Low Thyroid: An Illness That Feels Like Depression

Colette Dowling, LSMW

I first discovered I had low thyroid when I was about 50. I became so foggy and fatigued I could barely sit upright at my computer. I was tired when I woke up in the morning. It had been developing for months without my knowing what was going on. I blamed it, like everything else, on menopause. When a smart doctor decided to test for a thyroid problem and put me on a synthetic hormone medication, my life went back to normal in a matter of weeks. What a relief! I'd been readying myself for the old age home.

Low thyroid, or hypothyroidism, develops when the thyroid gland doesn't produce enough of the hormone, which controls the way the body uses energy. Thyroid hormone affects all body systems. People whose thyroid level is too low feel sick. Their symtoms are chronic fatigue, cold extremities, thinning hair, hoarseness.

Women are particularly vulnerable to developing low thyroid and their risk increases with age. Older women are the most vulnerable, though it certainly happens in younger women and can even interfere with getting pregnant. In rare cases, hypothyroidism occurs in infants and children. Untreated in infants it can cause brain damage, leading to mental retardation and developmental delays. Today, every state in the U.S. tests newborns for hypothyroidism.

Teens with low thyroid typically look much younger than their age. Once treated, though, an adolescent will catch up with his or her normal weight and height.

In adults, when hypothyroidism goes untreated it can eventually cause severe complications, including fluid around the heart and an increase in cholesterol and triglycerides (increasing the risk of coronary artery disease and stroke). Severe hypothyroidism can cause a life-threatening condition called myxedema coma. In the days of the old psychiatric asylums, many of the patients on the back wars who were thought to be cretins actually had untreated hypothyroidism.

What are the symptoms of low thyroid?

First, they can occur throughout the body. In adults, symptoms usually develop slowly and are often mistaken for part of the aging process. Symptoms may include:

Coarse and thinning hair. Brittle nails. Dry skin. A yellowish tint to the skin. Slow body movements and speech. Inability to tolerate cold. Feeling tired, sluggish, or weak. Memory problems, depression, or difficulty concentrating. Constipation. Heavy or irregular menstrual periods that may last longer than 5 to 7 days. Other, less common symptoms may include an enlarged thyroid gland (goiter), modest weight gain, a hoarse voice, muscle aches and cramps, a puffy face, and swelling of the arms, hands, legs, and feet.

What causes hypothyroidism?

Hashimoto's thyroiditis is the most common cause of hypothyroidism in this country. Other causes include surgical removal of the thyroid gland, radioactive iodine therapy, and thyroiditis after childbirth.

Less common causes include

* Viral and bacterial infections of the thyroid gland. * Problems with the pituitary gland or the hypothalamus (areas of the brain that produce hormones). * Too little or too much iodine in the diet (rarely seen in Western countries). * Some medications, including lithium carbonate and interferon alfa. * Congenital hypothyroidism (present from birth).

How is the illness diagnosed?

If you or your health professional think you may have low thyroid, or hypothyroidism, you will have blood tests to measure your thyroid hormones. If you have no or mild symptoms of hypothyroidism and blood tests show slightly abnormal levels of thyroid hormone, you may have mild (subclinical) hypothyroidism. This, too, can cause havoc with mood and fatigue.

How is it treated?

Simply, hypothyroidism is treated with thyroid hormone medication. Symptoms usually disappear within a weeks after treatment begins. Most people who develop hypothyroidism need treatment for the rest of their lives.

Can I prevent it?

You can't prevent low thyroid from happening, but you can watch for signs of the disease so it can be treated promptly. The American Thyroid Association recommends that all adults be tested beginning at age 35 and continuing every 5 years.

High risk-women older than 60, and anyone with a family history of thyroid disease or who has other autoimmune diseases, may want to be screened.

NYC psychotherapist Colette Dowling, LMSW, has a private practice in Manhattan. She is a graduate of The Smith College School for Social Work and has done advanced training in psychotherapy at the Institute for Contemporary Psychotherapy, in New York.

Colette has written many books on women's psychological and health issues, including The Cinderella Complex: Women's Hidden Fear of Independence and "You Mean I Don't Have to Feel this Way?": New Help for Depression, Anxiety and Addiction.

In her therapy practice,Colette specializes in the treatment of women. If you are interested in having a consultation write her at dowlingcolette@earthlink.net, or call718-594-0201.

To hear Colette speak about what it's like starting therapy with someone new, click on the button.

Information on Colette's therapy practice can be found at Psychology Today.

Further information on women's physical and mental health issues can be found at Colette's website.