Last week I was diagnosed with hypothyroidism.
Reviewing the last several months, it’s amazing it took so long for the diagnosis to be made. I hope that by writing this article, you can gain some awareness of what hypothyroidism might look like for you, so you don’t have to struggle as I did with seemingly apparent symptoms.
For weeks I just wanted to sleep. Constant fatigue ruled my days, and yet insomnia ruled my night. For months, tingling, numbness on the right side of my face, left arm, leg had me sounding when I talked liked I was inebriated. (Think of Novocain that never entirely wears off). Uncontrollable shaking, trembling, and a startle reflex made it impossible for anyone to hear me. Brain fog, inability to concentrate, putting a sentence together, holding a thought, and wanting to curl up in bed, felt like the best place to be.
Perhaps one of the most challenging symptoms for me to talk about is the psychotic features. Hearing voices, visual hallucinations, paranoia, and delusional thinking are signs of something beyond ADHD. I now understand that they resulted from a severe depressive episode in which psychotic features are apparent. I was afraid to disclose these, thinking ashamed to be talking about such symptoms. I wasn’t sure if I was going crazy.
Considering my experience, it seemed like a good time to talk about whether or not thyroid problems could cause symptoms of ADHD or if there is any overlap between these two disorders. Studies find that 80 percent of people with attention deficit disorder will have at least one other psychiatric disorder in their lifetime. The two most common are depression and anxiety disorder. Both can lead to some of the symptoms above.
ADHD is a medical diagnosis. Because several other medical conditions share symptoms with ADHD, it is essential to make sure that you get a correct and accurate diagnosis. Your physician should complete a thorough physical examination to rule out any physical conditions, including blood work, PET scans, and cardiac health status. Please keep in mind that any of the following disorders can be present alongside ADHD.
Hypothyroidism means that you do not have enough thyroid hormones, and your thyroid is working overtime to make more. The symptoms of hypothyroidism in adults may include:
- Lack of energy
- A constant tired feeling
- Mental fogginess
- Difficulty with short- and long-term memory
- Abnormal sensitivity to cold temperatures, which can develop gradually
- Muscle cramps and stiffness
- Weight gain (often despite a poor appetite)
- Dry skin and hair
- Hair loss
- Psychiatric symptoms, including depression
Hyperthyroidism means that you are producing too much thyroid hormone in your body. Below are some of the potential mental and physical symptoms of hyperthyroidism.
- Mental impairment, memory lapses, diminished attention span
- Trembling hands
- Itchy skin
- Unexplained weight loss despite increased appetite
- Heart palpitations
- Increased sweating
- Muscle weakness
- Hair loss
These are just some of the symptoms of a possible thyroid problem. If you have ADHD and suspect that you are experiencing a worsening of these symptoms, get it checked out by your doctor.
About 30 percent of those with ADHD will experience a depression episode at some time in their lives. In making a proper diagnosis of depression, your doctor should distinguish between depression and your ADHD symptoms. Here are some differentiating factors:
- Persistent sad or irritable mood
- Loss of interest in activities once enjoyed. With depression, a person finds no enjoyment in anything.
- Change in appetite or body weight with depression. Some may lose their appetite. With ADHD, loss of appetite is caused by hyper-focusing on other activities or related to stimulant treatment.
- Sleeping too little or too much Your doctor should assess your sleep patterns for some time, not just in the last week. With depression, tiredness is unrelated to how much sleep you are getting night after night. Many with ADHD do not sleep enough or sleep too much but what qualifies sleeplessness as a depressive symptom is the episodic nature; it occurs without a context.
- Physical agitation or slowing Your doctor will ask if you feel agitated or slow, even when engaged in something that interests you.
- Feelings of worthlessness or inappropriate guilt
- Recurrent thoughts of death or suicide are always serious clinical matters when someone has thoughts of suicide or a preoccupation with death. Depression brings on a mindset in which it seems rational to take one’s life.
- In addition to these clinical criteria, your doctor will ask you about your family history. Both ADHD and major depressive disorder run in families. Studies find that depression in individuals with ADHD is often caused by relationship conflicts or social isolation related to ADHD symptoms.
- Finally, your doctor should assess whether depressive symptoms are caused by, or exacerbated by, a medication you are taking or any side effects of medication. A physical exam also needs to be conducted to rule out thyroid problems or other medical conditions.
Evaluation Tool for Depression
- The Beck Depression Inventory or automatic thoughts questionnaire (for adolescents and adults) or children’s depression inventory (for children and adolescents) are quick, reliable surveys that could aid in diagnosing depression. The severity and course of a depressive episode may be charted if a patient monitors symptoms daily.
- The structured clinical interview for DSM-v disorders (SCID-5) (for adults) and diagnostic interview for children and adolescents-revised are reliable instruments that use the DSM-v criteria to assess for clinical conditions.
- Avoidance one of the expected behaviors of anxious people is avoidance. Whether it is about things or socially related situations (social anxiety disorder), avoidance is an attempt to prevent feeling anxious. However, avoidance only leads to more anxiety since it prevents a person from practicing how to tolerate that situation.
- Dealing with change, those with ADHD often like change, but they may also find change stressful since it requires new ways of engaging with their environment. People with anxiety are usually attached to the routine since it offers certainty in their lives. Your doctor should ask how well you deal with change and transition.
In addition to the above, as part of your evaluation, your doctor should always ask you about your family history. Anxiety disorders run in families. Knowledge is power. Dealing with ADHD symptoms is challenging enough. Coping with depression, hypothyroidism, or anxiety is debilitating. Only with proper assessment and diagnosis can treatment for both, either, or all be possible.
I’d like to hear about your experience with a Thyroid disorder, depression, and ADHD. You can reply to this email to share your experience with me.