When Doctors Misdiagnose Depression

Medical practitioners frequently fail to detect depression.

By Michael Yapko, published on March 13, 2003 - last reviewed on August 14, 2007

I'm a 52-year-old man in reasonably good health, but I have been feeling pretty down for a while. There are many different stresses in my life, but none are really new. I thought there might be something wrong with me medically, so I went for a thorough physical exam. I told my doctor about having sleep problems, low energy and difficulty concentrating, but he didn't find anything physically wrong with me. Am I making something out of nothing, or might I be depressed even though my doctor didn't say so?

Depression is an underdiagnosed disorder, meaning more people suffer with it than are identified. Most depression sufferers do not seek out mental health professionals for diagnosis and treatment, even though their ability to detect and diagnose depression is greater than that of medical practitioners.

Far more likely is that they will have seen a physician within the previous year, just as you did, and somehow slipped through the cracks, the diagnosis missed. In fact, a study published in the Journal of the American Medical Association showed that physicians miss the diagnosis of depression about half the time.

The reasons may be understandable, however. Physicians may have only a few minutes in which to see a patient; they simply may not have time to ask the relevant questions. Or more pressing physical problems may take priority.

Sometimes a personal bias towards more readily identifiable physical problems may lead physicians to miss the diagnosis of depression. Or, as is often the case, there just isn't time to draw out a patient who is not very communicative.

To your credit, you were communicative about your symptoms. It may have helped prompt your doctor, though, if you had asked about the possibility of depression. Fortunately, you can still ask. Or consult a mental health professional for what is statistically more likely to be a reliable and valid diagnosis—after your physician has ruled out any medical causes.