Some health conditions can mimic the symptoms of major depressive disorder. Some medications can also cause similar symptoms as a side effect.
Healthcare providers often screen for these conditions while diagnosing depression, or if treatment for depression isn’t working the way it should, says Aimee Daramus, PsyD, a licensed clinical psychologist and author of “Understanding Bipolar Disorder.”
This article explains what major depressive disorder looks like, and explores other conditions that look like major depressive disorder. It also explores medications and their possible contributions to major depression.
According to Dr. Daramus, these are some of the health conditions and medications that can cause depression-like symptoms:
- Low vitamin D levels
- Hypothyroidism
- Hormonal imbalances
- Stimulant withdrawal
- Birth control pills
- Blood pressure medications
What Is Major Depressive Disorder?
While most people feel sad once in a while, major depressive disorder is different. Also known as depression or clinical depression, it is a mood disorder that can make you feel sad or low for weeks or months at a time.
Depression is caused by multiple factors including an imbalance of certain brain chemicals, known as neurotransmitters, that affect mood.
The symptoms include:
- Persistent feelings of sadness or emptiness
- Feelings of worthlessness or hopelessness
- Feelings of guilt or anxiety
- Feelings of irritability or frustration
- Loss of interest in activities and interests
- Lack of energy and fatigue
- Difficulty with cognitive tasks like paying attention, recalling things, or making decisions
- Sleep changes, such as sleeping a lot or being unable to sleep
- Changes in appetite and weight
- Unexplained aches and pains such as headaches, body aches, cramps, or digestives issues
- Thoughts of death or suicide
Major depressive disorder is typically diagnosed and treated by mental healthcare providers. Treatment may involve therapy, antidepressant medications, or in some cases, neurotherapeutics.
6 Conditions That Look Like Major Depressive Disorder
Below, Dr. Daramus explains how these conditions may resemble major depressive disorder and how they can be identified and treated.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
Low Vitamin D Levels
Vitamin D is a nutrient that contributes to the functioning of the immune, nervous, and muscular systems. It also plays an important role in maintaining bone health by helping the body absorb calcium.
Approximately 5% of people in the United States have vitamin D deficiency. Low vitamin D levels may cause symptoms similar to major depressive disorder.
According to Dr. Daramus, the symptoms may include:
- Low moodHopelessnessFatigueLoss of appetite Changes in weightSleep difficultiesBone painMuscle cramps or achesWeakness
Hypothyroidism
Hypothyroidism, also known as underactive thyroid, is a health condition caused when the thyroid gland doesn’t produce enough thyroid hormone. This hormone plays an important role in regulating metabolism. Low levels of thyroid hormone can cause your metabolism to slow down.
A blood test can tell you if you have a vitamin D deficiency, says Dr. Daramus. She says your healthcare provider will probably recommend that you get more sunlight, eat foods with vitamin D in them, and take vitamin D supplements.
Hypothyroidism can also significantly affect emotions and cognitions, causing it to resemble depression. According to Dr. Daramus, the symptoms of hypothyroidism include:
- Depression
- Fatigue
- Weight gain
- Forgetfulness
- Brain fog
- Numbness or tingling in the hands
- Constipation
- Slower heart rate
- Muscle soreness or weakness
- Inability to tolerate cold temperatures
- Dry and coarse hair and skin
- Higher cholesterol levels
- Irregular or heavy menstruation or fertility issues
Hormonal Imbalances
In addition to thyroid hormones, adrenal problems can affect your levels of cortisol, a stress hormone, says Dr. Daramus. Known as adrenal insufficiency, it can occur when the adrenal gland doesn’t produce enough cortisol. Cortisol plays an important role in regulating your blood sugar, blood pressure, and metabolism.
You will have to get a blood test to determine whether or not you have hypothyroidism, says Dr. Daramus. Hypothyroidism can be treated with the medication levothyroxine, which helps supplement your levels of thyroid hormone. Treating hypothyroidism may help improve the depressive symptoms as well.
According to Dr. Daramus, the symptoms of adrenal insufficiency can include:
- DepressionIrritabilityDifficulty thinking and planningChronic fatigueLoss of appetiteWeight gainNausea or vomitingDiarrhea or abdominal painLow blood pressureLow blood sugarMuscle weaknessJoint pain
Stimulant Withdrawal
Stimulants are substances that cause a burst of energy and alertness. However, strong stimulants carry a risk of depression as part of withdrawal, says Dr. Daramus. Stimulants include cocaine, meth, and caffeine, as well as certain medications like Ritalin and Adderall.
A blood test can help diagnose adrenal insufficiency; however, additional tests and imaging scans may be required to determine its cause. It can be treated with corticosteroid medicine, which helps improve the cortisol levels in your body.
Misdiagnosis of depression and bipolar disorder are common in people who use cocaine, but any addictive stimulant, including prescription medication, can result in brief periods of depression during withdrawal, according to Dr. Daramus.
Symptoms of withdrawal can include:
- DepressionIrritabilityAgitation or restlessnessFatigueSlownessGeneral discomfort or uneaseIncreased appetiteNightmaresCravings for the substanceSuicidal thoughts
Use of Birth Control Pills
Oral contraceptives, or birth control pills, contain hormones that help prevent pregnancy. However, they can cause some side effects, particularly in the first few months of taking them. The side effects can include:
Symptoms of withdrawal generally get better with time; however, therapy and medication can help. Depending on the severity, hospitalization or treatment at a live-in recovery facility may be required.
- Spotting or irregular menstrual bleedingNausea or dizzinessBreast tendernessBlood clots, particularly in people who smoke or are above 35 Depression or mood changes
While the research has been conflicted on this, Dr. Daramus says a study of over a million people in Denmark reported that there is a small but real risk of depression from taking birth control pills. “This study confirmed the perceptions of many people who had noticed the onset of depression happening around the time they went on birth control.”
The risk of developing depression may be higher in people who have a history of depression.
Use of Heart Medications
The research about the link between medications for heart disease and depression has also been conflicting. Some studies show that they do not cause depression; whereas, other studies and reports from patients suggest that medications like statins, beta-blockers, and calcium-channel blockers can cause depression, says Dr. Daramus.
If you suspect the pill may be causing you to feel depressed, Dr. Daramus recommends consulting your gynecologist about other birth control options.
There are multiple possible explanations for the conflicting data, according to Dr. Daramus. She says one possibility is that certain populations are more prone to this side effect.
Dr. Daramus notes that another possibility is that the medication may not be causing the depression, but that it is an understandable emotional reaction to developing heart problems and needing treatment. “Therefore, the depression might coincide with beginning the medication, making it appear that the medication caused it directly.”
Depression in the context of a heart condition can cause symptoms such as:
- Mood and attitude changesFear and uncertainty about the futureLack of confidence in one’s abilitiesGuilt over unhealthy habits that may have contributed to heart diseaseLack of energyDifficulty sleeping
A Word From Verywell
The mind and body are deeply intertwined, so mental health conditions like major depressive disorder can cause both physical and emotional symptoms. Similarly, physical health conditions and certain medications can cause emotional symptoms like depression as well.
If you have a heart condition, it’s important to report symptoms of depression to your healthcare provider and get treated for it. Otherwise, depression can make it harder for you to take care of your health and worsen the outlook of your condition.
This can sometimes make it hard to determine the cause of the symptoms you’re experiencing. However, it’s important to correctly identify the condition, so it can be treated. Otherwise, treatment may not be effective and the symptoms may persist.
