Does Hashimotos cause irritability?

How Thyroid Disease Affects Your Mood

Heather M. Jones is a freelance writer with a focus on health, parenting, disability, and feminism.

Published on October 15, 2022

Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.

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The thyroid is a butterfly-shaped endocrine gland located in the neck. It plays a role in many areas of the body, including metabolism (the speed at which people burn energy), heart rate, mood, and cognition.

The thyroid produces hormones such as thyroxine (T4). Thyroid disease can cause, or be caused by, disruption in thyroid hormone production and regulation. An underactive thyroid is called hypothyroidism , while an overactive thyroid is called hyperthyroidism .

Approximately 20 million Americans have thyroid disease, with more than 12% of the U.S. population expected to develop a thyroid condition within their lifetime. As many as 60% of people with thyroid disease are not aware that they have it.

Read on to learn more about thyroid disease, its symptoms, and how it affects mood.

How a Thyroid Imbalance Affects Mood

Changes in mood and cognition have long been associated with thyroid disruption, going back to some of the earliest known descriptions of thyroid disease.

Hypothyroidism and hyperthyroidism are both associated with psychiatric disturbances that can mimic mental illness.

Hypothyroidism

People with hypothyroidism can show psychiatric and cognitive symptoms such as:

Slowness of thought/mental processes
Increased depressive symptoms (sometimes with paranoia)
Anxiety
Short temper
Excessive stress
Apathy/loss of interest and initiative
Difficulty with memory, especially for recent events
«Dulling» of personality’s vivacity
General intellectual deterioration
Muddled thinking
Psychomotor (physical movement related to cognitive processing) slowing
Symptoms that mimic melancholic depression or dementia (in severe, untreated cases)

The symptoms of hypothyroidism can develop slowly and be minor and/or vague in the early stages. Physical symptoms, such as weight gain or joint pain, may be noticed sooner than psychological or cognitive ones. Psychological symptoms, however, may be the reason a person with hypothyroidism seeks medical advice.

The mood stabilizer lithium (used in the treatment of some mental illnesses) can lead to hypothyroidism, which can then result in depression, particularly in women who are in their middle-aged years. People who are taking lithium—or any long-term psychiatric medications—should have their thyroids checked.

Hyperthyroidism

People with hyperthyroidism may experience:

Anxiety
Panic attacks
Tension
Nervousness
Mood swings/emotional lability (rapid changes between emotions)
Impatience/short temper
Irritability
Distractibility
Overactivity (higher than expected or typical activity levels)
Higher sensitivity to noise
Fluctuating depression
In extreme cases, symptoms that mimic schizophrenia , such as a loss of touch with reality, delirium , or hallucinations (these symptoms are seen less often now because of improved diagnostics and effective treatments)
Dysphoria (feelings of discomfort, unease, distress, or unhappiness)
Difficulty concentrating
Loss of interest in sex

People in their senior years with hyperthyroidism may have symptoms that include:

Apathy
Lethargy
Pseudodementia (cognitive impairments related to depression, not true dementia)
Symptoms that mimic a depressive disorder

How Is Thyroid Disease Diagnosed?

To make a diagnosis of thyroid disease, a healthcare provider may use tools such as:

A physical exam
Questions about symptoms and medical history
Blood tests (checking for things such as thyroid hormone levels)
Imaging tests (such as ultrasound, thyroid scan, or a radioactive iodine uptake test)
Thyroid fine needle biopsy (to check thyroid cells for cancer)

How to Manage Mood Swings and Anger

Addressing thyroid problems such as hypothyroidism or hyperthyroidism generally addresses the psychological and cognitive symptoms associated with the condition. If emotional symptoms continue even with effective thyroid treatment, there may be something else at play in addition to the thyroid condition.

Treating Hypothyroidism

Hypothyroidism is typically treated by replacing the hormones that the thyroid is not making, with the goal of replicating normal thyroid functioning as closely as possible.

Thyroid hormone treatments are usually taken orally in tablet, gel capsule, or liquid forms.

Your healthcare provider will monitor your hormone levels to make sure your dosage is correct and effective.

Treating Hyperthyroidism

Treatments for hyperthyroidism include:

Medication: Antithyroid medicines cause the thyroid to make less thyroid hormone, and beta blockers reduce symptoms such as tremors, rapid heartbeat, and nervousness.
Radioiodine therapy: Radioactive iodine, swallowed as a capsule or liquid, slowly destroys the cells of the thyroid gland that produce thyroid hormone. This usually leads to hypothyroidism, which is easier to treat and has fewer long-term effects.
Surgery: Part or most of the thyroid gland is removed. This is typically reserved only for rare cases, such as when people have large goiters (meaning those whose thyroid gland has grown larger) or are pregnant and cannot take antithyroid medicines.

Managing Irritability

If irritability is one of your symptoms, there are things you can try along with treating the underlying thyroid conditions. Ways to help yourself manage irritability include:

Reduce your intake of (or avoid) caffeine, tobacco, and alcohol.
Get enough good-quality sleep.
Engage in physical activity.
Determine what triggers your irritability (try keeping a diary to look for patterns).
Practice relaxation techniques, such as mindfulness, breathing exercises, or yoga.
Engage in activities you enjoy, such as listening to music, reading, or watching TV.
Be creative (paint, dance, sing, or make something).
Take a bath or shower.

How Common Are Anger or Mood Swings With a Thyroid Imbalance?

One study showed depression occurring in almost 50% of cases of hypothyroidism. Another study found that 60% of people with hypothyroidism reported depressive symptoms and 63% reported anxiety symptoms.

Other Signs of Thyroid Disease

Thyroid disease can also have physical symptoms.

Hypothyroidism

Physical symptoms of hypothyroidism include:

Fatigue
Skin changes, such as dry, rough skin and a pale complexion
Puffy face
Hair loss/dry, thinning hair
Voice changes
Decreased appetite
Weight gain
Joint and muscle pain
Intolerance to cold
Constipation
Decreased sweating
Heavy or irregular menstrual periods
Fertility problems in people who can get pregnant
Slowed heart rate
Goiter (enlarged thyroid, which may make the neck look swollen and can sometimes cause trouble with breathing or swallowing)

Hyperthyroidism

Physical symptoms of hyperthyroidism can vary, but may include:

Fatigue
Muscle weakness
Intolerance to heat
Sleep difficulties
Tremor (usually in hands) or twitching
Rapid and/or irregular heartbeat
Frequent bowel movements or diarrhea
Weight loss
Increased appetite
Goiter
Hyperactivity
Increased urination
Persistent thirst
Itchiness
Hives (raised, itchy rash)
Warm skin and excessive sweating
Red palms of the hands
Loose nails
Eye problems (such as redness, dryness, or vision problems)

Symptoms of hyperthyroidism in adults over age 60 may present differently than in younger adults, including a loss of appetite or withdrawal from other people. Their symptoms may be mistaken for depression or dementia.

Untreated hyperthyroidism can lead to serious health problems, including:

An irregular heartbeat that can lead to heart problems such as blood clots, stroke, heart failure, and other heart-related concerns
Graves’ ophthalmopathy (an eye condition that can cause double vision, light sensitivity, eye pain, and in rare cases vision loss)
Thinning bones and osteoporosis
Fertility problems in people who can get pregnant
Pregnancy complications (such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage)

What Are Some Thyroid Conditions?

Thyroid problems include:

Hyperthyroidism: Thyroid makes more thyroid hormones than the body needs
Hypothyroidism: Thyroid does not make enough thyroid hormones
Goiter: Enlargement of the thyroid
Thyroid nodules: Lumps in the thyroid
Thyroiditis: Swelling of the thyroid
Thyroid cancer

Summary

The thyroid is a butterfly-shaped gland in the neck that produces thyroid hormones.

Two common thyroid problems are hypothyroidism (too few thyroid hormones produced) and hyperthyroidism (too many thyroid hormones produced).

Hypothyroidism and hyperthyroidism can cause physical symptoms as well as psychological and cognitive symptoms (such as mood swings and symptoms that mimic mental illness).

Treating the underlying thyroid problems usually improves psychological and cognitive symptoms.

A Word From Verywell

If you have symptoms of thyroid disease, whether physical, psychological, cognitive, or in combination, talk to your healthcare provider. They can help you find the best treatment for you.

Frequently Asked Questions

Does hypothyroidism make you angry?
People with hypothyroidism can experience emotional distress such as depression, anxiety, and anger.
Can thyroid problems make you bipolar?

Though thyroid disorders have been associated with symptoms of mental illness, including mood disorders, symptoms of anxiety and depression with hyperthyroidism are most common. Bipolar disorders are less common.

What is thyroid psychosis?

Psychotic symptoms can occur in people with untreated hypothyroidism. This is called myxedema psychosis (a secondary psychotic disorder resulting from other medical conditions). It is typically treated with antipsychotics and thyroid hormone supplementation.

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Ritchie M, Yeap BB. Thyroid hormone: Influences on mood and cognition in adults. Maturitas. 2015;81(2):266-275. doi:10.1016/j.maturitas.2015.03.016
St. Luke’s Health. Is thyroid disease behind your mood swings?
American Thyroid Association. General information/press room.
Thyroid Foundation of Canada. The thyroid and the mind and emotions/thyroid dysfunction and mental disorders.
Hage MP, Azar ST. The link between thyroid function and depression. Journal of Thyroid Research. 2012;2012:1-8. doi:10.1155/2012/590648
MedlinePlus. Hypothyroidism.
National Health Service. Symptoms. Overactive thyroid (hyperthyroidism).
Office on Women’s Health. Thyroid disease.
MedlinePlus. Hyperthyroidism.
American Thyroid Association. Thyroid hormone treatment.
healthdirect. Irritability and feeling on edge.
Pankowski D, Wytrychiewicz-Pankowska K, Janowski K, Pisula E, Walicka M. The role of illness-related beliefs in depressive, anxiety, and anger symptoms: an on-line survey in women with hypothyroidism. Front Psychiatry. 2021;12:614361. doi:10.3389/fpsyt.2021.614361
MedlinePlus. Thyroid Diseases.
Hu LY, Shen CC, Hu YW, et al. Hyperthyroidism and risk for bipolar disorders: a nationwide population-based study. Kato T, ed. PLoS ONE. 2013;8(8):e73057. doi:10.1371/journal.pone.0073057
Mohamed MF, Danjuma M, Mohammed M, et al. Myxedema psychosis: systematic review and pooled analysis. NDT. 2021;17:2713-2728. doi:10.2147/NDT.S318651

By Heather Jones
Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism.

Thyroid disorders and their effect on cognitive function, mood and emotions

A healthy thyroid plays a vital part in brain chemistry, so we should not be surprised that a thyroid disorder can cause unpredictable mood changes. For example those with an overactive thyroid (hyperthyroidism) can suddenly feel tense and anxious. They may experience panic attacks, impatience, be overactive and have an exaggerated sensitivity to noise.

If you have an underactive thyroid (hypothyroidism) you may feel stressed and overwhelmed and experience depression, tearfulness, and loss of appetite. Overall you may feel a progressive loss of initiative, a dulling of personality and you may encounter memory problems, difficulty in concentration, muddled thinking and a lack of interest or mental alertness.

Unfortunately hypothyroidism medication is slow acting and it can take months before all symptoms are fully improved — which in itself can make people feel low.

In both thyroid disorders you may also suffer from mood swings or short temper and difficulties in sleeping. Generally the more severe the thyroid disease the more severe the mood changes.

All this is caused either by abnormal or rapidly changing thyroid levels or can be a side effect of treatment. For example, if you have hyperthyroidism and have been prescribed beta blockers to slow down your heart rate this can make some people feel less mentally alert, depressed and fatigued.

And naturally any physical changes caused by a thyroid disorder (such as weight gain or loss of hair) can lead to low self-esteem.

The main thing is not to keep such things to yourself but to talk to your doctor because this is part of your overall condition. The first thing your doctor can do is run tests to check if your thyroid medication is properly balanced. In many instances psychological symptoms will improve and vitality will return as the disorder is brought back under control by treatment.

In the event of severe symptoms which are not improving your doctor can refer you to a specialist in endocrinology and may also decide that anxiety or depression should be treated in its own right through therapy or anti-depressants.

Alongside these things you’ll respond better to medication if you manage your stress levels and eat a healthy diet. Try to establish a good sleep routine as well — winding down before bedtime and going to bed/waking up at the same time of day will help you break the cycle of lack of sleep at night making you irritable

Talk also to your friends and family so that they can understand what is happening and have the opportunity to be supportive.

Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.

As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link