Patients with hyperthyroidism and hypothyroidism can experience erratic and unpredictable mental states because of the imbalance.
Living with an endocrine disorder — such as hypothyroidism, Addison’s disease, or acromegaly (a dysfunction of the pituitary gland) — means dealing with physical issues as well as possible cognitive and mental health issues.
You might have noticed that your hypothyroidism comes with the frustrating side effect of a depressed mood, or that your adrenal disorder triggers anxiety, agitation, or an inability to focus. It’s unfortunately not uncommon, but being aware of how it all fits together and what you can do to manage it is key.
How your hormones can impact your mental health
More research is needed around how hormones and mental health are connected, but experts say there is definitely an interaction between hormones and well-being. Here’s what we know: Your endocrine system works in tandem with your nervous system — known as the hypothalamic-pituitary system — to maintain a sense of homeostasis or physiological equilibrium. This equilibrium is what the body wants, but when it’s not achieved, a lot can go wrong.
When something is out of balance with your hormones it has an effect on the whole system, which means you’re going to feel it manifest both in your body and your mind.
Ready for a deeper dive? According to Dr. Cory Rice, internist and certified practitioner, “The major endocrine glands in humans are the thyroid gland and the adrenal glands. If this chemical messaging system or the hormone feedback loops are negatively compromised in any way, this can have profound effects on someone’s health, particularly as it relates to their mental health.”
For example, he says, the thyroid gland is the “master gland” of our endocrine system. It’s responsible for producing the hormones T3 and T4, and it’s T3 that has a major role in one’s mental health. “Many of the T3 receptors in our body are concentrated in our brain. So if we have a thyroid gland that is underperforming (not making enough T4 and/or T3), there is not enough thyroid hormone getting to the brain. This can, and oftentimes will lead to increased rates of depression or anxiety or other mental health issues.”
For example, patients with hyperthyroidism and hypothyroidism can experience erratic and unpredictable mental states. Commonly reported are anxiety, brain fog, mania, lethargy, depressive mood, and confusion.
Dr. Rice also explains that the adrenal glands help to regulate our internal stress response.“If someone has physical, mental, or any other personal stress in their life, their adrenal glands may not function appropriately,” he says. “Stress is very common for a lot of people. Some stress is good for us, but if certain types of stress persist for too long, this can have dramatic, detrimental effects on someone’s health.”
One of the hormones responsible for how we experience and manage stress? Cortisol. “If a person has consistent, uncontrolled stress, it will compromise their ability to produce and use their cortisol,” Dr. Rice says. “If this happens, they will oftentimes get very fatigued and gain weight — among other problems. This can also lead to mood disorders such as depression, apathy, and anxiety.”
Dr. Patricia Celan says, “Excessive cortisol can actually reduce the activity of the hypothalamus, resulting in imbalances of chemical messengers affecting sleep, eating, sex, cognition, and more; all of which can mimic or contribute to a disorder such as depression.” This can be seen in disorders like Cushing’s disease.
Inflammation can also play a role in mental health
Another possible culprit? Inflammation, according to Dr. Kelly Bay, DC, CNS, CDN. Dr. Bay says that autoimmune reactions against the thyroid and abnormal thyroid hormones could increase inflammation throughout the body, which could then lead to cognitive and emotional health issues as well.
We know this, she says, because “markers of increased inflammation, particularly brain inflammation, are common among those diagnosed with major depressive disorder, anxiety, and other mental health conditions.” For this reason, some doctors prescribe anti-inflammatory treatments for patients with depression.
Make sure to speak with a doctor about all of your physical and mental health symptoms
Because the mind and body are so linked, it’s important to work with your healthcare provider to take a holistic, systemic approach to assess both your physical and mental health symptoms.
If you have or suspect you have an endocrine issue and are experiencing mental health symptoms, such as sudden feelings of anxiety or depression, or cognitive issues, such as trouble with focus or memory, Dr. Rice stresses the importance of working with a medical professional to test your hormone levels and adrenal responses before being prescribed antidepressants or antianxiety meds. This will help them determine the appropriate treatment. What may seem like depression might actually be successfully treated by thyroid medication before antidepressants, for example.
It’s also very possible that your mental health symptoms predated or existed alongside any sort of endocrine issues. It is a wise idea to connect your healthcare provider to your therapist or counselor. If you are thinking of speaking to a psychiatrist, it’s smart to let them know what sort of physical health conditions, such as an endocrine disorder, you have or are being tested for.
Adopt holistic, healthy lifestyle habits that can help support mental health
In addition to speaking with your healthcare providers about your physical and mental health — and any medications, you’ll need to take or adjust — you’ll want to invest in healthy lifestyle habits that can help support your mental health.
For example, if you’re tired all the time and can’t work out or engage in the activities you love, your mood will take a hit, leading to depression, which leads to more fatigue. This cycle can be broken by embracing daily stress-management techniques that tell your nervous system to put break into that all-consuming fight-or-flight mode.
Dr. Rice emphasizes a few key things that, over time, may contribute to better mental and cognitive health. These include good sleeping habits, smart lifestyle choices (avoiding alcohol as a stress-relief tool, for example, since alcohol can increase inflammation and is a depressant), and increasing exercise. “This can have a profound effect on mental health and, in many cases, can correct depression, anxiety, or other mental health issues,” he says.
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