Depression can be overwhelming. It can bring an otherwise healthy person to a complete halt. At any moment, nearly 10% of Americans are coping with some type of depression. More than just feeling sad, people have a lack of interest in their lives and no energy to do anything about it. They may gain or lose weight, sleep too much or too little. They can feel worthless to the point of considering, or completing, suicide. As a Registered Nurse, you certainly encounter these people both within and without your clinical practice.However, there are other conditions that can masquerade as depression. Before a patient is automatically diagnosed with clinical depression and started on an anti-depressant regime, there are a few outliers that should be considered.1. Dehydration: We all know the “eight glasses a day” slogan, but we also know that it can be easier said than done. Two studies done at the University of Connecticut showed that even a low level of dehydration can cause a dip in mood. Researcher Lawrence Armstrong, PhD, explains: “Our thirst sensation doesn’t really appear until we are 1-2% dehydrated. By then, dehydration is already setting in and starting to impact how our mind and body perform.”2. Low Blood Sugar: The “mood-sugar” connection shows up in all animals, including humans. When blood sugar drops, people feel hungry…and hunger causes feelings of anxiety and unhappiness. Adults who are insulin resistant (an aspect of type 2 diabetes) can be three times as likely to show moderate to severe depression symptoms. The good news? Eating low-carb, high protein food every 3-4 hours clears the symptoms.3. Vitamin D Deficiency: Estimates vary, but between 45-80% of Americans have low levels of Vitamin D. When Canadian researchers did a meta-analysis of 14 studies, they found a high correlation between low Vitamin D levels and existing depression, as well as an increased risk of depression. Sunlight has always been the best source of Vitamin D. Ten minutes of mid-day sun with exposed arms and legs will do the trick. Supplements will also help; make sure to choose a reputable brand.4. Hypothyroidism: If you’re feeling irritable, unable to concentrate or make decisions, worthless, and exhausted, ask your doctor to check your thyroid levels. About 300 million people around the world have insufficient thyroid levels, but only half know. Dena Trentini, who writes the “Hypothyroid Mom” blog, says, “Hypothyroidism, an underactive thyroid, is one of the most undiagnosed, misdiagnosed, and unrecognized health problems in the world.”5. Food Allergies: Gluten-free diets have become popular over the past few years, as people have become aware of the effects of hidden allergies. Dr. David Perlmutter, author of “Grain Brain,” is convinced that you don’t have to have full-blown celiac disease in order to suffer from some of the unpleasant reactions, such as becoming sad, anxious, and depressed. Dr. Perlmutter calls these “brain allergies,” and suggests keeping a food journal to track foods and possible mood associations.