Patients suffering from depression, increased anxiety and other mental health problems, doctors often detect abnormal levels of thyroid hormones in the blood. It has repeatedly pointed out that the treatment of the problems with the thyroid gland, in many cases, can lead to improved mood, memory and general mental state of a person.

Now scientists are exploring several contradictory relationship between subclinical thyroid disease and psychiatric problems in some patients. After a detailed review of the literature on this topic, it was concluded that the treatment of thyroid disease, even in mild forms, affecting about 2% of the population, can relieve psychiatric symptoms in some people, and help prevent the development of certain mental disorders. Many patients themselves pointed out that after the start of medication with thyroid hormones their condition improved markedly.

About the thyroid gland

The thyroid gland, a small organ in the shape of a butterfly, located in the front of the neck, produces two hormones: thyroxine Thyroxine - the main thyroid hormone Or T4, and triiodothyronine, also known as T3. These hormones play an important role in a surprisingly large number of physiological processes - from regulating body temperature and heart rate to the frequent cognitive functions.

Thyroid dysfunction can have many reasons, among them - the effects of radiation, the shortage or excess of iodine in the diet, use of certain drugs, such as lithium, and autoimmune diseases. The risk of developing thyroid disease increases with age. Excess thyroid hormone (hyperthyroidism) speeds up metabolism Improves metabolism and losing weight without dieting Causing symptoms such as sweating, heart palpitations, weight loss and anxiety. Deficiency of thyroid hormone (hypothyroidism) can lead to a strong physical fatigue, weight gain, lethargy, depression, weakened concentration and memory problems.

Research

In the early 20th century, the best description of clinical depression can be found in books about the diseases of the thyroid gland, but not in the textbooks of psychiatry. Doctors have long could not come to an agreement about the nature of the relationship between psychiatric symptoms and thyroid problems. This question resembles the famous philosophical dilemma of the chicken and the egg: if a malfunction of the thyroid gland cause mental disorders, or just the opposite?

Experts note that often in patients with thyroid disease misdiagnosed psychiatric disorders. One notable example is a patient 29 years old, which a decade ago was prescribed antidepressants to treat depression and increased anxiety. They did not help - in spite of the treatment, she continued to feel depressed. A few years ago, she, without waiting for improvements, ask your doctor to send her to the therapist. He first analyzed for thyroid hormones, and it turned out that the patient's autoimmune disease known as Hashimoto's thyroiditis - a common cause of hypothyroidism.

The patient was appointed levothyroxine - a synthetic analogue of thyroid hormone. Soon her depression and anxiety disappeared.

In a sense, this girl was lucky: her hormone levels obviously deviated from the norm. The normal range of levels of thyroid stimulating hormone, or TSH, are considered indicators of 0.4 to 5 (the higher the level of TSH, the thyroid gland is less active). Most endocrinologists agree that it is necessary to treat hypothyroidism patients with TSH level 10 or higher.

People than the TSH level is somewhere between 4 and 10 can be very difficult to get adequate treatment, especially if they have such minor symptoms such as fatigue, mild depression, or just light the psychological discomfort - all equally likely to refer to severe psychological problems and be an option rules.

Some doctors believe that these patients require treatment. In their opinion, if someone is always suffering from any emotional problems, and he subclinical hypothyroidism, such a person needs help. There are examples when using artificial thyroid hormone treated musicians suffering from intense fear of public speaking. One high-level musician recovered completely.

However, the idea of ​​treating subclinical hypothyroidism remains controversial, especially among endocrinologists. They point out that taking thyroid hormones can significantly increase the workload on the heart and worsen the symptoms of osteoporosis in postmenopausal women. On the other hand, the lack of timely treatment can also be bad for the heart, according to some sources, this may increase the likelihood of developing Alzheimer's disease and other dementias.

There are also a factor, as the suffering of the patient, which is extremely difficult to assess. Many experts are left without proper attention to the issue of quality of life is directly related to anxiety Anxiety - how to distinguish normal from disease?   and depression.

Development of the disease

In women, thyroid disease Thyroid disease - women at risk   develop much more often than men, especially over the age of 50 years, and some experts believe that the basis of the reluctance of many physicians to treat subclinical disorders are gender reasons. There are a lot of very strong and long-standing prejudices about women and their minor, superficial emotional problems, which are often attributed to the whims rather than the actual state of health. In some complaints simply close their eyes, attributing them to stress and worry over trifles habit; Moreover, the women themselves do not always go to the doctor, believing that depression and other unpleasant symptoms soon pass on their own.

In addition, psychiatric symptoms may be mild and very individual, that does not always give themselves the art and see in them the real problem.

Another difficulty lies in the fact that the expert is not clear that the same be considered a normal level of thyroid stimulating hormone.

TSH levels in a particular patient can be equal to 5, and many doctors feel that the index is not high enough to cause any symptoms. But if normal in this patient's TSH level is 0.5, a tenfold increase in its hardly pass unnoticed.

In the course held in 2006, the study in patients with subclinical hypothyroidism before and after treatment did neuroimaging of the brain. After six months of treatment with levothyroxine were found significant improvements in memory and executive functions of the brain.

Manic-depressive psychosis (MDP) - a disease that occurs in the form of separate phases - low (depression) and high (manic) mood, between which the patient is no different from healthy people, as the degradation of the individual with the disease does not occur.

Onset

The first attack Carnet may begin as a depressive and a manic state. Most often it is preceded by the harbingers of disease, which are not always seen by others and sick. It may be part of, and not always depend on external circumstances, change of mood. There may be surges as high mood (hypomania) and low (subdepression). Low mood is usually more often. This condition can last for years until some external influence (stress, disease, heavy loads, and so on) will not cause the first attack of the TIR. Most often this occurs after thirty years, but it can happen at any age.

Thus begins the disease, usually with a depression, and further flow can be as bipolar (manic replaced when depressed state and vice versa) and unipolar (when the attacks of the disease are manifested only depression, or only mania). The average duration of the individual phases of the disease - from three months to one and a half years, with the manic phase may be in two or three times shorter than depressive.

Retarded depression

This phase is more common and lasts longer. It is characterized by three main features. The first sign - a heavy, depressed mood, which literally puts pressure on the patient. At the same time suffering and physical condition: the patient there is a weakness, fatigue, decreased performance, loss of appetite, often - a bad dream.

The second feature - motor and speech retardation, the speed of motor responses and speech is sharply reduced, that is, to drive, for example, the car in this condition becomes dangerous. Growing apathy and indifference to everything that surrounds it.

The third feature - mental retardation. This dramatically changes the speed of mental reactions, impaired ability to concentrate on anything else. The patient can not concentrate on any reading or work, or any entertainment.

All these three characteristics form the mood and thoughts of the patient, which are pronounced depressive character. This is dominated by thoughts of his own insignificance, worthlessness, guilt in some sins. Often these thoughts lead to suicide patients - this is the most dangerous phase of depression Depression - a little more than a bad mood .

Depression consists of two components - body and soul, the patient is usually dominated by one of them. Bodily depression - the feeling of physical heaviness in the chest ("stone heart"), pain in other parts of the body. This often reduces blood pressure, which further enhances retardation patients. When mental depression prevails heavy emotional state, and depressed mood.

If such a person does not have time to help, he comes to a state of stupor - complete immobility and lack of response to external stimuli. He did not eat, drink or toilet visits.

For all depressions are characterized as disorders of the cardiovascular system, metabolism and sleep Dreams: how to understand our dreams .

Manic phase

Bipolar disease during the depression phase can transform into the manic state, but sometimes in between there is a small break. Mania manifested beautiful cheerful mood, which can quite match the external circumstances. And increases motor activity - the patient is constantly doing something (mostly unnecessary), bustles.

Mood swings and changes the direction of the thoughts, all the patient is seen in pink, he feels that he can turn the mountains, to do something great. Often these thoughts lead to the formation of delirium Brad - not only crazy   greatness. The efficiency in this state really is sharply increased, the patients are even able to earn some money, but then spending it on useless things. Often increases Sexuality Nine ways to experience their sexuality , A tendency to use alcohol and drugs.

But the manic phase usually is mild and rarely comes to severe symptoms.

Prognosis

Bipolar forms of the disease are less favorable than monopolar. When expressed forms of bipolar high percentage family history, earlier onset of psychosis and more phases of the disease, compared with monopolar. With age, with all kinds of TIR there is a tendency to increase the duration of the phases and the shortening of the light spaces.

Galina Romanenko