Depression versus Thyroid Issues, revisited

Currently, the first thing many doctors do when a patient complains of things such as fatigue, mood changes/instability, and/or loss of interests in activities is to require blood work to check thyroid function. It wasn't always this way. About 15 years ago, a primary care physician (who does not require specialized psychiatric training to practice medicine) would prescribe an antidepressant and send the patient out the door, without specialized treatment by a psychiatrist.

Today, things have changed. More awareness of how the physiological symptoms present themselves and what this indicates (a true body-system issue or a psychological issue presenting as a body-system issue) has vastly improved the treatment of the symptoms already mentioned. To revisit how depression and thyroid dysfunction mimic one another, I have revisited and revised a list of symptoms commonly seen in either of the two disorders. They are as follows:

•  I feel depressed, my moods change easily, I have feelings of worthlessness, I have difficulty concentrating, I seem to be losing interest in normal daily activities 

-  or  -  I have more feelings of sadness (all of these also qualify under the listing of Major Depressive Disorder Diagnosis)

•  I'm more forgetful lately


•  “I am gaining weight inappropriately” (*note from blog author: this is assumed to mean that you are eating and exercising in your usual way, and are gaining weight anyways)
     - OR - I'm unable to lose weight with diet/exercise

• I am constipated, sometimes severely

• I have low body temperature (feeling cold when others are "fine" or even if they're hot)

•  I feel fatigued, exhausted (*blog author adds that this is not due to change in sleep schedule or number of hours slept regularly)

• OR  - Feeling run down, sluggish, lethargic 
• Conversely, also, Feeling Restless may be an indicator 

•  My hair is coarse and dry, breaking, brittle, falling out -- AND/OR -- My skin is coarse, dry, scaly, and thick 

• My voice has a raspy sound to it

• My eyes and/or face have swelling/puffiness

•  I have pains, aches in joints, hands and feet

•  I have developed carpal-tunnel syndrome, or it's getting worse

•  (FOR WOMEN) I am having irregular menstrual cycles (longer, or heavier, or more frequent) – OR - I am having trouble conceiving a baby  

•  Other symptoms commonly associated with hypothyroidism patients:

·        My hair is falling out

·         No sex drive  (*blog author notes that this may also include a dramatic shift in sex drive, not necessarily "NO" sex drive)

·         Getting more frequent infections, that last longer  (such as recurrent sinus infections)

·         Snoring more lately  - AND/OR - I have/may have sleep apnea 

·         I feel shortness of breath and tightness in the chest 

·         I feel the need to yawn to get oxygen 

·         My eyes feel gritty and dry  - AND/OR -  My eyes feel sensitive to light 

·         My eyes get jumpy/tics in eyes, which makes me dizzy/vertigo and have headaches 

·         I have strange feelings in my neck or throat 

·         I have tinnitus (ringing in ears)  - AND/OR - I have vertigo 

·         I feel some lightheadedness 

·         I have severe menstrual cramps          


source from original article: about.com

Note that many of these symptoms are often diagnosed by primary care physicians as other issues (sleep disorders, autoimmune dysfunction, or somatic complaints (e.g. "there's really nothing wrong, you just think there is"). The fact that the community of medical professionals is required to stay abreast of new research and many choose to apply the findings to patient care is vital to continued treatment of psychiatric and physical issues alike.

This type of thinking is now spreading to the community of mental health professionals. I spent 45 minutes on the phone with a clinician yesterday justifying the need for mental health treatment for my child in consideration of the fact that the mental health symptoms she experiences developed 9 years before the physical symptoms manifested themselves in a manner which could be "seen by the naked eye." Treatment for physical and mental health issues isn't so cut-and-dry anymore.

We, as a treatment and consumer community are experiencing a movement toward whole-body healing, a holistic approach to treatment, and a long-term overarching goal of "highest quality of life" as the bar at which treatment is measured.

I, as a parent and as a clinician, am both hopeful and hesitant to see what develops as a result, yet ecstatic that this movement is finally taking place. It is long overdue.