Thyroid Disease and Depression

Living with thyroid disease may be a frustrating challenge, but compound the disease with depression, and it gets more difficult to deal with. When thyroid hormone levels are too low, a condition called hypothyroidism, patients report that they feel fatigued and may suffer from weight gain. In addition, constipation may result causing patients to feel bloated. Straining to pass stool can cause hemorrhoids and cramps. Add depression to the mix, and a patient can feel outright miserable.

Hypothyroidism Diagnosis

The symptoms are so varied. The only way to know for sure if a patient is suffering from hypothyroidism is to perform a blood test. TSH - thyroid stimulating hormone test - and T4 tests are the two blood tests that are used in the diagnosis of hypothyroidism. A physician could also look for dry skin, swelling, slower reflexes and a slower heart rate.

There is no cure for hypothyroidism. But fortunately, it is easy to treat. An endocrinologist will most likely prescribe medication to replace the amount of hormone that your thyroid gland can no longer make. The goal will be to bring your T4 and TSH levels back to normal levels. A simple pill-a-day lifetime hormone replacement can relieve uncomfortable symptoms. Determining the right dosage may require experimentation on the part of the endocrinologist. This can lead to frustration on the part of the patient, but with the right balance, symptoms could disappear.

Depression Signs and Symptoms

Depression can take many signs. Loss of interest in previously enjoyed activities, a feeling of sad, helplessness or hopelessness with or without crying spells are among a few of the symptoms. In addition, sleep deprivation, changes in weight, fatigue or slow body movements, less interest in sex and thoughts of death. Children and teens may react differently to depression and symptoms may vary. If you feel sad, helpless, or consistently tired, it is recommended that you see a health care professional.

Hypothyroidism - A Common Glandular Disorder

After diabetes, thyroid disease is the most common glandular disorder. Hypothyroidism - underactive thyroid - is twice as prevalent as over active thyroid glands - also called hyperthyroidism. Up to twenty percent of all chronic depression patients have been found to have low thyroid hormones.

A University of North Carolina study found that among women with decreased thyroid function, the rate of those that suffered depression was almost three times as great. Unfortunately, most patients who suffer from depression do not first get their thyroid tested.

Thyroid or Depression Concerns?

If you are concerned about your thyroid or are experiencing any symptoms that lead you to believe you might be suffering from hypothyroidism or depression, talk to a doctor for a personalized assessment.

Uncovering the Complex Relationship between Thyroid Function, Depression, and Anxiety

Once little understood and rarely discussed, mental health issues have now largely been freed from the shroud of confusion and stigma that long obscured them. Over the course of the last several decades, researchers have been able to make significant strides toward identifying the origins, causes, and course of many common mental health problems such as depression and anxiety.

Today, it is widely recognized that many, if not most of these disorders have their roots in chemical imbalances within the body. This growing recognition has vastly expanded the treatment options available for individuals diagnosed with depression, anxiety, and other related mental health issues.

Common organic causes of mental health problems include factors such as hormonal imbalances, particularly during or after childbirth or menopause, deficiencies or impediments in the uptake and distribution of neurotransmitters, and hypertension. Once diagnosed, mental health issues that are caused by these health problems can often be improved or even eliminated by treating the underlying illness or disorder.

In recent years, a number of prominent researchers have begun to explore the impact of thyroid disorders on mental health. Studies that have been undertaken to evaluate the relationship between these two factors have uncovered many interesting correlations. At the current juncture, many scientists believe that thyroid malfunction could play a role in a much higher percentage of cases of mental health problems than previously estimated.

Hypothyroidism and Depression

Hypothyroidism is the most common form of thyroid disorder. The suffix “hypo-“ means slow, under, or too little, and these terms describe the type of thyroid malfunction experienced by individuals with hypothyroidism. Basically, the insufficient production of thyroid hormones causes many of the body’s normal functions to slow down, resulting in problems like fatigue, weight gain, and mental fogginess.

Not surprisingly, many patients diagnosed with hypothyroidism also experience clinical depression. With many of the body’s normal processes slowed down, the mental/emotional sphere can also be negatively impacted.

Hypothyroid patients with depressive symptoms often report being unable to shake feelings of gloom and hopelessness. In severe cases, the patient can became incapacitated by depression, experiencing paralyzing sadness that can even include suicidal ideation.

The tendency of hypothyroid patients to be at increased risk of depression has long been recognized by the medical community. Indeed, ongoing depression is one of the hallmark symptoms of the disease that often aids in diagnosing hypothyroidism. Often, treating the underlying thyroid malfunction can greatly reduce or eliminate these types of depressive symptoms.

What researchers are just beginning to discover is the extent to which the thyroid may play a role in depression in the general population. Some scientists contend that slow thyroid function that is not severe enough to merit a diagnosis of hypothyroidism may play a role in causing many cases of depression. However, at this stage, this theory has not yet been proven and remains controversial.     

Hyperthyroidism and Anxiety

Just as slow thyroid function can cause or exacerbate symptoms of depression, the dangerously heightened pace of thyroid function has been linked to anxiety. Many patients diagnosed with hyperthyroidism complain of common anxiety-related symptoms, such as panic attacks, constant worrying, irritability, and restlessness. In many cases, these signs actually help doctors diagnose hyperthyroidism.

As many as 40% of all cases of hyperthyroidism have been diagnosed in part due to an individual’s persistent symptoms of anxiety. In an estimated 5-20% of all cases of hyperthyroidism, the degree of anxiety symptoms can be classified as severe, with 1-2% of hyperthyroidism patients suffering from anxiety-related psychosis. 

Likewise, in patients who present with general anxiety disorder, physicians often evaluate thyroid function to rule out hyperthyroidism as a potential cause. Often, when hyperthyroidism is treated with an adequate course of pharmaceuticals, related anxiety problems subside.

Optimal Mental Health for Thyroid Patients

For many patients with thyroid disorders, the resulting mental health problems can be the most difficult aspect of living with the disease. However, in most cases, adequate treatment of the underlying disorder, whether it is hypothyroidism or hyperthyroidism, often greatly reduces or eliminates the anxiety or depression.  Here are some mental health guidelines to keep in mind if you or a loved one is living with a thyroid disorder:

• Adhere strictly to your prescribed thyroid treatment in order to maintain stable thyroid function and limit the possibility for variability that could negatively impact your mood.
• If you continue to experience symptoms of depression or anxiety despite adhering to your prescribed thyroid treatment, consult your physician -- additional medication may be necessary to further alleviate your symptoms.
• It may be beneficial to supplement your pharmaceutical treatment with counseling, especially if you have lived with depression or anxiety for an extended period of time. A licensed helping professional will be able to help you make a healthy transition to a life without these symptoms.
• In some cases, patients with thyroid disorders can experience depression, anxiety, or other mental health issues that are not related to their disease, especially in response to stressful or difficult life events. Don’t rule out the possibility that your thyroid may not always be to blame for situational depression or anxiety.

For Further Reading

• http://thyroid.about.com/b/a/137486.htm

• http://www.webmd.com/depression/news/20040315/atypical-depression-thyroid-link-still-alive

• http://www.thyroid.ca/Articles/EngE10F.html