseases can be the organic basis for an anxiety disorder and with proper diagnosis and treatment can improve the quality of life of many anxiety sufferers. 

Polycystic Ovarian Syndrome is another very common endocrine disorder which, in a large percentage of patients, causes anxiety and depressive states. PCOS is caused by irregular levels of estrogen, progesterone and testosterone. It is estimated that 1 in 10 women have PCOS. Women with PCOS may suffer from acne, excessive hair growth, loss of hair, infertility, loss of menses, diabetes and weight gain. Some data reports that almost 80% of these woman suffer from anxiety, depression and other mood disorders. Treatment with birth control pills as well as medications to regulate insulin along with proper diet and exercise can significantly improve the physical and emotional symptoms of this syndrome. 

Along the way you may have what is referred to as an incidental finding. These unanticipated findings in the course of testing or medical care can hold they key to some anxious states. An incidentaloma is a tumor (-oma) found by coincidence (incidental) without clinical symptoms or suspicion. In our case it was a pituitary tumor, a microadenoma. Cushings Syndrome -an endocrine disease known to cause anxiety and phobic states -is suspected. 

Although I have primarily focused on the endocrine - anxiety connection, the list of diseases, disorders, syndromes, and medications that can contribute to or cause anxiety and depression is significant. 

Treating depressive and anxiety disorders, in some cases, needs to be a joint effort with a team of psychiatric as well as specializing physicians working in harmony. 

It has been my experience as a parent of a child with a severe anxiety disorder,that what you see is not always what you get. Proper diagnosis is the key. Finding the origin of a mental illness is often like finding a needle in a haystack. 

It took seven years and four endocrinologists before the proper treatment was initiated, a lot of time lost.

 

References: http://www.drrichardhall.com/anxiety.htm

 

From http://sunrise959.blogspot.com/