When we think of anxiety, mood swings, insomnia, or restlessness, we often assume the cause lies within the mind. But what if the real culprit is not psychological, but physiological? What if a small gland in your neck, the thyroid, is silently driving those mental health symptoms?
Hyperthyroidism, a condition where the thyroid gland becomes overactive and produces excessive thyroid hormones, is known for its impact on metabolism and energy levels. But what’s less talked about is its strong link to mental health. These hormones don’t just regulate bodily functions; they play a significant role in brain chemistry and emotional well-being, too.
To understand this connection better, we spoke with Dr Sandeep Vohra, Psychiatrist and Founder of NWNT.AI, who explained how hyperthyroidism can manifest as psychiatric symptoms and why timely diagnosis is crucial.
When the Body Mimics the Mind
The overlap between endocrine disorders and psychiatric conditions is not new, but it’s gaining much-needed attention. In recent years, research has increasingly highlighted how thyroid dysfunction, particularly hyperthyroidism, can closely mimic mental illness.
“A person with hyperthyroidism may present with restlessness, anxiety, irritability, sleep disturbances, or even manic-like behaviour. These symptoms can easily be mistaken for psychiatric disorders like generalised anxiety disorder, panic disorder, or bipolar disorder,” said Dr Vohra.
A 2022 meta-analysis in Translational Psychiatry found that patients who suffered from hyperthyroidism had 1.67-fold higher chances of being depressed compared to normal thyroid function patients. It is not a mere statistical observation, it is an actual diagnostic challenge in clinics worldwide.
More revealing, however, is the overlap of bipolar disorder and hyperthyroidism. "The manic phase of bipolar disorder, marked by rapid thoughts, impulsivity, insomnia, and heightened energy, mirrors the symptoms of an overactive thyroid. Unfortunately, many individuals are prescribed psychiatric medications without undergoing basic thyroid screening, leading to prolonged suffering and mistreatment," he added.
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Why It Matters
This misdiagnosis is not just academic; it’s deeply consequential. Such psychotropic medication, if administered without knowledge of the underlying cause, can worsen the condition, slow down effective management, and intensify patient distress.
According to a 2023 study, strong associations were established between subclinical thyroid dysbalances, particularly hyperthyroidism, and elevated levels of anxiety, depression, and mood disorders. It highlighted the physiological underpinnings of "thyroid-related psychiatric symptoms.
In India, a clinical comparison from Kashmir with 75 hyperthyroid women patients and the same number of euthyroid controls reported that 60% of patients with hyperthyroidism showed psychiatric disorders (major depression, generalised anxiety disorder, panic attacks, suicidality), whereas 34.7% showed these symptoms in the euthyroid group.
Despite these statistics, thyroid screening is still not a routine part of psychiatric evaluations in many parts of India. This needs to change.
A Call for Integrated Care
The thyroid-psychological health link is an example of the requirement for comprehensive, biopsychosocial models of care, in which endocrinologists, psychiatrists, and primary care clinicians work together. "A basic TSH, T3, and T4 blood test can be the difference between unwarranted psychiatric medication and focused hormone treatment that returns both mood and metabolic balance," said Dr Vohra.
Moreover, we must also acknowledge the psychosocial burden of hyperthyroidism, its impact on self-esteem due to physical symptoms like weight changes, hair thinning, and menstrual irregularities. These can, and often do, lead to secondary anxiety or depression, further complicating the clinical picture.
What Patients Should Know
"If you or someone you know is experiencing symptoms like persistent restlessness, mood swings, rapid heartbeat, heat intolerance, or unexplained weight loss, don’t rush to self-diagnose it as stress or anxiety," said Dr Vohra. Ask your doctor about thyroid testing. A diagnosis of hyperthyroidism is not a life sentence; with proper management, patients often experience a complete reversal of psychiatric symptoms.
Bottomline
Dr Vohra concluded, "In a country where mental health stigma still looms large and thyroid disorders affect nearly 42 million Indians, we must push for greater awareness of how intimately the mind and body are connected. As a psychiatrist, I urge both clinicians and patients: before we pathologise the mind, let’s first rule out what the body is trying to tell us."
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]