Depressed mood, low motivation, fatigue, weight gain—these sound like depression red flags. But those symptoms can also be a thyroid disorder manifesting. Moreover, the patient can have both health issues simultaneously, which worsens the symptoms. Yes, it is that complex. This article is to break down the connection between thyroid problems and depression!
Role of Thyroid Hormones in Mental Health
The thyroid gland and the brain are connected through the so-called hypothalamic-pituitary-thyroid axis (HGT). Its hormones are actively involved in metabolism, maintenance and brain functions. They also help the body to self-regulate the thyroid function. This explains why thyroid disorders have an impact on mental health and can manifest in depressed mood, anxiety, brain fog, low libido, and other symptoms common in affective disorders.
How Thyroid Disease Can Trigger or Worsen Depression
Depression and thyroid imbalance come hand in hand. Depression can be caused by both insufficient (hypothyroidism) and excessive (hyperthyroidism) thyroid hormone production. However, the association between depressed thyroid function and major depressive disorder (MDD, aka clinical depression) is stronger. While overt (clinically clear) hypothyroidism is relatively rare in patients with MDD (up to 4% were diagnosed), subclinical hypothyroidism (SCH or mild thyroid failure), occurs in 4% to 40% of patients diagnosed with depression.
From 2010 to 2019, there were multiple studies investigating the connection between thyroid disorders and depression. The conclusions were as follows:
- The patients with SCH were more prone to depression than those without it. Moreover, the prevalence of MDD in these patients was estimated to be about 63%.
- Diagnosed but untreated thyroid disorders were associated with depression and anxiety.
- Depression was found to be prevalent in patients with diagnosed hypothyroidism.
- It was suggested to screen patients diagnosed with MDD for thyroid disorders.
- Elevated levels of thyroid-stimulating hormone (TSH) may suggest SCH and cause severe depressive symptoms.
Thyroid disorders aggravate the clinical picture of depression due to the similarity of symptoms. And aminergic systems (key amines of which are serotonin and dopamine), interact with the HPT axis which can trigger depressive disorder in the event of metabolic abnormalities.
How Depression Can Influence Thyroid Function
The reverse connection also exists. For instance, serotonin deficiency, common in MDD, is associated with changes in the HPT axis and inhibited TSH release. On the other hand, depression is characterized by reduced somatostatin levels in the cerebrospinal fluid which contributes to higher TSH. The latter explains the prevalence of SCH in patients with depression.
What is Thyroid Disease
Thyroid disease is an abnormality due to which the patient’s thyroid gland cannot produce the right amount of hormones. There are several different variations of thyroid diseases:
- Hypo and hyperthyroidism (insufficient and excessive hormone production, respectively);
- Thyroiditis: inflammation of the gland;
- Hashimoto’s thyroiditis: an autoimmune condition when the body produces thyroid antibodies to attack the organ.
Causes
Depending on the disorder, the cause of thyroid issues can vary. With hypothyroidism, the origin is something that restricts the thyroid function, such as:
- Thyroiditis;
- Hashimoto’s thyroiditis;
- Surgical intrusions (e.g. thyroidectomy: full or partial removal of the gland);
- Iodine deficiency (iodine is used for hormone production)
- Birth defects.
Hyperthyroidism can be caused by:
- Nodules: non-malignant formations of thyroid tissues;
- Iodine overconsmption;
- Grave’s disease: an autoimmune condition responsible for about 70% of hyperthyroidism cases.
How Thyroid Disease Affects General Health
Thyroid hormones regulate metabolism, heart functions, breathing, the temperature of the body, digestion, mental functions, skin and bones, fertility, and energy levels. Therefore, thyroid disorders can have an impact on every listed item, causing a variety of subsequent issues.
Symptoms
The clinical picture depends on the patient’s individuality and the nature of the disease. The symptoms can include:
- fatigue, weakness, poor sleep;
- abnormal heart rate;
- anemia;
- skin changes: dryness or dampness;
- poor tolerance to heat or cold;
- slow speech and movement or hyperactivity;
- depressed mood and anxiety;
- digestive issues;
- frequent infections of the respiratory and urinary systems;
- decreased libido;
- irregular menstrual cycle, an abnormal amount of discharge;
- the development of a goiter, a swollen formation in front of the neck due to the enlarged gland.
Understanding Depression
Depression is also known as:
- clinical depression
- major depressive disorder, or MDD
- major depression
It is classified as a mood disorder. MDD is a serious affliction that affects the way a person feels, thinks, and behaves.
Causes
A major depressive disorder can be caused by:
- Chemical imbalance in the brain;
- Hormone imbalance;
- Genetics (hereditary depression, mood disorders in family history);
- Unresolved trauma, including childhood one;
- Abnormal changes in brain structure;
- Certain medical conditions, mostly chronic, often with a pain syndrome;
- Substance abuse.
Symptoms
Every person is an individual and can experience MDD differently. Generally speaking, it is possible that the patient is living with depression, if they experience some of the issues listed below, daily, for at least two weeks:
- Sadness, anxiety, feeling “empty”;
- Low motivation and self-esteem;
- Crying more often than they used to;
- Increased tiredness;
- Brain fog, trouble with focus, and memory;
- Sleep disorders;
- Changes in appetite and body mass;
- Suicidal ideations, self-harm;
- Slowed speech or movement;
- Decreased libido;
- Headaches;
- Pain syndrome;
- Dygestive issues.
Diagnosis
Depression
MDD can be diagnosed by a primary healthcare provider or a healthcare professional in mental health specifically. The doctor will survey the patient regarding their condition and ask about symptoms and other factors that can establish the source of the problem or rule out certain factors. Screening and testing may be necessary.
Thyroid Disease
To diagnose a thyroid disorder, a healthcare provider will order certain blood tests to measure levels of thyroid hormones (including those released by the gland itself and those that stipulate it). Abnormalities will help establish the diagnosis and develop a proper treatment plan.
Treatments for Depression
MDD treatment includes three main approaches that work best when combined:
- Medications (antidepressants).
- Therapy (psychotherapy and certain activities, such as animal-assisted or light therapy).
- Holistic approach and wholesome changes in the lifestyle.
Managing the associated health issues also can prove to be beneficial for a patient. For instance, anxiety and depression after thyroidectomy (thyroid removal) can be relieved through thyroid hormone replacement.
Treatment Options for Thyroid Disorders
If the gland function is reduced, say, after thyroid removal, depression and other symptoms are managed by taking synthetic hormones, just as we mentioned a bit earlier. This goes for the majority of hypothyroidism cases. With hyperfunction, however, the solution is just the opposite: radioactive iodine and anti-thyroid drugs that inhibit hormone production.
Summary
Thyroid function and mood disorders are closely connected. Two conditions can trigger or worsen each other’s development, and the treatment of one often includes addressing another. We advise you to consult your healthcare provider as soon as you notice troubling symptoms as they can mean both ailments or even their simultaneous development.
FAQs
What is thyroid depression like?
Its clinical picture matches commonly-know depressive symptoms
How do you fight thyroid depression?
A combination of treatment options for both thyroid disorders and depression is considered a potentially beneficial approach; however, each case is individual.
Does thyroid medication help depression?
If a thyroid disorder has been diagnosed, a respective treatment can improve the patient’s health status.
Can thyroid problems cause anxiety or depression?
Yes, the symptoms of affective disorders are commonly diagnosed in patients with thyroid issues.
Can hypothyroidism worsen depression?
Yes, it can aggravate its symptoms and complicate treatment.
Does depression cause thyroid problems?
To establish the precise chemical mechanism, further research is necessary but the connection between the two is clinically recognized.
