Are doctors using depression as a "catch-all" diagnosis instead of investigating the underlying cause of a patient's symptoms?
Originally Posted April 2017
Updated August 2019
Patients of all ages have reported similar experiences of visiting doctor after doctor hoping for answers on why they’re having headaches, fevers, blurred vision, extreme fatigue, tremors, heart palpitations, digestive upset, and other mysterious and debilitating symptoms. Over and over the diagnosis is made, often without a thorough examination or testing. “Depression,” they say. “I’ll give you a referral to a psychiatrist.” Or “It’s anxiety. There’s a medication for that.” Or simply “You’re just stressed. You need to relax more.” The widespread recognition of the mind-body connection among the medical community is a positive thing – but have some doctors taken it too far? Have psychosomatic illnesses become a catch-all diagnosis? If so, these physicians may be doing more harm than good in many cases.
It’s almost unheard of nowadays to hear a doctor say, “I’m really not sure what’s causing your symptoms.” For patients going through experiences like the ones mentioned above, honesty, compassion, validation, and thoroughness during a physician encounter would go a long way in helping these suffering patients who are “stumping” doctors right and left. But instead, in addition to quickly dismissing symptoms as purely psychological in nature, doctors often go a step further to belittle and lecture patients who dare mention something they themselves suspect might be going on. After all, why would a patient know anything about their own body and medical history? And don’t you know that nothing you find on the internet holds any weight, even research studies that can be accessed directly through trusted medical databases? (insert sarcasm)
This scenario is exactly what happened to archaeologist Ralph Burrillo, who works for the National Park Service and conducts research at the University of Utah.
An Archeologist Digs up his Hardest Challenge Yet – a Diagnosis of Lyme Disease
After seeing 14 doctors and fighting for answers, Ralph Burrillo was finally diagnosed with Lyme Disease – a tick-borne illness. He had contracted it while working on an archaeological project in Western Utah, a place previously thought to be free of the disease. Because of this, one of the doctors he saw berated him for even mentioning the possibility of Lyme disease, then proceeded to diagnose him with depression and sent him on his way.
Eventually, a physician’s assistant reluctantly agreed to run serological tests for Lyme. The results were positive. The part that was most disturbing to Mr. Burrillo, and many others who find themselves in the same situation, is that he didn’t come in complaining of sadness, thoughts of suicide, lack of motivation, or loss of enjoyment in daily activities – symptoms that would constitute a true diagnosis of depression. Instead, he came in complaining of persistent headaches that were non-responsive to medication, blurry vision, dizziness, extreme fatigue, insomnia, twitching, and other concerning symptoms – many of which do not fit a depression diagnosis. So while depression and anxiety are certainly valid conditions that need treatment, misdiagnosis is serious business.
Lyme or Depression as a “Trendy” Diagnosis? Statistics Speak
There are at least 1,000 scientific papers supporting the existence of persistent infection with the bacteria that causes Lyme disease. There is also evidence that Lyme is now widespread throughout the country instead of isolated in certain areas as previously thought – learn more about the spread of Lyme disease here. And yet many doctors, including the one Mr. Burrillo encountered, are dismissive when it comes to Lyme disease. He even referred to it as a “trendy” diagnosis made up on the internet that everyone thinks they have (and that is only treated by quack doctors who use “snake oil”). Here’s where the double standard needs to be called out.
Statistical research on depression and diagnostic criteria led Mr. Burrillo to explain in the article that the chance of each of his presenting symptoms being caused by depression was about 5% (or less for certain symptoms). Combined, the chance that all of them were caused by depression comes out to about 0.0000000004%. In light of the many people sharing similar stories, maybe it’s time for doctors to take a step back and ask if they are really the ones guilty of using a “trendy” or catch-all diagnosis for anything not easily attributable to something else. It seems as though these physicians would rather throw around a psychological diagnosis than have to admit uncertainty or continue investigating the source of the patient’s symptoms (what a novel idea!).
Depression – a Symptom, NOT a Cause!
It should be noted that Lyme disease can cause psychological symptoms such as depression and anxiety since it is a systemic illness – so can many other medical conditions that affect various systems of the body. But clearly, the root of the problem needs to be addressed and treating some symptoms while ignoring others is irresponsible, dangerous, and just plain uncaring. If the medical community has accepted the idea that the mind and the body are connected, then why have they only acknowledged one side of the coin – that what’s going on in the mind affects the body, but not the other way around – that what’s going on in the body effects the mind? It works both ways.
Unfortunately, Lyme disease patients aren’t the only ones being affected by this catch-all diagnosis. A New York City cardiologist shared her patients’ story in an article for Oprah.com. Even after having several episodes of heart palpitations, light-headedness, and nausea, a young woman’s doctor insisted her symptoms could all be chalked up to stress. It wasn’t until she saw the cardiologist and underwent some basic testing that she was diagnosed with a heart arrhythmia. Arrhythmias are treatable, but can be life-threatening if they go undiagnosed.
Finding a Doctor That Goes Beyond
While there are many compassionate and intelligent doctors out there who are practicing with logic, humility, and integrity – even one of these stories is one too many. Physicians need to be educated about the underlying causes of depression and how to differentiate between primary psychological disorders and psychological expressions of systemic diseases, such as Lyme. Until this becomes common knowledge among doctors, patients must continue to advocate for themselves and seek out experts in the diagnosis and treatment of these complicated conditions.
At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to find the answers you deserve and a treatment plan that is personalized to your specific condition. We’ll guide you every step of the way, monitoring your results to not only improve your symptoms, but optimize your health and improve your quality of life. To find out how we can help you, call us at 877-508-1177.
1. Ralph Burrillo. “Treatment Denial Drives Patients to Clueless Practitioners.” https://www.lymedisease.org/TheLymeTimes-V24-2/files/assets/basic-html/page5.html
2. Tara Narula, MD. “Stress: The Catchall Diagnosis That Can Compromise Your Health.” Oprah Health.
3. “Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes.” https://www.psnpaloalto.com/wp/wp-content/uploads/2010/12/Depression-Diagnostic-Criteria-and-Severity-Rating.pdf 4. ILADS. “Research & Literature.” International Lyme and Associated Diseases Society.