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Mental health and medical illness
When a thyroid, a deficiency, a medication or a chronic illness is doing the work of a psychiatric diagnosis, no amount of psychiatric treatment will fix it.
Why this deserves its own page
Psychiatry and general medicine are usually practised in separate rooms, by clinicians who do not speak to each other, using separate records. The patients who fall through that gap are the ones whose psychiatric symptoms have a medical driver that nobody screened for — or whose chronic illness is producing entirely understandable depression that has been left untreated because everyone assumed it was inevitable.
Medical conditions that produce psychiatric symptoms
- Thyroid dysfunction. Hypothyroidism mimics depression closely; hyperthyroidism mimics anxiety and agitation. Both are common, easily tested and frequently missed.
- Deficiencies. B12, folate, iron and vitamin D deficiency all affect mood, energy and cognition.
- Sleep apnea. A leading hidden contributor to treatment-resistant depression and to attention problems mistaken for ADHD.
- Diabetes and metabolic disease. Bidirectional: each worsens the other.
- Autoimmune and inflammatory conditions. Lupus, rheumatoid arthritis, inflammatory bowel disease and others carry direct psychiatric effects beyond the burden of illness.
- Neurological conditions. Epilepsy, Parkinson’s disease, multiple sclerosis, and the aftermath of head injury or stroke.
- Hormonal change. Perimenopause and postpartum periods, both routinely under-recognised in psychiatric assessment.
- Cardiac disease and chronic pain, where depression is common, undertreated, and independently worsens medical outcomes.
Medications that cause psychiatric symptoms
Corticosteroids, some blood pressure medications, hormonal treatments, certain antibiotics, interferon, some anti-epileptics, and a number of common over-the-counter preparations can produce depression, anxiety, agitation or cognitive change. Reviewing the full medication list — including what other physicians have prescribed — is a routine part of the evaluation here, and it is one of the more productive fifteen minutes in medicine.
The other direction
Untreated depression and anxiety measurably worsen the course of medical illness. They reduce adherence to treatment, amplify pain, impair recovery after cardiac events and complicate diabetes management. Treating the psychiatric condition is part of treating the medical one, and patients with serious illness are frequently told, in effect, that feeling this way is simply part of it. It does not have to be.
How this works at Tentie
Your medical history and current medication list are reviewed as part of the psychiatric evaluation, not as background. Laboratory work is ordered or requested through your primary care provider where warranted, and findings are discussed directly with your other physicians with your consent.
Dr. Torrijos’s referral base includes primary care providers, neurologists, cardiologists, internists and OB-GYNs who send patients specifically because the psychiatric assessment will account for the medical picture rather than ignore it.
Start with an evaluation
| Patients | Adults 18+ |
| Evaluation | Up to 90 min |
| Fee | [$XXX] |
| Format | In person or video |
| Languages | English, Spanish |
Reviewed by José M. Torrijos, MDBoard-certified adult psychiatrist, licensed in Texas. Last reviewed August 2026.
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Frequently asked
Should I see a psychiatrist or my regular doctor first?
Either. If a medical cause is suspected, the assessment here will identify what needs testing and coordinate with your physician. If your physician has already ruled out the obvious causes, that information makes the psychiatric evaluation faster and better.
Will you order blood tests?
Where warranted — either directly or through your primary care provider, whichever is faster and cheaper for you.
Can psychiatric medication be safely combined with my other prescriptions?
Usually, with attention to interactions. Reviewing your complete medication list, including from other physicians, is part of every evaluation, and complex cases are discussed directly with your prescribing physicians.
My doctor says depression is normal with my condition. Is it?
It is common. That is not the same as untreatable, and it is not the same as something you should be left with. Depression alongside chronic illness responds to treatment and improves medical outcomes when treated.