Common Misdiagnoses and Mania
Rare epilepsy can cause a variety of severe emotional and depressive symptoms: The book “Preventing Misdiagnosis of Women” reports on a case of a woman with severe personality and behavioral symptoms, and a diagnosis of Borderline Personality Disorder. She had extreme symptoms such as depression, cyclic moods, relationship problems, and many other emotional and neurological symptoms. After years of unsuccessful treatment, she was finally diagnosed with the rare Temporal Lobe Epilepsy, a form of epilepsy without seizures. Treatment for that disorder was highly effective and changed her life. See Preventing Misdiagnosis of Women (by Klonoff and Landrine); see also temporal lobe epilepsy.
Underactive thryoid may be misdiagnosed as depression: Hypothyroidism, or underactive thyroid, is an endocrine gland disorder that is more common in women. It can mimic many diseases, including depression. The patient often has depressive type symptoms, and may also have other symptoms of hypothyroidism such as tingling fingers (peripheral neuropathy), hearing loss, headaches, cold insensitivity, and many other symptms. Common misdiagnoses of hypothyroidism include depression, dementia, schizophrenia, or bipolar disorder (esp. rapid-cycling bipolar disorder).
Cushing’s disease can be mistaken for depression: Cushing’s disease (or similarly Cushing’s syndrome) is a possible misdiagnosis for a person diagnosed with depression. It is an endocrine disorder with many depressive-like characteristics, but also some physical symptoms; see symptoms of Cushing’s disease. Cushing’s disease may also have schizophrenia-like symptoms such as paranoia and delusions, leading to a misdiagnosis of schizophrenia. Manic or euphoria type symptoms are also possible, with a misdiagnosis of bipolar disorder. See overviews of depression, bipolar disorder, schizophrenia, and Cushing’s disease.
Manic-depressive (bipolar) disorder often misdiagnosed: Bipolar disorder, also called manic-depressive disorder, is often misdiagnosed before reaching a correct diagnosis. Some of the common misdiagnoses include depression and schizophrenia. See introduction to bipolar disorder.
Rare seizure-less epilepsy misdiagnosed as various conditions: A complex partial seizure disorder, such as temporal lobe epilepsy can be misdiagnosed as various conditions. Some of the possible misdiagnoses include depression, bipolar disorder, schizophrenia, borderline personality disorder, multiple personality disorder, somatization disorder, hypochrondria, an anxiety disorder, sexuality disorders, hysteria, and fugue.
Multiple sclerosis often misdiagnosed as mental disorder: The early stages of multiple sclerosis may cause various general feelings of wellness, happiness, euphoria, or manic-type symptoms in some patients. These symptoms may lead to a misdiagnosis of bipolar disorder (manic-depressive disorder), hypomania, cyclothymia, histrionic personality disorder, or similar disorders. Other patients may show depressive symptoms as part of Multiple sclerosis and risk a misdiagnosis of depression (i.e. non-bipolar unipolar depression). Other possible misdiagnoses of multiple sclerosis include somatization disorder, conversion disorder, neurotic disorders, or other psychological disorders. See the overview of multiple sclerosis.
Lupus is often misdiagnosed as other conditions: Systemic lupus erythematosus (SLE), often simply called “lupus“, is a difficult disease to diagnose and can manifest with numerous symptoms. Some of the possible misdiagnoses include depression, bipolar disorder, anorexia nervosa, chronic fatigue syndrome, fibromyalgia, schizophrenia (a less common manifestation of lupus with hallucinations and/or delusions), conversion disorder, somatization disorder, hysteria and other diagnoses. See the overview of lupus or symptoms of lupus.
Cluster of diseases with difficult diagnosis issues: There is a well-known list of medical conditions that are all somewhat difficult to diagnose, and all can present in a variety of different severities. Diseases in this group include multiple sclerosis, lupus, Lyme disease, fibromyalgia, thyroid disorders (hypothyroidism or hyperthyroidism), chronic fatigue syndrome, diabetes – all of these can have vague symptoms in their early presentations. Also, depression can have some symptoms similar to these conditions, and also the reverse, that many of these conditions can mimic depression and be misdiagnosed as depression.
Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a “nervous breakdown” and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).
Alzheimer’s disease over-diagnosed: The well-known disease of Alzheimer’s disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be Alzheimer’s, whereas there are many other less severe possibilities. Some level of memory decline is normal with aging, and even a slight loss of acuity may be noticed in the 30’s and 40’s. Other conditions can also lead a person to show greater forgetfulness. For example, depression and depressive disorders can cause a person to have reduced concentration and thereby poorer memory retention.
Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer’s disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.
ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in children is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA). See misdiagnosis of ADHD or symptoms of ADHD.
Bipolar disorder misdiagosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist. See misdiagnosis of bipolar disorder.
Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis. See misdiagnosis of eating disorders or symptoms of eating disorders.
Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The “normal” moodiness of teenagers can cause severe medical depression to be overlooked. See misdiagnosis of depression or symptoms of depression.
Undiagnosed anxiety disorders related to depression: Patients with depression (see symptoms of depression) may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression. See misdiagnosis of depression or misdiagnosis of anxiety disorders.