An underactive thyroid or hypothyroidism often comes hand in hand with depression and according to Thyroid UK’s survey in 2015, over 50% of the hypothyroid patients who took part in the survey, also suffered from depression. More than half.
Of those taking antidepressants, 47% saw no difference. Of course not, the underlying problem, being the poorly treated thyroid, or possibly adrenals, isn’t being fixed.
Dr Barry Durrant-Peatfield also estimates that of the people on antidepressants, 30-50% will have unrecognised hypothyroidism.
In thyroid patients of all ages, many of them may be labeled with psychiatric issues such as mental health issues, when they are actually due to hormonal insufficiencies such as adrenal fatigue. In one study, it was concluded that by correcting the underlying hormonal imbalance, many patients’ mental health improved, with some patients having a total reversal of psychiatric symptoms.
I’ve said before that your thyroid and adrenals’ health walks hand in hand, working together, and it’s because they are both part of the endocrine system. I’ll explain more about why one or both of them could be linked to your mental health, in this blog.
Your thyroid and your mental health.
Many hypothyroid patients find that their inadequately treated thyroid problem is brushed off as depression. It’s what happened to me. Some patients do have both conditions, but doctors need to realise that depression isn’t a scape goat for all symptoms left from a poorly treated thyroid condition.
For example, there are some symptoms of depression that are the same as those for hypothyroidism, such as:
- Low mood
- Being slow in speech and/or movement
- Feeling more tired than normal
But equally, there are some that are not present in depression, such as:
- Thinning of eyebrows
- Apuffy face
- Overwhelming fatigue
- Dry skin
- Hoarse voice
- Muscle weakness
- Slow heart beat
- Raised blood pressure
- Raised cholesterol.
These are PHYSICAL symptoms, and not caused by something mental, but something physical. They are signs that a patient isn’t adequately treated on their thyroid meds and this needs investigating.
When I raised these very concerns, I had two separate GPs tell me that it was all in my head and that I needed “to let go”. I was distraught.
We know our own bodies, and we know when something isn’t right.
The link between depression and thyroid problems is that it involves T3, one of the hormones a healthy thyroid should be producing. Unfortunately, 99% of the time doctors in the UK will only prescribe T4-only meds (like Levothyroxine) for our underactive thyroids/hypothyroidism, so we’re relying on our bodies to convert some of that in to the T3 we also need, and well.. our thyroids are already rubbish at their job, so why are we relying on them doing a good job at that?!
How are they linked?
Having low Free T3 is a likely cause for depression, mood swings, anxiety etc. when on t4-only medicine, as once this is treated with direct T3, it often improves greatly. This was certainly true for me. When I switched from T4-only Levothyroxine to NDT, which contains direct T3, my anxiety, depression and over-emotional tendencies lifted quickly.
T3 has an important role in the health and optimal functioning of your brain, including: your cognitive function, ability to concentrate, mood, memory and attention span and emotions and ability to cope with life’s stresses. Christiane Northrup, MD explains this further on her website, “[T3] is actually a bona fide neurotransmitter that regulates the action of serotonin, norepinephrine, and GABA (gamma aminobutyric acid), an inhibitory neurotransmitter that is important for quelling anxiety.” She also states: “If you don’t have enough T3, or if its action is blocked, an entire cascade of neurotransmitter abnormalities may ensue and can lead to mood and energy changes, including depression.”
T3 interacts with brain receptors and makes the brain more sensitive to chemicals such as Serotonin and Norepinephrine, which affects your alertness, memory, mood and emotion.
So if your doctor failed to check a full thyroid panel, when you complained about the above symptoms, you may have mental health issues caused by an inadequately treated thyroid problem.
If they did check them and say they’re adequately treated, make sure they fall in to these areas, as backed up by various sources: TSH below 2, Free T3 top quarter of the range and Free T4 mid range or a bit higher.
You do need all three doing, as doing just one or two isn’t accurate. You need the full picture.
Hashimoto’s and your mental health.
Hashimoto’s, prevalent in about 90% of us with hypothyroidism, is reported to cause swings of TSH, with hyper and hypo symptoms to match. Hyperthyroid symptoms can include hyperactivity, anxiety, irritability and disturbed sleep, whilst hypothyroidism often causes fatigue and depression. Do those swinging symptoms remind you of anything? Bipolar Disorder perhaps?
Also known as manic depression, it could well be suggested that Bipolar diagnosis’ are actually masking Hashimoto’s cases, where patients swing between hypo and hyper symptoms, as the thyroid is attacked and destroyed, and thyroid hormone is released into the bloodstream in waves.
The 2002 study: “High Rate of Autoimmune Thyroiditis in Bipolar Disorder: Lack of Association with Lithium Exposure”, found that Hashimoto’s antibodies were highly prevalent in a sample of outpatients with bipolar disorder, in comparison to a control group.
As Hypothyroid Mom says:
What complicates studies with bipolar disorder is that patients with bipolar disorder are often treated with the drug Lithium. Thyroid problems are a common side effect of this drug. Lithium can cause hypothyroidism, goiters (enlarged thyroid), and autoimmune thyroiditis. So what came first, the hypothyroidism or the lithium treatment. The fact that so many bipolar patients on lithium treatment and so many not on lithium treatment are found to have Hashimoto’s thyroid antibodies is cause for real concern.
Your adrenals and your mental health.
Adrenal fatigue/dysfunction/insufficiency could also be causing or contributing to your depression and emotional health. I’ve covered what adrenal fatigue is here.
Abnormal cortisol levels, adrenal fatigue, which is very common among hypothyroid patients, can result in cell receptors failing to properly receive T3 from the blood, which can explain why you may have some behaviour and symptoms typical of depression and continued hypothyroid symptoms, including:
- Wanting to be alone
- Unable to tolerate stress
- Jumping or feeling irritable at loud noises
- Emotional ups and downs
- Being a bit sensitive and taking things to heart more so than you used to.
You can test your adrenal function with a 24 hour saliva cortisol test, and work on fixing your cortisol output if it isn’t right. If your doctor won’t do this, you can very simply order it yourself and complete it at home. A UK test can be found here and a US test here. Once this is fixed, or when you are starting to recover from it, you should see your symptoms easing. It is then important to maintain good adrenal health to prevent it from happening again in the future. The book I reviewed by James Wilson was helpful in recovering when I confirmed I had adrenal fatigue. I’ve also been blogging about having that, separately.
So, if you have depression, anxiety, bi-polar etc. or you’ve been diagnosed with another mental health condition, and also have thyroid or adrenal problems, or suspect you do, explore the above and check they’re all in line. You may just find checking your thyroid and adrenals help you, and ensuring you have adequate Free T3 levels, like adding T3 did for me.
Simply trying to ‘fix’ or ease the mental health issues with more medication, is simply trying to fix the symptoms, not the actual cause. Something I learnt was wrong, in my Psychology course. Masking the cause will only serve to make things worse in the long run. Doctors need to stop giving us more and more medications that we may not need, and concentrate on making sure our thyroid glands are properly medicated in the first place.
As well as working on your thyroid hormone levels to improve mental health, you may benefit from seeking support from a therapist in the meantime, including those that can help you online: https://www.betterhelp.com/advice/psychologists/reasons-to-choose-an-online-psychiatrist/
You can click on the hyperlinks in the above post to learn more and see references to information given, but more reading and references can also be found at:
Written by Rachel, The Invisible Hypothyroidism
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Rachel is a Thyroid Patient Advocate and Expert with Six 2018 WEGO Health Award Nominations. She is a highly ranked writer appearing in the Top Hypothyroidism Websites and Top Thyroid Websites 2018, and is a qualified Diet and Nutritional Advisor, also currently studying for relevant qualifications and certificates in Life Coaching, Motivational Speaking, Reflexology and more. She has worked with The National Academy of Hypothyroidism, The BBC, The Mighty, Dr. Hedberg, Thyroid UK and ThyroidChange, to name just a few. She is well recognised as a trusted and useful contributor to the thyroid community.