Rule Out Medical Conditions

I want to rule out medical conditions as a cause of mental health symptoms and behaviors to ensure that the appropriate treatment is provided, avoid misdiagnosis, and enhance your safety and well-being. Medical conditions can present with psychiatric symptoms that mimic mental health disorders, and without proper evaluation, I may inadvertently treat symptoms in a way that is ineffective or even harmful.

One of the most critical reasons for ruling out medical conditions is that untreated or improperly managed physical illnesses can exacerbate psychological distress. For example, hypothyroidism can cause symptoms such as depression, fatigue, and cognitive difficulties, while hyperthyroidism can contribute to anxiety, restlessness, and even psychotic symptoms. Similarly, neurological conditions like epilepsy, traumatic brain injuries, or multiple sclerosis can lead to mood instability, aggression, or personality changes that might be mistaken for bipolar disorder or a personality disorder.

In addition, certain infections, such as Lyme disease or syphilis, can cause neurological and psychiatric symptoms, including mood swings, confusion, and hallucinations. Autoimmune disorders, such as lupus or celiac disease, can also manifest with depression, anxiety, and cognitive impairments. Deficiencies in essential nutrients like vitamin B12, iron, or vitamin D may lead to symptoms of fatigue, irritability, or even psychotic-like experiences, which could be misinterpreted as schizophrenia or depression.

Substance use and medication side effects are another crucial area of concern. Various medications, including corticosteroids, antihistamines, and certain antidepressants, can cause mood swings, agitation, or cognitive disturbances. Additionally, withdrawal from substances such as alcohol, benzodiazepines, or opioids can produce severe anxiety, depression, or even psychotic symptoms, requiring a medical approach to detoxification and stabilization.

Ruling out medical causes ensures that the interventions from your treatment plan align with your actual needs. If an underlying medical condition is responsible for the symptoms, psychotherapy alone may not be effective, and medical treatment will be necessary. For instance, if a client presents with panic attacks that are actually caused by an undiagnosed heart arrhythmia or hyperthyroidism, addressing the medical issue directly will likely resolve the psychiatric symptoms more effectively than cognitive-behavioral therapy alone.

Furthermore, ethical and professional responsibility dictates that therapists operate within their scope of practice. While therapists are trained to assess psychological distress, they are not medical doctors and should refer clients to a primary care physician, psychiatrist, or specialist when there is reason to suspect a medical cause. Collaboration with medical professionals enhances holistic care and prevents unnecessary suffering due to misdiagnosis.

Ruling out medical conditions ensures that therapy is appropriately tailored to the client’s true needs, enhances treatment effectiveness, and safeguards client well-being. By recognizing the interconnected nature of physical and mental health, therapists can work within an integrated care model, ensuring clients receive comprehensive support for both their psychological and physiological concerns. When it is appropriate and necessary, we will work together to schedule an appointment for a physical health examination.

Continuity of Care:

You mat be asked to complete a medical evaluation from a physician, to assess for any possible contribution of neurological, medical, or substance-related conditions to the symptoms and behaviors associated with your presenting problems. If you are being treated by (or has been treated by) your physician, please discuss and process any medical concerns, illness, disease, chronic pain, or physical health and wellness problems and goals with me.

Coordination of Care:

When it is necessary, I will provide a referral to a physician for a medical evaluation and physical health examination to rule out general medical or substance-related causes of their presenting problems. I will ask you to discuss and process medical concerns, illness, disease, chronic pain, or physical health and wellness problems and goals, with me. I will provide encouragement, support, and person-centered, strengths based guidance.