For such a small gland, your thyroid has a big job. It makes hormones that control how your body uses energy. These hormones affect your breathing, body temperature, heart rate, digestion and cognition. And the more hormones this mighty gland releases, the faster those systems function.
So what happens when something is amiss with your thyroid? Well, your entire body can feel “off,” says Linda Lester, MD. She’s an endocrinologist at Oregon Health & Science University in Portland. Drastic and seemingly unrelated changes can happen to your weight, energy and mood. And, yes, it can even lead to symptoms of depression.
About 20 million Americans have some form of thyroid disease, according to the American Thyroid Association. And what’s worse: Up to 60% of people with a thyroid condition may not know it.
If you’ve been diagnosed with depression, here’s what you need to know about the role your thyroid may play. (And if your conditions require medication, Optum Perks can help you save. Download our app today.)
Types of thyroid imbalances
Your thyroid is a butterfly-shaped gland at the base of your neck. It produces and releases hormones at a steady rate to keep your body humming along as it should. But certain conditions can cause hormone imbalances, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Two common thyroid problems are hypothyroidism and hyperthyroidism.
- Hypothyroidism happens when your thyroid doesn’t make enough of the hormones your body needs. When the gland is underactive, some of your body systems can slow down. Common symptoms are fatigue, weight gain, dry skin or dry hair, and a slower heart rate. It’s typically treated with replacement thyroid hormones that you take as a pill, such as levothyroxine (and, less commonly, liothyronine).
- Hyperthyroidism is when your body overproduces thyroid hormones. When you have an overactive thyroid, some body systems can speed up. Some common symptoms can be trouble sleeping, weight loss, mood swings and an irregular heartbeat. Treatments include beta-blockers (to relieve symptoms fast) or antithyroid medicines such as methimazole. These help your thyroid pump out less hormones.
Both conditions are more likely to happen to women and those who are over the age of 60. Other risk factors include a family history of thyroid disease or certain health conditions such as type 1 diabetes.
The thyroid and depression connection
Experts aren’t exactly sure why, but thyroid issues can bring about symptoms of depression. In fact, a 2021 study published in Clinical Endocrinology found that people with hyperthyroidism at the start of the study were more likely to develop depression 4 years later than those with normal thyroid hormone levels.
“Depression is more commonly seen with hypothyroidism but can also be seen with hyperthyroidism, along with anxiety and agitation,” says Dr. Lester. And that’s especially true in older adults. For example, younger people with an overactive thyroid may show signs of anxiety. This includes restlessness and chronic worry. But older adults may appear more apathetic.
What that looks like to an outside person, says Dr. Lester, is someone who sits quietly and doesn’t engage much in conversation, has slowed body movements or doesn’t move much. Or they sit with an inexpressive facial expression, something she says is often dubbed a “masked face” or “flat effect.”
So do depression and thyroid conditions always go hand in hand? Certainly not. In fact, it’s thought that most people with depression have normal thyroid function, a review published in the Journal of Thyroid Research found.
Depression can be caused by many different factors, says the National Institute of Mental Health. A family history of depression, trauma, stress and a wide range of health conditions or medications can all play a role. We answer your top questions about treating depression here.
Why a correct thyroid diagnosis matters (and how to get one)
Trouble sleeping, feeling low energy, changes in weight. Yep, these are some of the symptoms that depression and thyroid disorders can share. And that can make it hard for your doctor — and you — to tell the difference. But it is important to have an accurate diagnosis.
