When body and mind suffer at the same time
Low mood, anxiety, problems concentrating, a feeling of inner emptiness. Many women with hypothyroidism describe these symptoms long before their thyroid disease is recognised. Not infrequently, they are first dismissed as psychosomatic or explained by a separate mental illness. Yet the connection between thyroid function and mental wellbeing is well documented, even if it is not always given enough attention in medical practice.
How thyroid hormones affect the brain
Thyroid hormones are not only important for metabolism, heart rate and body temperature. They play a central role in the central nervous system. T3, the active form of thyroid hormone, influences the production and breakdown of neurotransmitters such as serotonin and dopamine, which are directly linked to mood, motivation and emotional stability.
With an underactive thyroid, when there is too little active hormone, this finely tuned system can fall out of balance. The result is symptoms that can hardly be distinguished from clinical depression.
Symptoms that are easily confused
The overlap between symptoms of hypothyroidism and mental illness is considerable:
- Lack of drive and apathy
- Joylessness and emotional numbness
- Sleep problems despite constant tiredness
- Memory and concentration problems
- Slowed thinking, sometimes called brain fog
- Irritability and mood swings
These symptoms can be signs of an underactive thyroid, of depression, or of both at the same time. That is exactly what makes the diagnosis so difficult.
Some people report that they were treated with antidepressants for years before anyone checked their thyroid. A simple blood test could have brought clarity sooner.
What research says
Studies show that a raised TSH value, a sign of an underperforming thyroid, is associated with a higher rate of depressive symptoms and cognitive impairment. Interestingly, some studies show that even a TSH in the upper normal range can already be linked to lower mood and wellbeing.
Whether optimising thyroid treatment improves psychological symptoms is the subject of intense scientific debate. The answer seems to be individual: in some women, depressive symptoms largely disappear once their thyroid levels are well adjusted. For others, psychological support remains important.
Taking both seriously
The message is not to reduce mental illness to the thyroid. It is that physical and mental health are closely intertwined and both deserve a thorough examination. Women who suffer from mood problems have the right to a thorough assessment that includes the thyroid. And conversely, thyroid patients should also keep an eye on their mental health, without feeling ashamed about it.