Would you Expect a Person to Eventually Be Diagnosed as "Depressed", If an Underlying Illness is Not -

Question

-Diagnosed or Misdiagnosed?

sadiemae, I'm Not Referring to Real Depression.

Jill, What Would you Call the Diagnosis of "Depression NOS"?

Psyengine, Unfortunately, people Are Labeled With Depression, When they Are Just Feeling "Down".

SAMI, too Bad this is Not Typically Done, Before the Diagnosis is Rendered.

Thanks, Spreed, Medical Dxs Can Be Very Costly, Especially the Misdiagnoses, An Insurance Company Accepting the Dx of a LPN? Looks Like they Wanted to Have an Excuse to Charge you More. APB Smear I don't Think Med. Students Today Have Ever Done One, Much Less Know What to Look for.

Okay Jill, it Appears that the Criteria for Real Doctors Not Well Known, Even to Those Who Are Suppose to Know, Like Spreed Said a: "Garbage Can" Dx.

Sort of Like Repairing a Tire On a Car, When the Engine is Shot.

The Use of

"Not Otherwise Specified"

why and what it means

Sometimes people are given diagnoses that have the term "NOS" attached to them (ex: Depression NOS). Why do professionals do this?

Sometimes it is necessary. It is used primarily when the following four conditions are met:

1. the presentation conforms to the general guidelines for a mental disorder, but the symptomatic picture doesn't meet any specific criteria for disorders.

2. the presentation cnforms to a symptom pattern that has not been included in the DSM-IV, but causes significant distress and impairment.

3. there is uncertainty about etiology (what causes the symptoms--drugs, medical condition, etc.).

4. there is insufficient opportunity for a complete data collection (in an ER, etc.).

[In Other Words a "Garbage Can" Dx.]

Answer 1

The question is how you keep coming up with these intriguing questions.
I see what you are driving at. My ex wife is an RN with a functional GI disorder. One of her fears is that doctors will label her as depressed rather than trying to figure out another explanation for periodic gastric outlet obstruction with vomiting.
I don't recall labeling anyone as "depressed" when I could not find an explanation, but most of my career was heme/onc rather than general internal medicine. I suspect that docs who see people with chronic fatigue or unexplained aches and pains or other symptoms that may not fit with laboratory findings to document a certain pathologic process - - those docs may be tempted to label someone as "depressed" for lack of a better dx.
I recall my son was labeled with mononucleosis when the CBC did not fit and no one had looked at a peripheral blood smear. (Doesn't anyone look at these anymore?) A nurse practitioner made the dx on the basis of a weak positive monospot test. I asked that it be repeated in a week, and it was then negative. The point is that this misdiagnosis led to an increase in his health insurance, and my attempts to have it changed were fruitless. (He had a sore throat, felt tired, and had no adenopathy or splenomegaly. CBC and diff normal.)

Medical diagnoses - - "Labels" - - can hurt people - - increase their insurance, affect their chances of being hired for employment, etc.
I think the point you would like made is that "Depression" is a garbage bag, fall back diagnosis which may be improperly used and can be harmful - - when the real problem is just beyond the scope of our knowledge.

Answer 2

"Depressed" is not a diagnosis. "Depression" is.

So the answer to your question, given your follow up comment, would be no, because depressed is not a medical condition. It is a behavioral response.

"Depression NOS" is still a form of clinical depression, diagnosed based on a set of criteria and physical and behavioral manifestations. If someone fits the diagnostic criteria set forth in the DSM-IV, then they can be diagnosed as such.

A person would not be diagnosed with "Depression NOS" unless they fit the criteria. And if they have some underlying medical issue which is not able to be identified, it is not beyond reason that a person dealing with some kind of mystery illness could start suffering from clinical, diagnosable depression, secondary to that other mystery illness.

Depression is an illness that goes hand in hand with many other illnesses. It is still a valid diagnosis despite the fact that the illness could have been triggered by other circumstances and did not begin organically.

Answer 3

Depression isn't allways caused by another illness. I have depression without any other underlying illness. It's a mental problem. I've been on med for yrs.

Answer 4

Of course, it is called disappointment or unfulfilled expectation or 'life is such a ripoff'. We all get depressed sometime, usually more than once a life time. Do we all get clinical chronic depression? I don't think so. How many chronically continually depressed people do you know. I don't know many if any. I think I've met may be two.

Answer 5

An underlying cause must be ruled out before a depressive illness is diagnosed.

Answer 6

Yes i suppose so!
"amour"