VERIFIED CONTENTAuthor: lek. Katarzyna Banaszczyk

Hypothyroidism is a common endocrine disease that affects a significant percentage of the population. It is a disease with a diverse clinical picture, which means that it is not always easy to diagnose. What psychiatric symptoms may result from an underactive thyroid gland? What to do in the event of their occurrence?

Hypothyroidism - what is it?

The essence of hypothyroidism is the deficiency of hormones produced by this endocrine gland. We are talking about thyroxine and triiodothyronine, which play a key role primarily in the regulation of our metabolism, but also in the secretion of other hormones - for example, growth hormone (i.e. somatotropin) and glucocorticosteroids produced by the adrenal glands.

In medicine, we most often deal with primary hypothyroidism, i.e. a defect of the thyroid gland itself. It is worth mentioning here that the most common cause of primary hypothyroidism is Hashimoto's disease, an autoimmune disease. In order to assess the efficiency of the thyroid gland, the level of its hormones in the blood is determined.

It is also important to determine the level of TSH - it is the so-called tropic hormone, which is responsible for stimulating the thyroid gland to produce thyroxine and triiodothyronine. TSH (or thyroid stimulating hormone) is produced by the pituitary gland.

Hypothyroidism - symptoms of the disease

Symptoms that are associated with hypothyroidism include:

  • weight gain;
  • sleepiness and general slowdown;
  • annoying feeling of cold;
  • dry skin;
  • constipation;
  • reducing the heart rate (i.e. bradycardia in medical terms);
  • fatigue and weakness.

You can definitely say that hypothyroidism is a multi-system disease, and its symptoms can be really diverse and also affect our psyche.

Hypothyroidism and depression

As shown by scientific reports, hypothyroidism (and especially its autoimmune inflammation, i.e. Hashimoto's disease) promotes the occurrence of depressive disorders. Let's recall the basic symptoms that cantestify to your developing depression. They mainly include:

  • deterioration of mood;
  • loss of the ability to feel joy (anhedonia);
  • loss of interest;
  • decreased activity and increased fatigue.

Importantly, hypothyroidism can be accompanied by severe and refractory depression called atypical depression. It is characterized by slightly different symptoms, which include mood swings, increased sleepiness and increased appetite.

Depression in Hashimoto's disease - causes

What is the reason for the increased risk of depressive disorders in autoimmune hypothyroidism? As scientific publications show, anti-thyroid antibodies, detected in people suffering from Hashimoto's disease, may be responsible for this.

Research has shown that increased levels of these antibodies correlate with the risk of developing depression. Therefore, it can be assumed that these antibodies are important in the pathogenesis of depressive disorders in the course of hypothyroidism.

Hypothyroidism may also increase the risk of postnatal depression.

Hypothyroidism and anxiety disorders

Anxiety disorders are a common ailment - it is believed that they may occur in up to 10% of people. population. Anxiety disorders are states that used to be called neuroses and are primarily emotional in nature. Neuroses are often associated with traumatic past experiences, including childhood.

Research shows that people suffering from hypothyroidism (primarily Hashimoto's disease) suffer from anxiety disorders more often than others. Which disorders from this group affect these patients more often?

Hypothyroidism and Obsessive Compulsive Disorder

A disorder from the group of neuroses that was significantly more common in patients with hypothyroidism was obsessive-compulsive disorder. The clinical picture of this disease consists of intrusive thoughts that keep recurring - these are called obsessions and the feeling of having to perform certain activities - this phenomenon is in turn called compulsions.

An example of an obsessive-compulsive disorder is washing your hands repeatedly for fear of microbes. People with this mental disorder may even suffer from damage to the skin of the hands.

Hypothyroidism and phobias

Another research worth presenting concerns the relationship between Hashimoto's disease and the occurrence of phobias. A phobia is a strong fear of contact with an object or situation. A phobic patient is aware of the irrationality of the perceived fear,however, he cannot control these emotions.

A particularly widespread phobia is social phobia, the essence of which is the feeling of strong anxiety during social exposure, that is, for example, when it is necessary to speak in public. Autoimmune hypothyroidism will increase the risk of developing phobic disorders.

Hypothyroidism and Generalized Anxiety Disorder

At the beginning of this paragraph, it is worth explaining what generalized anxiety disorders are. The essence of this disease is the constant feeling of fear and anxiety, as well as feeling threatened without an apparent reason. To recognize this individual, these sensations must last for at least 6 months.

Generalized anxiety disorders can also be accompanied by symptoms from the somatic side - for example, abdominal pain or pain sensation in different, different locations. Scientific reports show that generalized anxiety disorders are more common in people suffering from autoimmune hypothyroidism.

Hashimoto's encephalopathy - what is it?

Hashimoto's encephalopathy is the occurrence of disorders in the nervous system in patients with autoimmune thyroiditis. Thyroid antibodies, which are detected in the cerebrospinal fluid, are believed to be responsible for these abnormalities. The disorder is therefore autoimmune and results from immunological abnormalities.

This encephalopathy is more common in women, and its course is characterized by periods of exacerbation and clinical improvement. Hashimoto's encephalopathy responds well to steroid treatment, i.e. treatment that silences the immune system, which only emphasizes the essence of autoimmune disorders in the pathogenesis of this disease.

Hashimoto's encephalopathy - clinical symptoms

What are the symptoms of Hashimoto's encephalopathy? The following should be mentioned here, first of all:

  • disturbances of consciousness - i.e. disturbances in perceiving stimuli from the environment, as well as disturbances in perceiving oneself;
  • cognitive disorders - for example, concentration disorders or memory disorders;
  • stroke-like episodes - for example, muscle paralysis on one side of the body or sensory disturbances;
  • focal neurological disorders - an example of these are visual disturbances;
  • tremors;
  • epileptic seizures;
  • speech disorder;
  • behavior change;
  • psychosis - hallucinations can occur, i.e. incorrect perception of sensory stimuli, but also delusions, i.e. the presence of thoughts with incorrect content. An exampledelusions that may occur in the course of Hashimoto's encephalopathy are persecutory delusions - the patient is then convinced that, for example, someone is following him and wants to harm him;
  • personality changes;
  • insomnia or severe sleepiness;
  • weakness and increased fatigue.

Hypothyroidism and psychiatric disorders - summary

In conclusion, people suffering from hypothyroidism are more likely to develop mental disorders. Therefore, endocrinologists and family doctors caring for these patients should be alert to the possibility of such disorders. Balancing the hormonal balance, i.e. achieving the correct values ​​of thyroid hormones in the blood, does not mean that such a patient is no longer exposed to the possibility of a mental disorder.

If a mental illness is suspected, it is worth convincing the patient to a psychiatric consultation and to start appropriate treatment. Psychiatric disorders significantly reduce the quality of life of patients, so it is even more important to start appropriate treatment quickly.

Therapy with medication will not always be necessary, because in many cases - for example in the case of anxiety disorders, psychotherapy is usually sufficient treatment.

About the authorbow. Katarzyna BanaszczykA graduate of the medical faculty of Collegium Medicum in Bydgoszcz, UMK in Toruń. Currently, he is carrying out a postgraduate medical internship. Author of scientific articles and many educational articles aimed at disseminating medical knowledge.

Category:

Psychiatry