Graves’ Disease Mental Health. Emotional Aspects of Hyperthyroidism
The relationship between psychiatry and thyroid dysfunction has attracted a good deal of attention for the following reasons:
- Thyroid disorders, such as hyperthyroidism or hypothyroidism, can be accompanied by prominent mental abnormalities.
- Thyroid hormones have been used in the treatment of certain psychiatric conditions.
- Some drugs used for the treatment of mental illness can have an effect on the thyroid gland.
As you already know a frequent complaint of Graves’ Disease patients and their friends and family is emotional liability, mood disorders and hysterical symptoms with no apparent reasons. Periods of depression may alternate with manic symptoms. Some of the patients can experience panic-attack likely symptoms. The situation is even worsening by the fact that these patients get little or no sleep and have repeated palpitations throughout the day which additionally may contribute to their emotional condition.
People with an overactive thyroid may exhibit marked anxiety and tension, emotional lability, impatience and irritability, distractible overactivity, exaggerated sensitivity to noise, and fluctuating depression with sadness and problems with sleep and the appetite.
All disorders related to, or as a result of Hyperthyroidism or Graves’ Disease can be classified as Mental Disorders due to a General Medical Condition.
According DSM IV (the American Psychiatric Association Classification Book) a mental disorder Due to a General Medical Condition is characterized by the presence of mental symptoms that are judged to be the direct psychological consequence of general medical condition- in that case Graves’ Disease or Hyperthyroidism.
There are three disorders that are often associated with Graves’ disease:
1. So called Mood Disorders and more specifically Bipolar Disorder. Bipolar Disorder consists of 2 Main Episodes:
A) Depressed Episode (depressed mood most of the day, nearly every day, feeling of sadness and emptiness, irritable mood, markedly diminished interest or pleasure in almost all activities, significant weight loss when not dieting, insomnia nearly every day ect.
B) Manic episode: A distinct period of abnormality and persistently elevated, expansive, or irritable mood, lasting at least 1 week. During the period of mood disturbance three or more of the following symptoms have persisted: Inflated self- esteem or grandiosity decreased need for sleep, more talkative than usual or pressure to keep talking etc.
2. Anxiety Disorders are the other group of disorders often associated with Graves’ Disease. Panic Attack is often mistaken with the palpitations, accelerated heart rate, shortness of breath etc. Panic Attack is not codable disorder, but in order to be classified as a Panic Attack there should be an intense fear or discomfort.
3. Histrionic Personality Disorder. This personality disorder could be described as a pervasive pattern of excessive emotionally and attention seeking, indicated by the following: is uncomfortable in situations in which he or she is not the center of attention, inappropriate sexually seductive or provocative behavior, rapidly shifting expression of emotions, uses physical appearance to draw attention to self.
Most of the above mentioned symptoms are definitely present for Graves’ Disease. In fact, most of the times the mental symptoms proceed the disease itself, can be developed together with the disease, or exist separately without no evident connection.
More serious mental disturbances which used to accompany “thyroid crisis”, such as acute psychotic episodes, delirium and fever are rarely seen these days as a result of the improved detection of the illness and availability of effective treatment.
When it comes to Graves’ disease mental health, I believe that all the systems in our body are connected, then when treating one disease any medical doctor should have in mind possible mental symptoms as well. In all case, if any of those symptoms are present due to whatever reason, I suggest that you should consult a psychotherapist or psychologist so you can work on your psychological symptoms as well. If they are all result of your medical condition, when the disease has been treated they are more likely to disappear as well.
To learn more about how to deal with mental, emotional and psychological aspects of Graves’ Disease and Hyperthyroidism get my newest book “Mental, Emotional and Psychological Aspects of Thyroid Disorders” (Price $24.95).
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