The Emotional Side of Graves' Disease


© Elaine Moore
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Patients with Graves' disease (GD) are likely to experience emotional problems, including nervousness, irritability, anxiety, depression, and emotional lability, characterized by mood swings. Sudden crying for no apparent reason and overreacting are also common. Many patients report feeling edgy and irritable one minute, and normal the next.

Emotional changes in Graves' disease are primarily caused by the effects of excess thyroid hormone on thyroid receptors in the brain. Emotional disturbances may also result from nutrient deficiencies and exhaustion. Cognitive changes in GD caused by hormonal imbalances also weaken the ability to cope with stress. Compounding the problem, stress causes endocrine and immune system change, which exacerbate symptoms.

Writing in The Thyroid Solution, Dr. Ridha Arem explains that the most common effect of an overactive thyroid is anxiety. Anxiety in GD takes on an exaggerated form in which the increased worrying and overall feeling of insecurity and instability are worsened by mood swings, anger, inability to focus and foggy memory. The fear associated with these symptoms may cause patients to develop panic attacks and agoraphobia, a condition which makes its victims afraid to leave their homes.

In early stages of GD, patients may feel energetic and elated. They may even experience hypomania, a subdued form of mania, which may progress to mania or psychotic episodes. Tremors and hyperkinetic movements are a frequent occurrence and are caused by the effect of excess thyroid hormone on the nervous system. Muscle wasting can be so dramatic in Graves’ disease that patients may have difficulty climbing stairs, adding to their anxiety and depression.

Dr. Arem reports that job performance is frequently affected by symptoms of hyperthyroidsm. In extreme cases, he writes, patients may become mentally and emotionally disabled. He lists the most common mental effects of hyperthyroidism as anxiety, nocturnal anxiety with insomnia, panic attacks, depression, excessive concern about physical symptoms, emotional withdrawal, disorganized thinking, guilt feelings, loss of emotional control, irritability, intense mood swings, episodes of erratic behavior, paranoia, and aggression.

It’s hardly surprising that many GD patients encounter problems at work. In fact, many patients, report being accused of having drug problems before their GD diagnosis. One male patient who I interviewed reported being accused of using drugs by his boss and subjected to a random drug test. While he knew drugs weren't the problem, this job related stress aggravated his GD symptoms, and he admitted to fearing that he was losing his mind. When he was finally diagnosed with GD, his co-workers accused him of exaggerating his symptoms of muscle fatigue, and complained that he wasn't pulling his share. He ended up eventually quitting this job.

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