Hypothyroidism is a disease that develops as a result of a decrease or lack of production and blood thyroid hormones. The latter produces two main hormones – triiodothyronine and tetraiodothyronine , which are called T3 and T4 for simplicity. “Guides” the production of thyroid hormones thyroid-stimulating hormone of the pituitary gland (TSH). If T3 and T4 become low, then the pituitary receives a signal, and the level of TSH in the blood increases, which stimulates the production of thyroid hormones.
Symptoms of hypothyroidism: weakness, constipation, hair loss
In adults (more often women) hypothyroidism is manifested by fatigue, changes in blood pressure, disorders of the digestive system, excessive sensitivity to cold, hair loss, weight gain that is difficult to lose, dry skin, menstrual disorder, swelling, as well as weakness, fatigue, reluctance to do anything and depressed mood. These latter symptoms bring hypothyroidism closer to depression, which is also characterized by similar manifestations.
Naturally, doctors and patients are wondering if there is a link between depression and hypothyroidism, and how to distinguish between these two conditions. In addition, they can be combined in one patient. It is logical to assume that before treating depression the patient should check the level of thyroid hormones (with hypothyroidism, the level of T4 is reduced, and TSH is increased), and vice versa – if under the influence of hormone replacement therapy, which is used for hypothyroidism, symptoms of depression do not pass, refer the patient to psychotherapist.
How often do hypothyroidism and depression
The relationship between depression and hypothyroidism has long been identified. Statistics show that depression develops in 40-66% of patients with hypothyroidism. And some experts believe that depression in hypothyroidism is more common than in the general population, regardless of how well hypothyroidism is treated.
Russian scientists conducted a study in which patients with hypothyroidism were asked to answer the questions of the Hamilton test (a questionnaire to detect depression). It turned out that moderate depression occurred in 72.9% of patients with overt symptoms of hypothyroidism. The authors came to the conclusion that the signs of depression are the initial manifestations of hypothyroidism. On the other hand, implicit hypothyroidism is diagnosed in 9–52% of patients with depression.
Signs of Depression Against Hypothyroidism: Anxiety
Depression is characterized by reduced mood, loss of the ability to enjoy life, loss of interest in things that previously could be carried away, decreased activity, vigor, slowed thought processes, decreased performance, decreased attention and memory, feelings of guilt, thoughts of their own uselessness and worthlessness, insomnia or drowsiness. In severe cases, it comes to reluctance to live and thoughts about suicide.
According to doctors, on the background of hypothyroidism, depression is more severe. Often there is the so-called astenodepressive syndrome, when the symptoms of depression are combined with asthenia, that is, weakness, lack of strength. It manifests itself as irritability, tearfulness, and at the same time, lethargy of emotions, lack of initiative , inhibition of physical and mental activity.
Patients with hypothyroidism are also peculiar anxiety, even panic attacks. They talk more actively about their complaints than patients with depression without hypothyroidism. In the absence of hypothyroidism, patients often have a pessimistic mood, low self-esteem, whereas hypothyroidism is not characteristic of pessimism, but there is a tendency to hypochondria – fear of complications, fear that the treatment will not work.
Treatment of depression in hypothyroidism
Researchers have found that antidepressant treatment is less effective if depression occurs in the setting of hypothyroidism. In a third of patients after the elimination of hypothyroidism, no signs of depression are observed. However, with the addition of triiodothyronine to thyroxin treatment, that is, the actual hormone T3, depression occurred in 90% of cases.
It is important to note that both diseases respond well to treatment, although they are treated differently. And you can get rid of that and the other. If there are symptoms of depression, it makes sense to turn to a psychotherapist who, if the treatment fails, will refer the patient to an endocrinologist to check the level of thyroid hormones. A competent doctor is able to pick up such antidepressants that will relieve the state of depression, if it persists after the treatment of hypothyroidism for three to four months.
The link between depression and hypothyroidism
Some doctors call the thyroid gland the “battery” of our body. With the insufficiency of its hormones, all processes, including metabolism, slow down, thermoregulation is disturbed. Most of all, it is the nervous and digestive systems that suffer from hypothyroidism. It is not for nothing that in case of congenital hypothyroidism in children, in the absence of timely treatment, mental retardation develops. The normal functioning of the thyroid gland makes people energetic, active. And with a lack of her hormones, lethargy, weakness, depressed mood and other signs appear.
Depression, to put it simply, develops with a deficiency in the body of a substance called serotonin. In hypothyroidism, there is a violation of the metabolism and the production of certain mediators (serotonin also belongs to mediators). Symptoms of depression will overlap with signs of hypothyroidism. But the intake of properly selected antidepressants can get rid of depression, as well as the intake of synthetic thyroid hormones allows you to get rid of hypothyroidism. Thus, both diseases are connected not only by the clinical picture (partially), but also by biochemical changes in the body. By the way, interestingly, an excess of thyroid hormones (hyperthyroidism) can also cause symptoms of depression.