An underactive thyroid can do more than slow your metabolism. For some people, hypothyroidism manifests with mental health symptoms like low mood, dysphoria, and anxiety. Addressing the underlying cause can help.
You have hypothyroidism when your thyroid gland doesn’t produce enough thyroid hormone to support your body’s function. Although thyroid dysfunction is often associated with metabolic function, it can lead to many other symptoms — both mental and physical.
Thyroid hormones affect
Hypothyroidism also has effects on your brain, including regulating the production of chemicals related to your mood, stress response, and focus.
Depending on your overall health and the severity of your condition, a variety of mental health symptoms are possible. These symptoms may include:
- a pervasive feeling of unease and discontent (dysphoria)
- depression
- anxiety
- brain fog manifesting as forgetfulness, difficulty concentrating, and slowed problem solving
- changes in mood
- mania, or periods of unusually elevated, agitated moods
In cases of untreated severe hypothyroidism, or in people with some mental health conditions, symptoms may also include:
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Common mental health diagnoses in people with hypothyroidism
Major depressive disorder (MDD), also known as clinical depression, is the
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Hypothyroidism is associated with more than just depression, however. Although not as commonly, it’s also linked to higher chances of developing anxiety disorders and bipolar disorder (BD).
This doesn’t mean hypothyroidism is always a direct cause of a mental health condition.
Although some evidence suggests the condition may play a role in MDD, its role in other mental health conditions is less clear. More research is necessary to determine the link between hypothyroidism and conditions like BD and schizophrenia.
Rarely, severe hypothyroidism can result in myxedema psychosis. This is a state of altered perception featuring:
- delusions
- hallucinations
- paranoia
- severe depression
- cognitive impairment
Causes of hypothyroidism are also associated with mental health symptoms. Hashimoto encephalopathy (HE), for example, is a rare autoimmune condition that professionals think may be related to Hashimoto thyroiditis. Although Hashimoto thyroiditis primarily affects your thyroid gland, HE affects your brain. Both conditions can cause hypothyroidism.
Mental health symptoms of HE can include:
- personality changes
- delusions
- hallucinations
- cognitive decline
The hormones your thyroid gland produces are essential to neurological (and other) processes in your body.
Among their many functions, thyroid hormones influence the regulation of mood-related neurotransmitters like:
Without enough thyroid hormones in circulation, the balance of these neurotransmitters is thrown off. This may result in mood symptoms like anxiety, depression, and dysphoria.
Thyroid hormones are also important to your brain’s metabolism, or how effectively your brain utilizes energy. Reduced thyroid function means brain metabolism slows down. With that, you may experience a decline in cognitive functions like memory and concentration.
Hypothyroidism can also reduce cerebral blood flow, or the amount of blood supplied to your brain. This can reduce available oxygen and nutrients, further contributing to mood symptoms and cognitive impairment.
Fatigue, weight gain, hair loss, and skin issues are also possible experiences of hypothyroidism. These — combined with the demands of doctor visits, testing, and coordinating life around a long-term condition — may negatively affect your mental well-being.
Addressing hypothyroidism is a big part of managing its associated mental health symptoms. With effective treatment, the physical and mental symptoms of hypothyroidism can improve.
In fact, supplementing your missing thyroid hormones with a synthetic (manufactured) version can completely control hypothyroidism and restore your body to its typical function.
If you have a thyroid disorder like Hashimoto thyroiditis, your management plan will include individualized therapies, such as immunosuppressant medications.
In addition to managing hypothyroidism, you may be able to improve related mental health symptoms by:
- getting regular exercise
- eating a nutrient-dense diet
- engaging in stress management techniques, like deep breathing, meditation, or progressive muscle relaxation
- learning more about the mental health symptoms of hypothyroidism to help you recognize and manage them
- limiting or eliminating substances that can affect your mood, such as alcohol
- joining support groups to connect with others with hypothyroidism and learn from their experiences
Even though hypothyroidism is a physical condition, speaking with a mental health professional about your psychological symptoms can help. Therapists can work with you to improve thought and behavior patterns that contribute to depression or anxiety, and they can provide guidance on coping skills and stress management strategies.
It’s possible that some mental health symptoms aren’t directly related to your hypothyroidism. A mental health professional can also help you assess the underlying causes.
Hypothyroidism may manifest with mental health and physical symptoms. Depression is a common experience among people with hypothyroidism, but anxiety, dysphoria, and psychosis may also be possible in some cases.
Treating hypothyroidism with medications can help. Working with a mental health professional can also help you develop coping strategies.