And the investigation should begin with looking at baseline physiology by evaluating the vital signs. A long lasting change of mood, chronic depression, mania, anxiety, etc… is most likely a physical sign of a underlying undiagnosed or early stage of a medical illness or motor injury to the body or unlooked for blood loss resulting in chronic mood change. Being sick, having an impairment [motor injury] , blood loss resulting in deficiency, etc…there are many reasons for non-specific signs such as chronic mood changes, personality changes and cognitive changes and new difficulties with normal functions at work at school or at home. And evaluating vital signs will be an important first step in recognizing possible physiologic physical problems.
Is that so hard? Well, it involves a more complex understanding of human biology, injury, infection and physical illness. Organ failure, especially can creep up and affect someone for years before blood tests can detect it. Vital signs will probably be affected way before any blood tests will help the diagnosis, allowing for thinking about how best to help the patient given the abnormal physiological results, if any.
This is an entirely new way to view mood and longterm change to mood. Psychological support can still be useful, especially to deal with the news of abnormal physiology, if this is what the vital signs [RR, HR, BP, T] suggest, because realizing one is ill or injured and needs medical treatment will take its toll, as well.
To be continued….