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Why Am I So Tired? The Thyroid and Depression
Kylie Roessner RN-BSN
If you find yourself reaching for an extra cup of coffee or pining for a nap between Zoom calls, you can often point to the reason: an early wake-up time, a series of especially busy days, or maybe even a late-night Netflix binge. But if you're not feeling refreshed after a good night's sleep, there may be something else causing your tiredness and lack of energy. If your fatigue is paired with a persistent low mood, depression is one possible explanation, but it's not the only one. Issues with the thyroid gland can also cause tiredness and low mood. Hypothyroidism is a common contributing factor in mood changes, especially among women and older adults. Hypothyroidism and depression can also have a significant overlap in symptoms, and both require medical attention, so it's important to see a doctor for an evaluation if you're experiencing symptoms of one or both.
What Is the Thyroid?
The thyroid is a shield-shaped gland in the front of the neck, just behind the Adam's apple. It releases hormones that affect every cell of the body. The thyroid contributes to several bodily functions, including telling the body how to use calories, regulating body temperature, speeding up and slowing down heart rate, helping muscles contract, regulating how fast food moves through the digestive system, and managing how quickly cells regenerate. When the thyroid stops working as it should, typically due to factors such as medications, age, genetics, or autoimmune disease, it can cause a host of problems related to body functions and sense of well-being, including mental health.
The Thyroid and Depression
Hypothyroidism occurs when the thyroid is not secreting enough hormones, which can result in a number of symptoms that overlap with those of depression, including:
- Fatigue
- Weight gain
- Low mood
- Difficulty concentrating
These symptoms are so similar to those of depression that they often lead people to believe they have Major Depressive Disorder (MDD) instead. But while the presentation of a depressive episode caused by hypothyroidism and one cased by MDD may be the same, the diagnoses are different; with hypothyroidism, the depressive episode is related to low serum thyroid hormone levels, but with MDD, the direct cause is unknown. In addition, the effects of hypothyroidism can worsen pre-existing depression. There are other symptoms of hypothyroidism that don't overlap with depression, such as constipation, feeling cold all the time, stiff muscles, cramping, and hair loss. Being aware of the symptoms of hypothyroidism and depression can enable you to paint a more complete picture of your condition for your doctor so they can help you get the treatment and care you need.
The Impact of Hyperthyroidism
Hyperthyroidism, on the other hand, is when the thyroid produces too much thyroid hormone. In a lot of ways, it's the opposite of hypothyroidism. Instead of causing a slow metabolism, hyperthyroidism can cause the metabolism to operate too quickly, making it difficult to gain and retain weight. Instead of feeling depressed, you may feel anxious or nervous with hyperthyroidism. You might also experience heart palpitations, difficulties with sleeping or tolerating heat, and muscle weakness. Anxiety is the most common mental health concern caused by hyperthyroidism, with 60% of hyperthyroidism patients reporting it. However, hyperthyroidism can also occasionally cause depressive symptoms, especially among elderly people. People with hyperthyroidism can also develop a large thyroid, or goiter, in the neck. It may also lead to Grave's ophthalmopathy, which causes the eyes to bulge out of their sockets. If you notice any of these symptoms, it's important to contact your doctor for further evaluation.
Diagnosis and Treatment
The good news is that the diagnosis of thyroid conditions is relatively simple, typically consisting of a blood test. From there, treatment is also fairly straightfoward, though it is usually life-long and may require regular checkups to ensure that the dosage is appropriate. Treating thyroid conditions can effectively moderate depressive symptoms caused by the thyroid and prevent other health problems associated with thyroid issues. In addition, thyroid disease treatments are sometimes used alongside antidepressant medications as mood boosters, even when a blood test shows normal thyroid function, according to Harvard Medical School. The potential relationship between the thyroid and depression underlines the importance of a comprehensive physical exam for fully addressing your symptoms. It's a classic case of a sound body contributing to a sound mind.
If you are seeking relief from depression symptoms, remain persistent in your search. Thyroid medications, antidepressants, and non-drug treatments like Transcranial Magnetic Stimulation (TMS) have all been shown to improve quality of life for people with depression. Talk to your doctor about which treatment option may be the best fit for you.
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At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. 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Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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