Common conditions that can mimic depression

There are some conditions and disorders that have symptoms that actually make a child look and feel depressed. But when you dig down to find the root cause, you find that the symptoms are a sign of a different underlying issue. When a child comes in with depression symptoms, the statements we hear can include, “I feel tired all the time,” “I just don’t want to do anything,” “I get these headaches all day,” and “I just don’t have the energy.” It is always important as providers and as parents that we do justice by our kids by conducting thorough evaluations and dig deeper in order to get to the root cause of the problem at hand.

Below are some of the more common findings that can reflect similar symptoms as depression but reflect different underlying issues.

Vitamin B12 deficiency

Vitamin B12 is a vitamin that can be present in some foods but is probably best known as a popular supplement. It tends to be absent in many plant-based foods so it’s not surprising that this could be a concern for patients who are vegetarian or vegan. There are many functions to this vitamin including forming healthy red blood cells, development and myelination of the central nervous system (brain and spinal cord), and DNA synthesis (creating new DNA strands).

Symptoms of Vitamin B12 deficiency that can also be mistaken for depression include fatigue, feeling like your heart is beating too fast and out of your chest, and neurological changes. While other labs should be evaluated in addition to Vitamin B12, this should be included in your child’s lab work, especially if the above symptoms are being witnessed.

Iron deficiency anemia

Having low iron levels and being anemic, means that the body cannot adequately transport oxygen from the lungs to the rest of the body. This can lead to symptoms such as shortness of breath, fatigue, headaches, dizziness, feeling weak, and difficulty concentrating or even reporting “brain fog.” Sounds similar to feelings of depression, right? Young women are especially more prone to being anemic and having low iron levels, especially after they start their period, so it is important to check a hemoglobin, hematocrit, and iron lab studies at the very least.

Hypothyroidism

An underactive thyroid means a drop in the hormones being produced from the thyroid gland. We all know that with hormone fluctuations can come with physical and emotional consequences and hypothyroidism is no different. Symptoms can include weight gain and fatigue, feeling depressed, and also difficulty concentrating and memory issues. Evaluating a thyroid should start with a family history, lab work, and an potential endocrinology referral depending on those results.

Vitamin D deficiency

You guys know I love this Vitamin and I wrote about it in one of my previous blogs. But it’s because of how important it is! Children especially can have symptoms such as irritability, fatigue, and weakness. We all know that during those dreary winter months it is easy to feel like you’re feeling stuck, sad, and beyond ready for the sun to come out. Well that isn’t a coincidence. The lack of sunlight for this period of time can be part of the reason we are deficient in Vitamin D leading to feelings of depression and sadness.

Metabolic disorders

One of the most recent trends in research has been how metabolism and nutrition (particularly its production of serotonin) affects brain function and the part it could be playing with the rise in anxiety, depression, as well as psychiatric disorders such as bipolar disorder and schizophrenia. It is important that when evaluating a child’s history, types of foods they are ingesting are discussed as well as any parental concerns surrounding their child’s eating habits and behaviors. It is important to determine whether or not that facet of a child’s health could be affecting the mental concerns that brought them in. Beyond evaluating cholesterol levels and electrolyte levels, there are labs that can look into amino acid levels, inflammation, and urine amino acid levels.

Sleep disorders or seizures

A restless sleep or lack thereof can cause lack of concentration, falling asleep during or immediately after class, and poor school performance. Naturally when kids are not doing well in school we want to know why and it is always important to rule out a sleep or seizure disorders. Some questions your provider should be asking include:

·       How many hours of sleep does your child get a night?

·       Are they a restless sleeper?

·       Do they wake up tired even after a supposed good night’s sleep?

·       Are they falling asleep in school?

·       Are they napping even after sleeping well through the night? (Typically a question for school-age children)

·       Has there been any regression in their developmental skills?

If a child is experiencing poor sleep, fatigue, or a regression in certain skills, we should always be looking for potential sleep or seizures disorders that could be causing this. Again, not to scare anyone, but these are just some possibilities that should be considered when evaluating a child with depression symptoms.

Remember that a full evaluation is important when it comes to screening a child for depression, that we do not take it at face value. A deep dive into a child’s history and performing further examination including lab work and imaging should be considered to rule out any potential underlying conditions.