Symptom Management: Depression

Introduction 

Hey, welcome back to the Thyroidcafe. I’m sorry we missed a week. I was sick with a cold. But also, I may have opened a box… belonging to Pandora. Depression is a complex and deep topic, so I won’t be able to talk about it fully. I hope to shed some light on why thyroid disease can cause depression and some treatment options.  Okay, let’s unmask these two bandits.

Depression and thyroid disease

One of the first things I learned about my birth family was that my grandmother had Hashimoto’s disease. For years she struggled to find the right medication. Turns out, what was thought to be depression, was untreated Hashimoto’s disease. This is a common case. Depression and Thyroid disease mimic each other so well, it’s hard to determine who the real culprit is. To make matters more murky, those with Hashimoto’s disease and hypothyroidism are 31-69% more likely to have depression* Fortunately, Thyroid disease has been associated with depression since 1873, so there’s a ton of research about it

Bandit #1: Thyroid disease

This slippery sucker seems like an easy catch. Every study I read, said depression should improve once thyroid pills are taken. But you know I give major side-eye to the “Magic Little Pill Theory”. Pills aren’t magic, but they can be one of the steps to treating depression. Some depression treatments work for improving your thyroid health as well. Lifestyle and diet changes, physiotherapy and exercise are all weapons against both baddies.   

The hormones involved in thyroid disease (Thyroxine (T4),  Triiodothyronine (T3) and Triiodothyronine (rT3) and Thyroid antibodies etc.) are abnormal in those with depression, even if they do not have thyroid disease. Doctors have been using thyroid hormones to aid anti-depression therapy since the 1960’s. So these two bad bandits are also best friends. Your T4 and T3 levels are the two that seem to be linked to depression. So I recommended desiccated medication in Fundamentals of Medication. I talked to my doctor, and am making the switch myself. Wish me luck, reviews to come. Doctors are also using neuroimaging to track down the exact location of these masked mad men. If you want to read about it, see “Sources” below.

Bandit #2: Depression

If your thyroid hormones optimized, but depression continues, we may have another bad guy to catch. (okay, I’ll stop with the crime fighting) Depression is a diagnosis, not a mood. Your doctor will  test to evaluate if you have it and which type. Then make a treatment plan. As per life, it takes time and trying. Typical treatment options are:

  1. Psychotherapy: It can be what works for you: group therapy, online, workbook or in a group.  
  2. Lifestyle changes: 30 mins walking has been proven to help reduce depression, dietary changes, alcohol and drug management, and  journaling 
  3. Medications: There are many out there. Talk to your doctor about side-effects, length of time you expect to be on them, and the risks in stopping the medications. 
  4. More information

Killing my Bandits

All this studying and struggling with depression led to two conclusions. One, it’s not just “all in my head.” There are legitimate physiological reasons thyroid warriors fight depression. Two, what works for some, may not work for me- for now. While I try to be open, there are steps I am not ready to take. One may obsessively write *blushes awkwardly,* another may exercise improves their depression. Either way, we take up the sword. That’s why we have this community. So we can exchange ideas and take up arms together. 

Conclusion

Depression and thyroid disease have long been associated. The shame of past generations is slowly raising its head and staring these illnesses in the eye. While getting the proper dose of thyroid medication has been proven to improve depression, the battle doesn’t stop there. If you feel you need more help, chat with your doctor about your options. Choosing to switch to desiccated pills may help, along with lifestyle changes and other medications. Whichever way you fight, continue to be your own thyroid advocate.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246784/

https://academic.oup.com/jcem/article/83/9/3194/2865402

https://www.liebertpub.com/doi/abs/10.1089/thy.1998.8.951

https://www.sciencedirect.com/science/article/abs/pii/S0022399905000875

https://www.karger.com/Article/Abstract/127099

*Trzepacz PT, McCue M, Klein I, Levey GS, Greenhouse J. A psychiatric and neuropsychological study of patients with untreated Graves’ disease. General Hospital Psychiatry. 1988;10(1):49–55. 

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