Anxiety and Depression: Why Do Doctors Miss The Diagnoses?

The truth is that both disorders can sometimes be very challenging to diagnose.

Portrait of a frustrated student being surrounded with piles of books

A change in grades is often the first indication of depression or anxiety.

Children and teens may suffer from both anxiety and depression.  At times, a physician may only be willing to treat a child for one of the two conditions.  This can pose a problem in finding relief for a patient, especially when the two conditions have overlapping symptoms.

Frequently, doctors will miss that a child is suffering from either condition. “It’s all in your head,” and “it’s just a phase” are phrases that have been commonly heard in the past by parents of children who were eventually diagnosed with depression. While anxiety alone may be easier to pinpoint, if symptoms of depression are also part of the mix, an accurate evaluation can become complicated.  Family doctors can be excellent at figuring out medical puzzles, but many have not had the necessary training — lacking exposure to current research findings and evaluation protocols — to be able to properly assess the combination of these diseases in most children and teens.

As Christopher Willard, PsyD, a clinical psychologist in private practice in Cambridge, Mass., and author of Child’s Mind: Mindfulness Practices to Help Our Children Be More Focused, Calm, and Relaxed says, “Depression may manifest with different symptoms for different people and those symptoms often overlap with symptoms of anxiety disorders, bipolar disorders, post-traumatic stress disorder, or even addictions.”

Anxiety and Depression:  Understanding the Disorders

Anxiety and depression are two of the most common mental health disorders. It may appear that only adults experience anxiety and depression due to the various stressors in their lives, but these two disorders can be quite common in children and teens. According to the National Institute of Mental Health, approximately 9 million children (11% of the nation’s population of children), will have a depressive disorder by age 18.

What is Depression?

Depression is the result of the brain circuits’ inability to control emotional functioning. It is termed a mood disorder and is characterized by intense and persistent negative emotions, as well as physical symptoms. Sometimes a negative event, such as the loss of a loved one, or severe and prolonged stress, will trigger an episode of depression; however, episodes can also occur spontaneously.  Common symptoms of depression include: feeling blue or sad for no apparent reason, chronic fatigue, pessimism, insomnia, loss of interest in everyday activities, poor academic performance, becoming socially withdrawn, unexplained headaches and/or body aches, shortness of breath, frequent urination, gastrointestinal problems, and/or muscle tension.  It can run in families; therefore, people with immediate family members (e.g., parent or sibling) with depression are more likely to develop it themselves.

Today, medical science deems depression to be a medical condition.  Those in the medical community who have recently studied depression have been steering away from considering it solely psychological. This shift has occurred with those medical professionals who have a keen understanding of depression due to significant exposure to medical research.  It hasn’t received significant attention as a disorder by a large faction of general practitioners.

What is Anxiety Disorder?

Anxiety is a mental disorder characterized by worrying, nervousness, feelings of impending danger, rapid breathing, extensive sweating, trembling, and trouble concentrating. It can be quite common in children and teens, as well. According to the National Alliance on Mental Illness, 8% of youth have an anxiety disorder, a number similar to depressive disorders in these youth.

Types of Anxiety Disorders:

  • Separation anxiety disorder: anxiety related to separation from parents or others who have significant nurturing roles,
  • Selective mutism failure to speak in certain situations, such as a class presentation,
  • Specific phobias: major anxiety that comes about when exposed to a specific object or situation,
  • Social anxiety disorder: insecurities in social situations,
  • Generalized anxiety disorder: persistent anxiety which manifests during events or circumstances which, to most, would be an unremarkable or meaningless. (The average age of getting one of these disorders is 14 years.)

Problems When the Two Conditions Overlap

Someone with anxiety may feel short of breath, but so may someone with depression. A person with depression may be experiencing gastrointestinal problems, but so may someone with anxiety. Another may have trouble falling asleep or staying asleep. These symptoms are attributed to both anxiety and depression.

In order to properly evaluate a patient with anxiety, depression or a combination thereof, most doctors would need significantly more time than most allot for routine visits. Additionally, diagnosis should be only the first of many steps in the evaluation process of a patient.

Depression and Anxiety Can Be Tricky to Diagnose 

If you believe a family member may be suffering from one of these undiagnosed disease, investigate reputable medical practices with experience with these conditions, and one that will continue the evaluation process throughout treatment.

The Institute would be happy to answer questions you may have regarding these disorders.  If you would like to schedule an evaluation, call today:  770-817-9200.