Thyroid and Depression
It's a sad but true fact that many people suffering from thyroid symptoms tend to be belittled and put down. Then, handed a prescription for an anti-depressant, they are sent on their way. We'd like to share Wendy's story with you, just one of many involving unrecognized hypothyroidism.
My Battle With Depression
Wendy Webb Osterloh
My battle with depression started many years ago, as a wee child. I remember that in High School ,I was always obsessed with suicide in all aspects, I also attempted it a few times then. I also carried a razor blade in my wallet "just in case". I was still coping as such with keeping my GPA up and class attendance. I was also very much into a fantasy life I created through writing. I recall that I wanted to be wanted so much I was always creating about my being kidnapped and also about suicidal topics.
I went away to College. The very first Friday in October, my first year, I was hit by a car, as I was walking. I had no serious injuries, other than maybe a concussion as I landed on the left side of my head and body about twenty feet away. That could be what triggered my thyroid disease. Head and/or neck injuries are suspected to be a catalyst for thyroid disease. During that first year in college, I put on a tremendous lot of weight very fast---over 75 ponds in two and a half months, without changing my eating patterns or activity levels. I was also very depressed. I do not recall any suicide attempts during that time, but I had stopped attending classes, and was very much retreating. I was put on anti-depressants and valium at that time, none which helped for long. I was still debating about suicide though. Finally, I was "counseled out" of that University due to my depression and being unable to cope with that and thus non-attendance. Right after I was ousted, I recall staying in a motel room a few days before heading back up to Washington. I was also very paranoid. I would panic and hide every time I heard a siren go by, as I thought they were coming for me. I went back to Washington, and a few months later, I moved to Las Vegas.
I took to Vegas, and stayed and went back to college. By that time I was classified as disabled due to clinical depression. I attended, but it took longer as I was still depressed without much relief. I was also going through long periods of staying awake for days on end. I took to gambling as relief for my depression. Unfortunately, that did not work, the gambling added to the depression with guilt and worry, and when I lost, that just added more depression. I graduated and was unable to find employment.
I also started going into my more severe suicidal times. I had therapy, which did not seem to help, as well as being on various antidepressants. I was also not thinking clearly. I was having nosebleeds, so I thought that I should let my nose bleed until I died, not stopping the flow as normal. Well, my nosebleed stopped sooner than it ever did!
One of my best friends was attending law school in Houston. He was killed while walking home from dancing one evening. This threw me deeper into depression. I become very anorexic when depressed (would not think of it to see me!) I also was not sleeping and I was so depressed I would not do much other than just sit. I was living alone and had no phone. I put on Kenny Rogers "Blaze of Glory" and took what was considered a lethal dose of my anti-depressant at that time (don't recall which one). I woke up in the hospital with tubes in every orifice. I still was fighting, and they had to put me in restraints. I spent the next few weeks as an inpatient in the locked ward, before I had a hearing. During that time, I recently learned, my best friend was told by the psychiatrist to next time let me complete the suicide!. That sure infuriated her! While in that locked ward, I was having auditory hallucinations and was very paranoid. I also was put on Prozac, which only helped for a bit.
Fast forwarding to a few months ago: I started on Natural thyroid hormones. My depression has lifted and the ups and downs have seem less extreme. The T3 hormone is what is seems to help.
A key question I'm regularly asked is: "Is my depression DUE to the thyroid disease -- i.e., a diagnosis of "depression secondary to hypothyroidism" -- or is it just a coincidence? Doctors do not have a definitive answer, although, according to mental health experts, "as many as 40% of clinically hypothyroid patients (mainly women) have significant depression. This is often accompanied by psychomotor slowing and mild cognitive impairment."
According to the Thyroid Society...
Most patients with hypothyroidism have some degree of associated depression, ranging from mild to severe. 10% -15% of the patients with a diagnosis of depression may have thyroid hormone deficiency. Patients with depression should be tested to determine if they have a thyroid disorder.
Several research studies have been done and continue to be done on the association between depression and thyroid disease. Although all forms of depression, including bipolar disorders like manic depression, can be found in either hypothyroidism or hyperthyroidism, depression is more often associated with hypothyroidism. Many patients with hypothyroidism have some degree of associated depression, ranging from mild to severe.
There is also thinking that starting thyroid hormone therapy may help alleviate the depression without added anti-depressants or psychotherapy once the thyroid treatment has stabilized.
T3 Thyroid Hormone Helps with Major Depression Treatment
April, 2003 -- Israeli experts have found that as many as half of all patients experiencing unipolar and non-psychotic major depression do not respond to initial selective serotonin reuptake inhibitor (SSRI) antidepressant treatment. As a result, the researchers have developed a formula of progressively increased doses of prescribed antidepressant drug, usually Prozac (fluoxetine). And those who are unresponsive also receive triiodothyronine (T3), from 25 to 50 micrograms per day.
In research reported on in the International Journal of Neuropsychopharmacology, 81 patients were started on fluoxetine 20 mg; and 9 patients received paroxetine, and at four weeks, 74 completed treatment, and at that time, 44 -- or 48.9% -- responded to the regimen. An additional 5 patients (16.6%) responded when the SSRI dose was raised to 40 mg two weeks. Patients who did not respond to SSRI treatment were evaluated at the onset to be far more depressed.
T3 was added, and found to be effective among 10 out of 16 women patients (62.5%), but was not effective in any of the 9 male patients who received it. Although values were within the normal range, patients who responded to T3 had higher serum thyroid-stimulating hormone (TSH) levels than those who did not.
16 November, 2003
The researchers speculate that the effect of T3 may be related to thyroid function even within the normal range.
Source: "Algorithm-based treatment of major depression in an outpatient clinic: clinical correlates of response to a specific serotonin reuptake inhibitor and to triiodothyronine augmentation" Int J Neuropsychopharmacology 2003;6:41-49.
What thyroid treatment has done for me is giving me hope, and the ability to recover myself.
I will write more on thyroid disease and depression and related issues at a later time
Wendy Webb Osterloh
November 6, 1954 - January 19, 2006