Key Takeaways
- Thyroid disease can cause mood swings and make people feel anxious or irritable.
- Treating the thyroid problem often helps improve mood-related symptoms.
The thyroid is a butterfly-shaped endocrine gland located in the neck. It plays a role in many areas of the body, including metabolism (the speed at which people burn energy), heart rate, mood, and cognition.
The thyroid produces hormones such as thyroxine (T4). Thyroid disease can cause, or be caused by, disruption in thyroid hormone production and regulation. An underactive thyroid is called hypothyroidism, while an overactive thyroid is called hyperthyroidism.
About 20 million Americans have thyroid disease, and over 12% of the U.S. population is expected to develop a thyroid condition during their lifetime. Up to 60% of people with thyroid disease are unaware they have it.
Read on to learn more about thyroid disease, its symptoms, and how it affects mood.
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How a Thyroid Imbalance Affects Mood
Mood and cognitive changes have long been linked to thyroid disruption, traced back to early descriptions of thyroid disease.
Both hypothyroidism and hyperthyroidism are linked to psychiatric disturbances that can mimic mental illness.
Hypothyroidism
People with hypothyroidism may experience psychiatric and cognitive symptoms like:
- Slowed thinking
- Increased depression symptoms, sometimes with paranoia
- Anxiety
- Short temper
- Excessive stress
- Apathy or loss of interest and initiative
- Memory difficulties, especially for recent events
- Dullness in personality
- Overall intellectual decline
- Muddled thinking
- Slowed physical movements related to cognitive processing
- Symptoms similar to melancholic depression or dementia, especially in severe or untreated cases
The symptoms of hypothyroidism can develop slowly and be minor and/or vague in the early stages. Physical symptoms, such as weight gain or joint pain, may be noticed sooner than psychological or cognitive ones. Psychological symptoms, however, may be the reason a person with hypothyroidism seeks medical advice.
The mood stabilizer lithium (used in the treatment of some mental illnesses) can lead to hypothyroidism, which can then result in depression, particularly in women who are in their middle-aged years. People who are taking lithium—or any long-term psychiatric medications—should have their thyroids checked.
Hyperthyroidism
People with hyperthyroidism may have:
- Anxiety
- Panic attacks
- Tension
- Nervousness
- Mood swings or rapid emotional changes
- Impatience or short temper
- Irritability
- Distractibility
- Higher than usual activity levels
- Increased sensitivity to noise
- Fluctuating depression
- In extreme cases, symptoms resembling schizophrenia, such as loss of reality, delirium, or hallucinations (less common now due to better diagnostics and treatments)
- Dysphoria (feelings of discomfort, unease, distress, or unhappiness)
- Difficulty concentrating
- Loss of interest in sex
People in their senior years with hyperthyroidism may have symptoms that include:
How Is Thyroid Disease Diagnosed?
To make a diagnosis of thyroid disease, a healthcare provider may use tools such as:
- A physical exam
- Questions about symptoms and medical history
- Blood tests (checking for things such as thyroid hormone levels)
- Imaging tests (such as ultrasound, thyroid scan, or a radioactive iodine uptake test)
- Thyroid fine needle biopsy (to check thyroid cells for cancer)
How to Manage Mood Swings and Anger
Addressing thyroid problems such as hypothyroidism or hyperthyroidism generally addresses the psychological and cognitive symptoms associated with the condition. If emotional symptoms continue even with effective thyroid treatment, there may be something else at play in addition to the thyroid condition.
Treating Hypothyroidism
Hypothyroidism is typically treated by replacing the hormones that the thyroid is not making, with the goal of replicating normal thyroid functioning as closely as possible.
Thyroid hormone treatments are usually taken orally in tablet, gel capsule, or liquid forms.
Your healthcare provider will monitor your hormone levels to make sure your dosage is correct and effective.
Treating Hyperthyroidism
Treatments for hyperthyroidism include:
- Medication: Antithyroid medicines cause the thyroid to make less thyroid hormone, and beta blockers reduce symptoms such as tremors, rapid heartbeat, and nervousness.
- Radioiodine therapy: Radioactive iodine, swallowed as a capsule or liquid, slowly destroys the cells of the thyroid gland that produce thyroid hormone. This usually leads to hypothyroidism, which is easier to treat and has fewer long-term effects.
- Surgery: Part or most of the thyroid gland is removed. This is typically reserved only for rare cases, such as when people have large goiters (meaning those whose thyroid gland has grown larger) or are pregnant and cannot take antithyroid medicines.
Managing Irritability
If irritability is one of your symptoms, there are things you can try along with treating the underlying thyroid conditions. Ways to help yourself manage irritability include:
- Reduce your intake of (or avoid) caffeine, tobacco, and alcohol.
- Get enough good-quality sleep.
- Engage in physical activity.
- Determine what triggers your irritability (try keeping a diary to look for patterns).
- Practice relaxation techniques, such as mindfulness, breathing exercises, or yoga.
- Engage in activities you enjoy, such as listening to music, reading, or watching TV.
- Be creative (paint, dance, sing, or make something).
- Take a bath or shower.
How Common Are Anger or Mood Swings With a Thyroid Imbalance?
One study showed depression occurring in almost 50% of cases of hypothyroidism. Another study found that 60% of people with hypothyroidism reported depressive symptoms and 63% reported anxiety symptoms.
Other Signs of Thyroid Disease
Thyroid disease can also have physical symptoms.
Hypothyroidism
Physical symptoms of hypothyroidism include:
- Fatigue
- Skin changes, such as dry, rough skin and a pale complexion
- Puffy face
- Hair loss/dry, thinning hair
- Voice changes
- Decreased appetite
- Weight gain
- Joint and muscle pain
- Intolerance to cold
- Constipation
- Decreased sweating
- Heavy or irregular menstrual periods
- Fertility problems in people who can get pregnant
- Slowed heart rate
- Goiter (enlarged thyroid, which may make the neck look swollen and can sometimes cause trouble with breathing or swallowing)
Hyperthyroidism
Physical symptoms of hyperthyroidism can vary, but may include:
- Fatigue
- Muscle weakness
- Intolerance to heat
- Sleep difficulties
- Tremor (usually in hands) or twitching
- Rapid and/or irregular heartbeat
- Frequent bowel movements or diarrhea
- Weight loss
- Increased appetite
- Goiter
- Hyperactivity
- Increased urination
- Persistent thirst
- Itchiness
- Hives (raised, itchy rash)
- Warm skin and excessive sweating
- Red palms of the hands
- Loose nails
- Eye problems (such as redness, dryness, or vision problems)
Symptoms of hyperthyroidism in adults over age 60 may present differently than in younger adults, including a loss of appetite or withdrawal from other people. Their symptoms may be mistaken for depression or dementia.
Untreated hyperthyroidism can lead to serious health problems, including:
- An irregular heartbeat that can lead to heart problems such as blood clots, stroke, heart failure, and other heart-related concerns
- Graves’ ophthalmopathy (an eye condition that can cause double vision, light sensitivity, eye pain, and in rare cases vision loss)
- Thinning bones and osteoporosis
- Fertility problems in people who can get pregnant
- Pregnancy complications (such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage)
What Are Some Thyroid Conditions?
Thyroid problems include:
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