Psychological symptoms often accompany thyroid disorders. This can be confusing and frightening, especially if we cannot find the information and support we need. Here we provide some information to assist you in managing these symptoms.

The thyroid gland produces hormones that regulate the body’s metabolic rate, as well as heart and digestive function, muscle control, brain development, mood and bone maintenance.  In addition to physical symptoms, there can also be psychological symptoms. In short, abnormal thyroid levels can unsettle our emotions.

Of course, no two people are affected in exactly the same way. However, examples of psychological symptoms include:

• anxiety (e.g. general anxiety disorder, agoraphobia, social anxiety etc)
• low mood
• difficulty sleeping
• neurological difficulty e.g. changes in intellectual functioning, memory and concentration problems, difficulty with speech and language
• trauma and stress after being unwell for some time or difficulty adjusting to your illness.

Living with a physical illness can also be a cause of anxiety and low mood. For example, changes in appearance due to thyroid eye disease, hair loss and changes in weight can lead to feelings of low self-esteem or mood.  It is also quite common to have strong emotional reactions before, during or after treatment for conditions such as thyroid cancer.

Some treatments for thyroid disorders can also contribute to psychological symptoms. Steroids, for example, can aggravate depression. Beta-blockers, sometimes prescribed to control heart rate in hyperthyroid patients, can also make some people feel tired and depressed.

The good news is that for most people psychological symptoms improve as the thyroid disorder is brought under control. It is therefore essential to take your medication regularly as taking tablets inconsistently can affect your thyroid hormone levels and may cause you to feel worse.

Sometimes it may feel as if your medication is not really working. Levothyroxine, for example, can take several months to take full effect so it is important you remain on the course of medication for it to work effectively. It is also common for people to feel emotionally ‘out of sorts’ for some time, even once their blood tests return to normal. However, if you still feel unwell, we advise you to return to your doctor to see whether your medication may need adjusting. If symptoms continue to persist, your doctor may be able to undertake further investigations to see whether there is something else going on with your health.

Tips for self-care

There are a few things we can all do to better manage our psychological health. Busy lifestyles and stress can sometimes mean these become less of a priority. The following self-care techniques could be worth a try:

Open communication

It’s normal not to want to bother people or to feel guilty about asking too much of others. Some of us tend to bottle up our feelings, which can result in frustration and resentfulness. Remember, people around you generally wish to help but are often not sure how to. Learning to say how you feel and how to ask people for things can help you receive the support you need.

Make time for things

We could all benefit from finding some ‘me time’ but often don’t prioritise this. If there are things that help you to relax, like having a bath or pursuing a certain hobby, make sure you set time aside to do these. If you don’t have a particular pastime you enjoy, something as simple as reading a book or doing a jigsaw puzzle can all help. Even if you can’t physically meet up with friends and family, talking to them online or having virtual meets ups can make you feel more connected to others.

Try to look after your physical health

Regular exercise does not have to be strenuous to be effective. Our advice is to choose things that are appropriate to you and don’t add to your stress levels. For example, if you used to enjoy running but don’t feel up to it, why not try another activity which may boost your mood.  Your appetite may have been affected by your mood, however, it’s important to try and eat a healthy balanced diet. Try not to drink too much alcohol or take drugs to make yourself feel better. These can make anxiety and depression worse and may interfere with any medication you are taking.

Be kind to yourself

A starting point for this is talking to yourself with the same love and respect you would like to receive from your friends and family when you’re having a tough time. Being hard on yourself only tends to exacerbate low mood, anxiety and frustration.

Try new things

When we’re feeling stressed and anxious, we tend to stay within our comfort zones.  However, this strategy does not serve us well over time. We can help improve our ability to cope by broadening our knowledge and expanding our experiences. These don’t have to be giant steps. Small things, like walking a new route, help our comfort zone to grow. With each step you should find your confidence improves.

Make time to practise the ‘Rule of Three’ 

This is a very simple technique that helps to bring balance to your mindset and mood. Each day before you go to bed make a list of three things where you experienced some kind of positive feeling (writing it down strengthens the memory). In the morning reread the list from the previous day (which primes your brain to go and look for similar things). In the evening add three more things to your list.

Be aware of your moods

Therapeutic techniques, such as mindfulness, can also help you to become more aware of your own moods and reactions and improve your mental wellbeing. Mindfulness apps, such as Headspace and Calm, may be worth a try. Keeping a mood diary may also help you to identify what makes you feel better or worse.

No-one seems to understand

Dealing with psychological symptoms can be very isolating as those around you may not appear to comprehend how you are feeling. Many people find it really helpful to talk to others who have been through similar experiences. The BTF’s local support groups and telephone volunteer contacts are a good way to connect with others. They provide the opportunity to share your feelings and to receive support from fellow thyroid patients. Supporting each other not only helps those who are suffering, it also contributes to the wellbeing of the giver. We are always looking for people to set up new groups in their area so please contact us if you would like to know more.

Details of our network of volunteer telephone contacts, local groups and closed Facebook groups are on the BTF website

What other sources of information and support are there?

We offer a range of resources to support you with any psychological symptoms you may be experiencing. You can find information about common symptoms, their causes and treatment options in our

BTF guide to psychological symptoms and thyroid disorders 

Your local NHS may offer free IAPT  (Improving Access to Psychological Therapies) courses, which provide tools and tips to manage stress and to engage in self-care.

Psychological therapy may also be helpful for some. Cognitive Behavioural Therapy (CBT) helps us learn to manage our problems by examining the ways our thoughts, feelings and behaviours impact upon each other. Acceptance Commitment Therapy (ACT) can be helpful in addressing our responses to illness e.g. sadness, anger, loneliness etc, rather than trying to suppress or solve them, which may contribute further to our suffering.

Information on NHS support available 

NHS Every Mind Matters

This article has been compiled with the help of Dr Sue Jackson, chartered psychologist and Dr Michelle Griffiths, chartered health psychologist and BTF local group coordinator and featured as an article in our member newsletter, BTF News.

More information on living with thyroid disorders is available here. Many patients also find our network of volunteer telephone contacts and local support groups a valuable resource.

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