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  • Writer's pictureStacy Taylor, LCSW

Medical Masquerades

Updated: Mar 1, 2019

An acquaintance of mine, Susan, was going through a traumatic divorce. But her son, Jacob, seemed to be suffering even worse than Susan. A once sociable teenager with a lot of friends and straight A grades, Jacob’s mood plummeted. He isolated himself, stayed alone in his room, and spent most of his time on the computer.

Worried, Susan brought Jacob to a series of psychotherapists and doctors. They all assumed Jacob was depressed because of the divorce. They also pointed out that teenagers may go through changes of personality and behavior patterns.

One day, Jacob complained of a headache so severe that Susan took him to the Emergency Room. When Susan also mentioned Jacob’s depressed state, the savvy doctor ordered a brain scan. It turned out that Jacob’s symptoms were not psychological. He had a brain tumor.

Luckily, Jacob’s tumor was operable, and he is fine today. He was extremely fortunate to have found an Emergency Room doctor who took his symptoms seriously.

This is not always the case. Many people suffer from what are called, “Medical Masquerades; ” that is, medical problems that disguise themselves as psychological ones.

While Jacob’s situation was dramatic, I have seen numerous clients who have had less serious medical issues that caused or worsened their psychological issues. Some of the most common Medical Masquerades are the following:

Thyroid problems. Thyroid disorders have become epidemic, and this is likely due to the widespread use of industrial chemicals. Thyroid problems are common in women, particularly in middle age. Some endocrinologists believe that half of all people with thyroid problems are undiagnosed. Symptoms of thyroid disorders may include the following: fatigue, mood swings, depression, irritability, low libido, anxiety, easy weight gain or loss, hair thinning, dry skin.

Many doctors, as well as psychotherapists, are quick to assume that the above symptoms indicate depression or even manic depression (bipolar disorder). Since anti-depressants, such as Paxil and Lexopro, are easily available, these are often suggested.

While doctors may run a thyroid test, called the TSH, the test is not l00% accurate. Further, some endocrinologists believe that the current test range should be narrower than the current one, and that too many people with thyroid problems are not being diagnosed.

Blood sugar problems. Low blood sugar (hypoglycemia) and erratic blood sugar can also cause psychological symptoms, such as depression, anxiety, and irritability, as well as medical symptoms, like headaches, fatigue, and dizziness. While doctors can order a blood test for diabetes, they generally will not test for hypoglycemia, because the test is time-consuming and expensive.

However, you can see for yourself whether low blood sugar problems are contributing to your distress. For a week or two, change your diet by eliminating sugar, reducing carbs, increasing protein, and eating more often. Remember to eat three meals a day, and a couple of snacks. If your symptoms are getting better, you’re on to something!

For women over 40, mood swings, depression, panic attacks, or irritability can be due to the normal changes of peri-menopause. Peri-menopause is a 5 to l0 period of time prior to your period stopping (which is called menopause). For some women, peri-menopause can begin in their 30’s or even, rarely, in their 20′s.

Other medical problems that can masquerade as psychological ones include: MVP (mitral valve prolapse, a benign heart condition that can panic attacks); environmental contaminants, such as mold; mercury poisoning, generally from too much fish; seizure disorders; diabetes; overuse of caffeine or legal or illegal drugs; or food allergies, such as gluten intolerance.

In my years of doing therapy, I have seen innumerable people who were misdiagnosed as having an emotional problem when their main problem was medical. The trouble is that most medical and mental health professionals are quick to assume that symptoms are psychological.

Therefore, it’s important to be proactive, and to learn as much as they can about your symptoms. Don’t assume that because the doctor says you are fine, that there is no physical basis for your psychological stress!

The good news is that in some cases, simple changes to lifestyle may alleviate emotional symptoms. As a therapist, I’m committed to helping clients explore all the possibilities that will lead to improved psychological and medical health.

(Please note: check with your health care professional before exploring any new medical or nutritional treatment.)

(Also, note: any reference to a person, in this blog or any blog, is a composite, not a real person.)

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