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.
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