One of the cruelest things about thyroid disorder is that it can change your mood: hyperthyroidism can produce symptoms that include ‘manic’ behaviors such as extreme agitation and panic responses; while hypothyroidism can present as depression-adjacent conditions. This can cause unsympathetic people in your circle to dismiss your as yet undiagnosed illness as being ‘all in your head’ and something you need to ‘snap out of’. But there is another layer to this issue: that of your actual mental health during the process of narrowing down your specific condition and finding the right treatment.
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Thyroid disease can be hard to diagnose because everyone is different: some people are naturally slower in their movements and thoughts, while for others, who tend to be full of energy and brio, slowing down to the level of the first set of people can be a sign that there is something amiss. Thyroid illness is not an easy diagnosis: it is usually arrived at through a process of trial and error – and then lighting upon the right treatment is achieved the same way!
Thyroid conditions are caused by an excess or deficiency in thyroid hormone being available for the body to use. This causes the pituitary to respond by increasing or decreasing the amount of Thyroid Stimulating Hormone (TSH) that it produces to encourage the thyroid to do its work. Therefore a lot of TSH in the blood can mean that your thyroid is underactive, while little TSH means the opposite – there is too much of the two thyroid hormones T3 and T4 being produced. Hyperthyroidism can only be treated by fully reversing it to the point that the thyroid becomes underactive – and underactive thyroid (hypothyroidism) is treated with carefully tailored doses of artificial thyroid hormones – see more about levothyroxine tablets here – which restore your body’s functioning to nearly normal.
This whole process takes a matter of minutes to read about – but diagnosing the precise condition or cause of the thyroid dysfunction can take months or even years, if symptoms are mild or outliers. After the diagnosis has been arrived upon, working out a suitable treatment can take almost as long – definitely many weeks, sometimes as long as six months or so. This endless round of feeling ill, going to the doctor, describing symptoms only to be greeted with puzzled frowns and shrugs is very hard on the psyche. People can begin to second-guess their own symptoms: ‘Maybe I am just lazy?’ ‘Perhaps I should try harder/ go to bed earlier/ do more exercise?’ (None of which will work when your body is literally not functioning properly!) And having these doubts is not great for your mental health either. Once you are diagnosed, you still face a longish time of adjusting your dose of thyroid hormone to arrive at a place where your body functions well, and you feel healthy and energetic again.
So not only are you feeling terrible, with a range of symptoms that can be changeable and quite hard to pin down, beginning to second guess yourself, even as your illness also interferes with your emotional state – no wonder your mental health takes a dip! The good news is that any mental health woes associated with thyroid disease are time-limited. As soon as you get onto the right regimen and begin to feel more like yourself as the brain fog or agitation dissipates, your mental health will begin to recover too. Knowing that you are in for a long slow return to health can seem like another cause for low mood – but do be reassured that it will lift, and that once you are back to normal, you will forget just how awful this period of uncertainty, testing and experimentation was.
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