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When Your Thyroid Makes You Crazy! It's Not Always Mental Illness

Updated on August 10, 2013
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It’s not always depression or bipolar disorder. Sometimes it’s thyroid disease.

Something healthcare professionals, like doctors and nurses, are taught is that when mental illness is suspected, we must first rule out medical conditions that can be causing the problem. There are many medical illnesses that can and often do mimic mental illness. If medical illnesses are not ruled out and a mental illness is diagnosed instead, what happens with the medical illness? The answer to that question is quite simple: it does not get treated and the person gets sicker and sicker.

For example, the carotid artery supplies blood, oxygen, and nutrients to the brain. Over time, the carotid artery can narrow with plaque build up (fatty deposits, not plaque like what builds up on your teeth). The narrowing of the carotid artery prevents the brain from getting what it needs and can cause symptoms very similar to dementia, (e.g. Alzheimer’s disease). If the carotid artery is not checked and instead, a person is diagnosed with dementia, the artery can further narrow and eventually, the person may have a stroke. Truly heartbreaking, indeed.

What does this have to do with your thyroid?

The symptoms of hypothyroidism can very closely mimic the symptoms of depression, and the symptoms of hyperthyroidism can very closely mimic the symptoms of bipolar mania.

Let us take a look at some of those symptoms:

Hypothyroidism and Depression: Comparison of Symptoms

 
Hypothyroidism
Depression
Depressed mood
X
X
Fatigue
X
X
Increased sleeping
X
X
Crying spells, mood instability
X
X
Cold intolerance
X
 
Weight gain
X
X
Suicidal thoughts or behaviors
 
X
Feelings of worthlessness, hopelessness
X (Not as likely)
X (Likely)
Decreased energy
X
X
Decreased libido
X
X
Constipation
X
X
Lack of pleasure in life
X
X
Slowed responses
X
X
Puffy face
X
 
Muscle aches and pains
X
X
Heavier menstrual periods
X
 
Brittle nails and hair
X
 
Note the amount of overlap in the symptoms. This makes it difficult to differentiate the two and patients as well as health care providers may make a mistake in diagnosis.

Hyperthyroidism and Bipolar Mania: Comparison of Symptoms

 
Hyperthyroidism
Mania
Increased self-esteem
 
X
Decreased sleep
X
X
Anxiety
X
X
Irritability
X
X
Racing thoughts
X
X
Difficulty concentrating
X
X
Increased libido
 
X
Risky behavior
 
X
Muscle fatigue and weakness
X
 
Increased sweating
X
 
Increased resting heart rate
X
 
Sensitivity to heat
X
 
Tremor
X
 
Weight loss
X
X
Increased appetite
X
 
Increased bowel movements
X
 
Pressured speech (speaking rapidly)
X
X
Again, note the overlap. There are many commonalities.

As you can see, there is quite a bit of overlap. It is easy to confuse the symptoms of these two disorders, and most often, you will see someone being diagnosed with mental illness when he/she really needs treatment for an overactive or underactive thyroid. It is rare to see someone diagnosed with thyroid disease when he/she actually has mental illness alone. Why is that? Because there are lab tests to tell us when there is something wrong with the thyroid gland, but there are no lab tests for depression and bipolar disorder. Those diagnoses are based on symptoms.

If you think you may be suffering from thyroid disease, you may request lab tests from your primary care provider or your psychiatrist. Many psychiatrists will test the thyroid before diagnosing mental illness, so check with your psychiatrist to see if this has already been done. If your thyroid tests are abnormal it is extremely important that you see an endocrinologist. These doctors specialize in the treatment of thyroid and other endocrine diseases.

Why is it important to get thyroid disease treated?

Thyroid disease is very treatable. There are specific medications to treat hypothyroidism. There also are medications for hyperthyroidism (e.g. Synthroid, Levoxyl), in addition to outpatient radiation and sometimes surgical procedures (e.g. complete or partial removal of the thyroid gland). Medications for depression and bipolar disorder will not treat thyroid disease.

Untreated hypothyroidism can cause extreme weight gain (this often is enough to prompt most people to get treatment), but it also can cause a life-threatening condition called myxedema coma. Untreated hyperthyroidism can cause a life-threatening condition called thyrotoxic crisis, also known as thyroid storm.


It is extremely important that we advocate for our own health. If you think you or a loved one is suffering from mental illness or thyroid disease, get help immediately. Neither mental illness nor thyroid disease is something that will cure itself or go away with time and both can cause life-long and/or life-threatening conditions.

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    • profile image

      Skip2Molou 5 months ago

      I am a Grave's patient. 16 months on ATD MMI. Responsive but not entirely controlled, I am currently relapsed TSH 0.01. Anyway...saw my dermatologist for sparse rash. In his summary, he diagnosed Factitial Dermatitis. That means I have harmed myself in order to get medical attention. Wrong. I put hydrogen peroxide in my shampoo which caused the irritation on my hands.

      I was in a hyper state and irritated by the lack of understanding of the emotional impact this disease has had on my face my body and my soul.

      I'm not crazy. I'm hyperthyroid.

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 6 months ago from West Virginia

      Becky, You absolutely should go to the hospital. Any time you have chest pain, it needs to be addressed ASAP. Hyperthyroidism can cause heart problems, so please, go to the doctor/hospital immediately. Let us know how you're doing!

    • profile image

      Becky 6 months ago

      I have extreme burning and tingling sensations, bad muscle weakness, short of breath, red eyes, weird feeling in the back of my neck, along with diarrhea, no sleep.. I was diagnosed with depression..and now say I have hyperthyroid.. the sweating is awful and my veins are starting to protrude at times, I have sharp stabbing pains in my chest, now my toes draw up and have muscle twitching.. bad shaking hands when I hold something..I am not on meds yet.. I go in a week, what can I do for now.. I feel awful!! I am on Celexa 20 mg and fish oil, cut d3. My throat has pain! Been going on since June pretty bad!! I feel like my vitamins are depleted.. should I go to hospital?? It's getting way worse!!

    • profile image

      Ryan 2 years ago

      any advice for someone going from 150 of the levthrothoxin (sorry for wrong spelling ) to 100 , its about my mom but I'm noticing her talking about things that haven't happened or have happened in the past

    • profile image

      Kay 3 years ago

      New research has shown a link between bipolar disorder and a genetic thyroid disorder. Some doctors are saying it's because the lithium causes low thyroid because the people they are testing are already diagnosed with bipolar and have been on lithium, but it looks as if it may be that Thyroid regulation — causing both hyper- and hypothyroidism – is causing bipolar disorder. It certainly makes me think that they need to look at people who have unipolar depression as well.

    • nurseleah profile image
      Author

      Leah Wells-Marshburn 4 years ago from West Virginia

      Denise, thank you for your comment and for stopping by. I see this occasionally in my practice--patients treated for mental illness who actually have a physical disorder resulting in mental illness symptoms. It's such a relief to them to have their physical illness treated! There is a huge stigma related to mental illness, and it is one of my life's goals to help increase awareness and decrease social stigma. One step at a time, eh?

    • denise.w.anderson profile image

      Denise W Anderson 4 years ago from Bismarck, North Dakota

      With a history of both thyroid disease and mental illness in our family, I have counselled my children and others to regularly get their blood checked, especially when they are experiencing either mental health or physical health issues. Once they know that their thyroid is normal, then we can address the mental health problems. Thanks for bringing this very important issue to the forefront.