Underlying Depression Can Be a Real Pain in the Neck

A 30-year-old schoolteacher suffering from severe stomach pains and loss of appetite is examined by his family doctor. The incorrect diagnosis--gall bladder disease.

The real problem: depression.

Across the nation, 10 million Americans are seriously depressed at any one time, said Dr. Charles V. Ford, a psychiatrist at Vanderbilt University Medical Center in Nashville.

The condition affects all ages, races and incomes, although more women than men are depression victims. But Ford said that because depression is frequently misdiagnosed, many sufferers will not get the treatment they need.

Many Errors

“Unfortunately, doctors diagnose the disorder correctly in only 25% to 50% of these cases,” he said.

Recently, doctors have started taking a second look at patients diagnosed as having Alzheimer’s disease, according to psychologist Mark Kelly. In some of those cases, which are considered untreatable, the real problem may be depression.

Kelly said Abraham Lincoln is probably an example of a person with depression that was overlooked. The 16th President was moody, withdrawn and pessimistic at times.

“Assuming our retrospective diagnosis is correct, he was depressed, but a highly functioning individual,” Kelly said.

Lincoln Untreated

Lincoln, like many depressed people today, was not treated for the condition--or may have been treated for physical complaints that were nothing more than symptoms of depression.

“We saw a woman who had run up medical bills of at least $20,000,” Ford said.

The patient had a variety of expensive medical tests and an operation when there was nothing wrong with her except “underlying depression,” he said.

And even though medical doctors are being trained to recognize the malady, Ford said, the woman’s case is not unusual.

Physical Complaints

“Depression is the ultimate psychosomatic illness,” he said, explaining that the physical complaints become as real as the psychological problem.

Treatment varies according to the severity of the problem. Therapy may include hospitalization and drugs, and nearly always involves counseling. Some patients also receive shock treatments.

The treatment of depression is almost always effective, but many sufferers do not seek it out of embarrassment, Kelly said.

For some people, the social stigma attached to mental illness keeps them from seeking appropriate treatment. Others believe it is a sign of weakness.

Denied Depression

One devoutly religious member of a fundamentalist church was unable to sleep and could not stop overeating, but she rejected a physician’s diagnosis of depression and refused to see a therapist.

“They say to themselves, ‘To be depressed is to be sinful,” Ford said. “They feel that being depressed is a denial of faith, so they deny the depression.”

“A number of people feel if they go see a psychologist or psychiatrist they’ll be labeled as crazy, not only by the the doctor, but by family and friends,” Kelly said. “This is one idea we’re trying very hard to combat.”