Having Graves’ disease can be stressful. This autoimmune disease attacks the thyroid, and thyroid function plays a role in many aspects of your health. When Graves’ disease leads to thyroid eye disease (also called Graves’ ophthalmopathy), it’s natural to feel overwhelmed.
Thyroid eye disease may affect mental health in many ways. It may affect your self-esteem and reduce your independence. The hyperthyroidism caused by Graves’ disease may also increase the risk of mental health conditions.
How might Graves’ disease affect mental health?
Graves’ disease is a leading cause of hyperthyroidism. This is when the thyroid gland is making too much hormone. Thyroid hormone helps regulate many aspects of your body, including:
Breathing
Weight
Digestion
Heart rate
Menstruation
Fertility
Energy
Mood
Hyperthyroidism can cause many issues with these everyday functions. You may struggle with diarrhea, have trouble sleeping at night, feel irritable, and deal with fatigue and muscle weakness.
“We know [that] these things contribute to stress, and stress [may] make the problem worse,” says Jose Sanchez Escobar, MD, Endocrinologist at Lenox Hill Hospital, Northwell Health. “It’s not a time to blame yourself. It’s a time to look for help.”
How might thyroid eye disease increase the risk of mental health conditions?
People who have both Graves’ disease and thyroid eye disease may be even more vulnerable to mental health disorders. People with thyroid eye disease are generally more likely to have anxiety or depression than the average U.S. adult.
Thyroid eye disease may cause double and blurry vision, which may affect your ability to drive, participate in certain hobbies, or even engage in some work tasks. This may be frustrating, and it may affect your independence.
Graves’ ophthalmopathy may also change your appearance. It may cause the eyelids to retract and the eyes to bulge outward. This may make you look perpetually stunned or angry to others. This may take a toll on your confidence and self-esteem.
“In my experience, a lot of my patients are quite anxious about their appearance,” says Dr. Sanchez Escobar.
How might thyroid eye disease increase the risk of loneliness and isolation?
For some people with thyroid eye disease, these challenges and feelings may lead them to limit their worlds. They may avoid public places or being around strangers. They may feel self-conscious or that others are staring at them.
Loneliness and isolation are risk factors for mental health disorders, such as depression. Loneliness doesn’t just refer to how many people you know and see on a daily basis. It also includes how accepted you feel around others.
People with thyroid eye disease may also feel that their relationships are strained because they may not be able to do the things they used to do. Vision symptoms may affect their ability to do certain hobbies with friends (such as road tripping, skiing, or golfing).
How might a strong support system help improve mental health?
Thyroid eye disease may create barriers in your relationships, but it’s worth it to nurture these bonds. Positive social interactions and a strong support system help create a buffer against anxiety and depression.
It may help to feel like you have someone you can talk to about what you’re going through. This may be a friend or family member — but it could also be your doctor or therapist. “Just the cathartic act of talking and putting words to your feelings can be very helpful,” says Dr. Sanchez Escobar.
Your doctor can also help you find the best treatment plan for your thyroid eye disease and Graves’ disease. Treatment may help reduce symptoms of hyperthyroidism, which may improve your quality of life. With your condition under control, you may find it easier to manage your mental health.
Jose Escobar, MD, is a board-certified endocrinologist at Lenox Hill Hospital.
References
American Thyroid Association. (N.D.). Graves’ eye disease (Graves’ ophthalmopathy or Graves’ orbitopathy).
Cockerham, K. P., et al. (2021). Quality of life in patients with chronic thyroid eye disease in the United States. Ophthalmology and Therapy.
Harandi, T. F., et al. (2017). The correlation of social support with mental health: a meta-analysis. Electron Physician.
McAlinden, C. (2014). An overview of thyroid eye disease. Eye and Vision.
MedlinePlus. (2021). Hyperthyroidism.
Mushtaq, R., et al. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical & Diagnostic Research.
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Graves’ disease.
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Hyperthyroidism (overactive thyroid).
Yeatts, R. P. (2005). Quality of life in patients with Graves ophthalmopathy. Transactions of the American Ophthalmological Society.
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