Although hypothyroidism and depression are distinct diseases, they are interconnected in many people's lives. Sometimes depression is the first indication that a person's thyroid is underactive (meaning hypothyroid).
If your doctor has diagnosed you with hypothyroidism, this means that your thyroid (a butterfly-shaped gland in the lower part of the neck) is secreting insufficient amounts of thyroid hormone, which, in turn, could interfere with the functioning of virtually every organ, tissue, and cell in the body. But because of an overlap of some symptoms of hypothyroidism and depression, doctors and patients may overlook the possibility that a depressed patient could actually have an underactive thyroid as well. In those cases, the person's depressive symptoms could be caused by hypothyroidism itself.
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If you have hypothyroidism, you may have symptoms of fatigue, lethargy, difficulty concentrating, and excessive sleepiness that may lead to feelings of depression and the extreme sadness and despair that can accompany it. At the same time, you could have other symptoms commonly associated with an underactive thyroid, including:
Depression is more significant in people with hypothyroidism than those without thyroid problems. To help doctors determine whether depression is actually caused by or associated with hypothyroidism, depressed patients need to be screened for thyroid disorders. If hypothyroidism is present, diagnostic blood tests can confirm this diagnosis, specifically showing a low level of thyroxine (a thyroid hormone) and a high level of thyroid-stimulating hormone (TSH).
Studies show that if you have both hypothyroidism and depression, rather than relying on antidepressant drugs, your depressive symptoms may improve with thyroid-replacement medications such as Levothyroxin or Synthroid, which help increase the levels of triiodothyronine (also called T3) and/or thyroxin (T4) -- two major thyroid hormones in the body. In people with hypothyroidism and depression, thyroid-replacement drugs may not only relieve the feelings of depression, but also boost the effectiveness of antidepressant drugs. When thyroid pills lower TSH levels to the normal range, the symptoms of depression often subside.
Getting Help for Hypothyroidism and Depression
If you're feeling depressed, see your doctor. Because both hypothyroidism and depression can be treated successfully, a proper diagnosis -- including blood tests to measure thyroid hormone production -- is an important first step toward effective management. If symptoms that are associated with hypothyroidism and depression worsen, consult your doctor immediately.
SOURCES: Fountoulakis, K. BMC Psychiatry, March 15, 2004; vol 4: pp 6. Garber, J. Journal of Family Practice, June 2006; vol. 55: pp S1-8. Thyroid Foundation of America web site: "Depression and Thyroid Illness." WebMD Medical Reference: "Understanding Thyroid Problems." MedicineNet: "Hypothyroidism." National Institutes of Health web site: "Medical Encyclopedia: Hypothyroidism." Demet, M. West Indian Medical Journal, September 2003; vol 52: pp 223. Mayo Clinic web site: "Hypothyroidism." Altshuler, L. American Journal of Psychiatry, October 2001; vol 158: pp 1617.