Hypothyroidism: Does It Cause Anxiety and Depression?

Hypothyroidism is a condition that can happen when the thyroid gland does not make enough thyroid hormone. This hormone helps to keep almost every organ in the body working well. And it can affect mood. 

Having abnormal levels of thyroid hormone can cause symptoms of both anxiety and depression. But sometimes it’s difficult to tell the difference between depression and the symptoms of hypothyroidism. 

Can hypothyroidism cause anxiety?

Yes, hypothyroidism can cause anxiety. In fact, up to 4 in 10 people with new hypothyroidism have symptoms of anxiety. This is likely because of the thyroid hormone’s effect on the central nervous system. Having low levels of thyroid hormone can change the neurotransmitters in the brain that are responsible for your mood.

Symptoms of hypothyroidism and anxiety

Anxiety symptoms due to hypothyroidism are similar to anxiety disorder symptoms. It’s common to experience:

• Anxious mood (feelings of restlessness)

• Muscle aches 

• Feelings of tension

• Increased sense of fear

• Stomach upset

• Sexual dysfunction 

• Insomnia

Can hypothyroidism cause depression?

Yes. Many people have symptoms of depression when they have hypothyroidism. In fact, people with hypothyroidism are more likely to have depression than those with normal levels of thyroid hormone. Some people with hypothyroidism have feelings of sadness and irritability. But some have all the symptoms of clinical depression.

Symptoms of hypothyroidism and depression

Feelings of depression can significantly affect daily life. People who have hypothyroidism and feel depressed often have symptoms like:

• Increased sadness

• Slowed physical movements

• Loss of appetite or weight gain

• Excessive tiredness

• Low energy

• Poor concentration

Hypothyroidism can cause symptoms of depression by lowering your energy and physical strength. Low thyroid hormone levels can slow down brain functioning, which people can experience as depression. 

Having hypothyroidism can slow you down physically, too. It may be harder to do everyday things like work or exercise. And you might not have enough energy to socialize or be around people. Feeling tired and spending more time at home alone can also lead to depression or worsen existing depression.

Depression in hypothyroidism vs. clinical depression

Some people with hypothyroidism feel depressed but don’t have symptoms of clinical depression. But it’s possible to have clinical depression and hypothyroidism. In fact, one study reported that almost half of people with hypothyroidism also have clinical depression. 

Clinical depression is when you feel persistent sadness and other symptoms of depression for 2 or more weeks. These symptoms include:

• Feelings of worthlessness or guilt

• Increased irritability

• Changes in sleep

• A lack of interest in activities

• Thoughts of death or suicide

Many hypothyroidism symptoms are also symptoms of depression. So it can be hard to tell the difference between hypothyroidism and depression. If you have hypothyroidism and depression, your provider will help find the best treatment for your symptoms.

Treating anxiety and depression when you have hypothyroidism

There are several options for treating anxiety and depression when you have hypothyroidism.

Thyroid hormone replacement

For anxiety and depression due to hypothyroidism, the best way to manage symptoms is to take thyroid hormone replacement. For most people, symptoms of hypothyroidism go away once thyroid hormone levels are back to normal.

SSRIs

If symptoms of depression or anxiety don’t go away with thyroid hormone replacement, your provider may suggest an antidepressant. The first-choice option in this case is usually an SSRI (selective serotonin reuptake inhibitor). SSRIs are medications that are commonly used to treat depression and anxiety.

Natural treatments

Lifestyle-based treatments can help your symptoms of depression and anxiety, too. Many of these are free, and you can start them right away. Here are some recommendations:

• Sleep: Most experts recommend getting 7 to 8 hours of good-quality sleep every night.

• Exercise: Studies show that moving your body to raise your heart rate can help manage symptoms of depression and anxiety.

• Relaxation techniques: Deep breathing or massage can help lessen the symptoms of stress and anxiety.

• Task planning: Try to break large tasks into smaller ones. Do things that need focus earlier in the day or during the part of the day when you typically focus best.

• Light therapy: Light therapy has been effective in helping some people improve their mood.

• Spiritual practices: Studies show that spiritual practices such as prayer can help lessen depression in some people.

• Talk therapy: Talk therapy is a proven way to help improve symptoms of depression. Different types of talk therapy include cognitive behavioral therapy and psychodynamic psychotherapy.

No matter how you and your provider decide to manage your symptoms, remember to keep taking your thyroid hormone replacement.

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Written by:

Tracy Asamoah, MD

Tracy Asamoah, MD, is a child and adolescent psychiatrist, writer, and physician coach in private practice in Austin, Texas. She completed medical school at the University of California, San Francisco, and both her general psychiatry residency and child and adolescent fellowship at the David Geffen UCLA School of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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