The negative intrusive thoughts began before my feet touched the floor.
You are so lazy, I thought to myself. You could never hold a REAL job. You can barely string together three sentences.
All I had to do that day was to crank out one quality blog before getting the kids from school, but every few paragraphs I needed to lie down.
Since I hadn’t been sleeping well for months and was used to feeling fatigued, I assumed my exhaustion and concentration problems were merely symptoms of my chronic depression.
But there was actually something more going on than depression.
“Your thyroid is not making enough thyroid hormone,” a new doctor told me over the phone that day. “That’s the first thing we have to work on, because low thyroid levels can affect a lot of things and make you feel very tired and depressed.”
As a physician who practices “functional medicine,” a science that engages the entire body to address the underlying causes of disease, she took a dozen vials of blood from me the week before as part of a comprehensive consultation.
The thyroid is a butterfly-shaped gland in the front of your neck that produces hormones that control how your body uses energy and a lot of other things, like body temperature and weight. When your thyroid is underactive (hypothyroidism), your symptoms might include:
- Weight gain
- Fuzzy thinking
- Low blood pressure
- Slow reflexes
When your thyroid is overactive (hyperthyroidism), symptoms include:
- Weight loss
- High heart rate
- High blood pressure
The interesting thing is that I’ve had my thyroid levels checked for eight years now, ever since an endocrinologist spotted a tumor in my pituitary gland. However, not until a comprehensive lab test was done did a doctor suggest treatment for low levels of both T3 and T4 hormones.
According to the American Thyroid Association, more than 12 percent of the American population will develop a thyroid condition. Today an estimated 20 million Americans have some form of thyroid disease; however, 60 percent are unaware of their condition.
Many of those people will visit their primary care physician or a psychiatrist and report symptoms of depression, anxiety, fatigue, insomnia, and fuzzy thinking. They might receive a diagnosis of major depression, general anxiety, or bipolar disorder, and leave the doctor’s office with prescriptions for antidepressants, mood stabilizers, sedatives, or all three.
Dana Trentini, mother of two, was diagnosed with hypothyroidism the year following the birth of her first son in 2006. She was overwhelmed with fatigue. Her pregnancy weight was impossible to lose.
Her hair began to fall out. And kidney stones landed her in the emergency room. She was treated by a leading endocrinologist and became pregnant again; however, her thyroid stimulating hormone (TSH) reached levels far above the recommended reference range for pregnancy and she miscarried.
In October 2012, she launched the blog “Hypothyroid Mom” to help educate others about thyroid disease.
“The mission of Hypothyroid Mom is clear — to drive awareness,” she writes on her blog. “The Thyroid Federation International estimates there are up to 300 million people, mostly women, with thyroid dysfunction worldwide, yet over half are unaware of their condition.”
Everyday Health featured Hypothyroid Mom in January 2014 for Thyroid Awareness Month: “How Mom’s Thyroid Problems Can Hurt Baby.” It is Dana’s life mission to bring about universal thyroid screening in pregnancy.
“I will save babies in memory of my lost child,” she writes.
A friend led me to her fascinating post, “Mental Disorder or Undiagnosed Hypothyroidism?” In this post, she features a letter from one of her readers who was diagnosed with bipolar disorder and pumped full of meds, ready to undergo electroconvulsive therapy (ECT).
The woman, Jana, writes: “Finally after four years of bipolar medications to the max, a close family member was diagnosed with hypothyroidism so my doctor tested me, too. I have a family history of thyroid disease. I was diagnosed with hypothyroidism.”
And then she says something that makes me think all persons taking antidepressants and mood stabilizers should have their thyroid checked: “Every single time I attend a bipolar support group, I ask everyone if they are hypothyroid and every time half the people raise their hand and the other half have no clue what it is and they don’t know if they have been tested.”
Dana then highlights a few studies linking bipolar disorder, depression, and thyroid disease. As she mentions, the use of lithium to treat bipolar disorder complicates matters, because the medication can itself cause thyroid problems.
However, plenty of research points to the connection between bipolar disorder and thyroid disease even in those who aren’t medicated with lithium, as well as the connection between different kinds of mood disorders and hypothyroidism. Dana mentions these:
- A 2002 study entitled “High Rate of Autoimmune Thyroiditis in Bipolar Disorder: Lack of Association with Lithium Exposure” found that Hashimoto’s thyroid antibodies were highly prevalent in a sample of outpatients with bipolar disorder as compared to a control group.
- An interesting study of bipolar twins versus healthy control twins showed that autoimmune thyroiditis is related not only to bipolar disorder itself but also to the genetic vulnerability to develop the disorder.
- A 2004 study found a link between thyroid autoimmunity, specifically the presence of thyroid peroxidase antibodies (TPO Ab+), with anxiety and mood disorders in the community.
- A 2005 study found that subjects with Hashimoto’s disease displayed high frequencies of lifetime depressive episodes, generalized anxiety disorders, social phobia and primary sleep disorders.
For some people, thyroid treatment is straightforward and brings fast relief of symptoms. Mine has been more complicated because I take lithium for my bipolar disorder and I have a pituitary tumor. I’m extremely sensitive to medications that stimulate thyroid production: What should be a therapeutic dose for me causes insomnia. I am hopeful, however, that I will eventually find a solution.
If you suffer from depression, anxiety, or both, please get your thyroid checked. Read Dana’s post, “Top 5 Reasons Doctors Fail to Diagnose Hypothyroidism.”
An underactive thyroid can make you feel depressed, fatigued and fuzzy brained. An overactive thyroid can cause anxiety and insomnia. If you fluctuate between the two, you will have similar symptoms to those of bipolar disorder.
Thyroid disease may very well be at the root of your problem.
Published originally on Sanity Break at EverydayHealth.com.
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Last reviewed: By John M. Grohol, Psy.D. on 25 Jun 2014
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Borchard, T. (2014). Depressed or Anxious? Check Your Thyroid. Psych Central. Retrieved on August 29, 2014, from http://psychcentral.com/blog/archives/2014/06/27/depressed-or-anxious-check-your-thyroid/