Deepa Nayak (name changed), a Mumbai-based entrepreneur, recently discovered that she had thyroid cancer. “I had absolutely no idea that this could have even been a possibility,” confesses Nayak, who has been on medication for hyperthyroidism. She also says that she has been dealing with mood swings and depression and had addressing it with therapy and medication.
The connection between emotional regulation and the thyroid gland is something many thyroid patients must relate to. The hormones produced by the tiny, butterfly-shaped gland located at the front of our neck regulate a lot of our bodily functions, including metabolism, growth, digestion and development. And the overproduction or lack of these hormones can lead to disorders, such as depression, anxiety, mood swings, and poor stress response, among other things.
To mark thyroid awareness month, January, we explore the connection between the two. Dr Ashok Kumar Jhingan, Senior Director, Centre for Diabetes, Thyroid, Obesity & Endocrinology at the BLK-Max Super Speciality Hospital in Delhi, talks about the function of the thyroid gland. According to him, the small gland plays a crucial role in managing functions like heart rate, breathing, digestion, body temperature and brain development. Dr Aasim Maldar, a consultant endocrinologist and diabetologist at the PD Hinduja Hospital & MRC, Mahim sheds some more light. He states that the thyroid gland helps in the production of heat and energy by maintaining basal metabolic rate, muscle function, bone health, skin and hair functioning and reproductive health. The thyroid hormones are critical for the normal development of the brain during foetal life and infancy. It is also needed for normal growth and puberty in children.
The thyroid also plays a significant role in regulating mental health. “Whatever your type of thyroid disorder, it can make you feel more emotional than you felt before and you may find that your mood changes, sometimes rapidly and unpredictably,” shares Dr Manish Jain, a consultant psychiatrist at BLK-Max Super Speciality Hospital. He adds that anxiety, depression and even psychosis have been related to either hypo or hyperthyroidism. “Moreover, there are studies which reveal that in patients with depression, the active form of thyroid hormone T3 levels can be low which prevents an adequate or good response to antidepressants,” he shares.
Dr Sweta Budyal, a consultant at the Fortis Hospital Mulund, who is associated with the hospital's Diabetology & Endocrinology, explains that thyroid hormones also impact various neurotransmitters (chemical messengers in the brain) in different areas of our brain, playing a crucial role in memory, learning, emotions, judgement, mood, and cognition. While hyperthyroidism could manifest as anxiety, irritability, frequent mood changes, difficulty in focusing, muscle weakness and headaches, hypothyroidism may present with slowing of thought and speech, impaired learning, depression, decreased attentiveness, memory issues and apathy.
So how do you manage your mental health if dealing with a sluggish or overactive thyroid gland? Getting treatment initiated for the underlying thyroid condition is very often the first step towards the resolution of the symptoms but recovery takes time. “ Until such a time, there are some ways to handle emotional issues- talk to your endocrinologist/ physician, and if needed get in touch with a therapist. A mental health professional can help with issues regarding difficulty eating or sleeping, and can also help work through the emotional issues,” advises Dr Maldar.
It also is a good idea to actively work on managing stress by making time for activities which you enjoy, or by practising meditation. Eating healthy food, and making exercise a priority helps improve metabolism and makes you feel good about yourself. “People with thyroid disease should take care of their mental health through open communication," adds Dr Jhingan. “Learning to say how you feel and seeking help is essential.”
After Nayak had a thyroidectomy and began thyroid replacement therapy, she began significantly feeling happier and calmer. “I feel like I have more control over my mood, my feelings and my personality than I did before. Of course, I still do have episodes of irritability and frustration but I can course-correct easily,” she says.
Tips to manage mental health better
Manage your diet
Eat a balanced diet. People with hyperthyroidism should avoid seafood and iodine-rich foods Patients on thyroxine supplements should avoid taking soy, iron or calcium supplements, and antacids.
Take supplements if indeed
It is always better to talk to your doctor about taking a multivitamin (like biotin) and mineral supplements, as some can affect the laboratory results of thyroid tests.
Manage your stress and weight
Stress can cause thyroid hormone resistance, while higher body weight means more thyroxine requirement. Thus, reducing stress and maintaining a healthy weight are important.
Exercising three to five times a week increases muscle mass, boosts metabolism, and can help to avoid weight gain and lethargy.
Take medication regularly
Maintain proper compliance with your thyroid medication and schedule regular follow-ups with your physician
Divya Naik is a Mumbai-based therapist