Reviewed by: Yang Xueling (Zhujiang Hospital, Southern Medical University)
When you have a doctor who suspects depression, your doctor may ask you to do a blood test. You may have the question: Isn't depression a mental illness? Why do you need a blood test? This is because some physical disorders can cause depressive symptoms, for example, hyperthyroidism or hypothyroidism can cause mood problems.
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1. What is the relationship between thyroid function and depression?
The thyroid gland produces and regulates thyroid hormones, which can affect energy levels, mood, weight, digestion, absorption of food, sexual function, etc.
When the thyroid gland produces too many hormones, the body consumes energy faster than expected, which is called "hyperthyroidism" (hyperthyroidism). The following manifestations are associated with hyperthyroidism:
Goiter;
Intolerance to heat;
Low menstrual flow and long menstrual period;
Irritability or nervousness;
Rapid heartbeat;
Muscle weakness or tremor;
Sleep disorders;
Frequent bowel movements;
Weight loss.
When the thyroid gland does not secrete enough hormones, the body slows down to consume energy, which is called "hypothyroidism" (hypothyroidism). The following symptoms indicate the possibility of hypothyroidism:
Dry and rough skin and hair;
Fatigue;
Forgetfulness;
Excessive menstrual flow, short cycle;
Hoarseness;
Susceptibility to colds;
Weight gain;
Goiter (goiter).
Some symptoms of hyperthyroidism and hypothyroidism, such as fatigue, irritability, weight changes, and sleep problems, may be similar to depression.
Doctors have blood tests to determine hormone levels, including:
Thyroid-stimulating hormone (TSH) released by the pituitary gland;
Triiodothyronine (T3);
Thyroxine (T4).
2. What causes thyroid disease?
About 20 million Americans suffer from thyroid-related diseases. People of all ages are at risk of developing thyroid disease. Women are 5-8 times more likely to develop thyroid disease than men.
There are many causes of hyperthyroidism or hypothyroidism.
Hypothyroidism can be caused by:
Thyroiditis, inflammation of the thyroid gland can affect the level of thyroid hormone production;
Hashimoto's thyroiditis, a painless inherited immune system disease;
Postpartum thyroiditis, which can occur in 5% to 9% of pregnant women, is usually temporary.
Caused by certain drugs (such as lithium carbonate and amiodarone), or side effects of iodine deficiency.
Hyperthyroidism can be caused by:
Graves' disease, goiter (also known as diffuse goiter);
Nodules formed in the thyroid gland can cause it to be overactive;
thyroiditis, an inflammation of the thyroid gland that can cause the release of stored hormones (if thyroiditis leads to the release of almost all hormones, hypothyroidism can occur);
Excess iodine may be present in some drugs and some cough syrups.
3. How to treat thyroid diseases?
In the treatment of hypothyroidism, levothyroxine or triiodothyronine is commonly used clinically. Among them, levothyroxine is a synthetic hormone that replaces the thyroid hormone that is missing in the body. The two drugs can sometimes be used in combination.
Hyperthyroidism is more difficult to treat. Radioactive iodine therapy is the most common treatment but may cause hypothyroidism. Therefore, after receiving the relevant treatment, doctors often recommend taking levothyroxine to normalize hormone levels.
Fourth, women's hormone changes make them closer to depression
As mentioned earlier, women are more likely than men to develop thyroid disease, and women are more likely than men to be diagnosed with depression. From a biological point of view, women are more likely to develop hormone-induced depression.
During menstruation, estrogen, etc. fluctuate, causing some women to experience depression-related symptoms such as sadness, irritability, and fatigue before menstruation, which are often part of PMS. There is also a more serious emotional problem associated with menstruation called premenstrual anxiety disorder (PMDD).
During pregnancy, hormonal changes can cause physical and emotional changes. After pregnancy, hormone levels in a woman's body change dramatically, which can be one of the triggers for postpartum depression. Up to 80% of women develop mild depression immediately after childbirth, but usually disappears quickly; 10% to 20% of new mothers develop depression.
Perimenopause and menopause, women also experience changes in hormone levels, may experience symptoms such as fatigue, sleep disturbances, weight gain, skin changes, and may induce menopausal depression.
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