To make a mental health condition diagnosis, it’s very important to always investigate for any other medical conditions that could be causing or exacerbating the mental health symptoms.
For example, if someone presents with depression and fatigue, they should be investigated further and tested for their vitamin D levels, iron studies, and Vitamin B12 levels, as well as a thyroid screening. We also always need to consider hormonal contributions with a good gynae history, and check for poor sleep quality due to a sleep disorder. These might not be the full reason for the depressive condition, but they often co-occur with a mental health condition and aggravate the symptoms, making treatment more challenging.
Another example is someone presenting with anxiety with or without panic attacks. An iron deficiency can cause symptoms similar to anxiety, such as a raising heart and feeling faint and difficulty sleeping/staying asleep. Thyroid conditions can present exactly like anxiety or panic disorder clinically, and it’s vital not to miss this as some thyroid conditions can even be life-threatening if not treated.
When someone presents with psychosis or mania, we do a more thorough medical workup, as delirium (which is a medical emergency) presents often with severe psychiatric symptoms. This can be due to an underlying infection, electrolyte abnormalities, an autoimmune disorder, stroke, dehydration, swelling on the brain, trauma, etc. Many of these causes are completely treatable and reversible, which is why it’s essential to work these patients up very well, at times including a brain scan.
If you or your loved one is presenting with psychiatric symptoms, please always ask your doctor to check your physical health too. If something is picked up and treated, it will not only be life-changing for your physical health, but will also much improve your mental health condition and treatment outcomes for that.