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 or child 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, as well
as Polycystic Ovarian Syndrome.
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.

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