Could Your Mental Health Symptoms Be Caused by an Underlying Physical Condition?

Updated January 2026

Diagnosis is a complex process due in part to the fact that many different health issues can cause similar symptoms. Strokes, for example, may present as a migraine-like headache and multiple sclerosis shares symptoms with fibromyalgia and Lyme disease.

This diagnostic complexity can also lead to a misdiagnosis of anxiety or depression. A number of mental health conditions share symptoms with both common and less common physical health problems. If you’ve been diagnosed with anxiety or depression, it can be valuable to explore the diagnosis more deeply with your physician and ask if there are other conditions that may be the root cause for your symptoms.

When should you question your diagnosis?

If your symptoms strongly suggest a mental health issue, your physician may not pursue diagnostic tests that could uncover an underlying physical cause for your symptoms. While those symptoms may in fact be the result of a mental health condition, there are situations where a more in-depth work up to identify an underlying physical health problem is prudent, including:

• Your symptoms start suddenly, with no clear cause like the death of a loved one, loss of a job or financial setback, or a new diagnosis of a serious health problem like cancer
• You have no history of mental health issues
• There is no family history of anxiety, depression, or other mental health issues
• You’ve recently experienced head trauma
• Depression occurs for the first time after age 55, although factors such as living with a chronic condition, chronic pain, caregiver stress, and isolation can cause new onset depression in older people

Physical health problems that share symptoms with anxiety

Anxiety can cause a wide range of physical symptoms. Some of the most common include:

• Palpitations (fast heart rate, skipped beats, pounding heart beats, fluttering heartbeat)
• Rapid breathing/shortness of breath
• Dizziness
• Fatigue
• Trouble concentrating
• Sleep problems
• Gastrointestinal symptoms like stomach pain, cramps, and diarrhea
• Mood changes
• Nervousness
• Sweating
• Brain fog
• Headaches

Several different physical health problems can mimic the symptoms of anxiety and panic disorders, including:

• Heart disease and heart attack (If you don’t have a history of anxiety or panic attacks and experience dizziness, chest pain, shortness of breath, and/or sweating, call 911 or go to the nearest emergency room to rule out a heart attack.)
• Respiratory diseases, including asthma and COPD
• Uncontrolled or difficult to manage diabetes
• Overactive thyroid (Hyperthyroidism can cause a rapid heart rate and sleep problems.)
• Chronic pain
• Sleep apnea (Sleep apnea can cause you to wake with a rapid heart rate, as well as cause headaches, memory issues, and mood changes.)
• Irritable bowel syndrome
• Lyme disease
• Rare tumors that cause your endocrine system to over-produce adrenaline, called pheochromocytomas, and some types of brain tumors
• Adrenal gland problems
• Peptic ulcers
• Low blood sugar
• Estrogen fluctuations during the menstrual cycle and menopause
• Polycystic ovarian syndrome
• Vitamin B12 deficiency
• Electrolyte imbalance
• Neurological disorders including Alzheimer’s disease, myasthenia gravis, and Guillan-Barre syndrome
• Postural orthostatic tachycardia syndrome (POTS)

The use of some over the counter and prescription medications and supplements, including pseudoephedrine, green tea extract, and high doses of vitamin D, can also cause anxiety-like symptoms.

Is it depression or a physical health problem?

Like anxiety, depression shares several symptoms with a range of physical health problems. Depression symptoms can include:

• Fatigue
• Sleep disturbances (Both insomnia and sleeping too much can occur with depression.)
• Loss of appetite
• Sudden weight loss or gain
• Irritability
• Loss of interest in things you previously enjoyed
• Trouble concentrating

Some physical health problems that may share these symptoms include:

• Underactive thyroid
• Diabetes
• Anemia
• Chronic fatigue syndrome
• Vitamin D and B12 deficiency
• Alzheimer’s disease and other types of dementia
• Parkinson’s disease (The chemical changes in the brain caused by this disease can cause lack of motivation and interest.)
• Certain cancers (Early symptoms of cancer such as weight loss, fatigue, and loss of appetite are also depression symptoms.)
• Sleep apnea
• Lyme disease
• Autoimmune diseases, such as lupus and multiple sclerosis
• Hypercalcemia (High blood calcium levels can cause depressed mood, feeling tired all the time, and memory problems.)
• Premenstrual dysphoric disorder (PMDD)
• Medication side effects (Feelings of sadness and depression can be caused by opioids, steroids, sleep medications, anti-anxiety medications, and anti-seizure drugs.)

Six steps to help you get the right diagnosis

To ensure that you get an accurate diagnosis, talk with your physician and make sure she or he explores all possible, appropriate diagnoses. These steps are a good place to start.

• Ask if there any other medical conditions that could cause your symptoms. Find out if there are physical health problems that cause symptoms similar to those you’re experiencing. Ask your physician whether there are diagnostic tests that could help refine your diagnosis or rule out conditions with similar symptoms.
• Be an active partner in your care. By tracking when your symptoms started, what makes them better and worse, how/if they have changed over time, whether you’ve been diagnosed with a new physical health problem, and whether you’ve started or stopped taking any medications can augment the information your physician can use to reach a diagnosis.
• Get a second opinion. Especially if your original diagnosis was made by a mental health specialist or in the emergency department, talk with your primary care provider about whether a physical health issue could be the underlying cause of your symptoms.
• Ensure your physician has all the information needed to make an accurate diagnosis. Provide your physician with access to your complete, up-to-date medical record and family history so she or he is aware of past diagnoses and risk factors. Ask if there is information in your medical history that does not fit with the current diagnosis or suggests a different diagnosis may be possible.
• Research possible causes of your symptoms. Your health advisor can provide evidence-based information about potential alternative diagnoses that you can share with your physician.
• Avoid self-diagnosis. With the vast amount of information about health on the Internet, you may be tempted to not just research your symptoms but to also develop your own diagnosis. But if you arrive at your physician’s appointment and tell your provider, “I think I have X,” that may shut down other avenues that could lead to an accurate diagnosis.

Connect with PinnacleCare

For more information about how PinnacleCare could support you with mental and physical wellness, connect with us today.

PinnacleCare is a member of the Sun Life Financial Inc. (“Sun Life”) family of companies. PinnacleCare and its employees do not diagnose medical conditions, recommend treatment options or provide medical care, and any information or services provided should not be considered medical advice. Any medical decisions should be made only after consultation with and at the direction of your medical provider. Any person or entity who provides health care services following a referral or other service provided does so independently and not as an agent or representative of PinnacleCare.

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