A global crisis can severely affect mental health for everyone, but especially for those who experience mental illness. Depression and anxiety already often impact those with hypothyroidism, so the added stress of a pandemic can certainly worsen or trigger symptoms.
Acknowledging, identifying, and acting on mental distress in these unprecedented times is essential to managing its impact.
Common mental health symptoms
Emotional or mental health symptoms are common in patients with thyroid dysfunction. Understanding the implications may help you to take effective action.
Anxiety
COVID-19 is undoubtedly causing anxiety for many. A survey by the Chinese Psychology Society found that nearly 43% of people experienced anxiety related to the coronavirus outbreak. Some key worries are that you or someone in your family will get sick, that you may be at higher risk due to your thyroid condition, or that your finances will be negatively impacted.
Loneliness
To slow the spread of COVID-19, public health experts and the CDC encourage social distancing to keep sick people from contact with healthy people. However, this physical distance can understandably lead to emotional loneliness, which has adverse mental and physical impacts like elevated levels of stress and inflammation.
Depression
People who are isolated or quarantined may also experience traumatic stress. A survey by the University of Toronto found that nearly 29% of people quarantined during the SARS outbreak in 2003 experienced symptoms of traumatic stress and depression.
Strategies to support mental wellness
Ahead, a list of coping strategies to help get manage these uncertain times.
Test and treat your thyroid condition
Understand what's happening with your thyroid function to set yourself up for success. This time is likely to cause mental distress in everyone. Still, if you also have an underactive thyroid gland, you can level the playing field with treatment.
If you have symptoms of hypothyroidism, we recommend that you measure your thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid peroxidase (TPO) antibodies.
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Common symptoms of hypothyroidism include:
- Fatigue
- Increased sensitivity to cold
- Constipation
- Dry skin
- Weight gain
- Puffy face
- Hoarseness
- Muscle weakness
- Elevated blood cholesterol level
- Muscle aches, tenderness, and stiffness
- Pain, stiffness or swelling in your joints
- Heavier than normal or irregular menstrual periods
- Thinning hair
- Slowed heart rate
- Depression
- Impaired memory
- Enlarged thyroid gland (goiter)
Should your results show that your thyroid is underactive, it is easily treatable in almost everyone. Optimizing your thyroid levels with thyroid hormone replacement medication is usually the first step in minimizing symptoms like mental health issues. When choosing thyroid medication with your doctor, remember that there is no one-size-fits-all treatment. Each of us is unique with individual sensitivities.
Limit your news consumption
Of course, the news is useful to understand updates and precautions, but obsessively reading, watching, and listening to the news about the outbreak can be harmful to your mental health. The National Alliance on Mental Illness recommends relying only on one or two reliable sources of information and establishing a reasonable rate of consumption. Choose small windows of time once or twice a day to check trustworthy sources like the CDC or the WHO's daily situation reports, and then find ways to separate yourself from it.
Develop a contingency plan
Preparation can help to alleviate stress and anxiety. Make a plan for yourself and your family in case there is a COVID-19 outbreak in your community. Make a list in advance of where and how to get practical help, if needed. Speak to your health care advisor about any coronavirus precautions that may be specific to your hypothyroid or Hashimoto's needs.
We advise you to stock up on your thyroid (or other) medications in case you become limited by quarantine or product shortages. You can schedule a live video visit with a Paloma Health thyroid doctor to get the necessary refill scripts.
If you can't or don't want to go to a retail pharmacy, you can get your medications delivered. CVS Pharmacy and Walgreens are waiving charges for home delivery of prescription medications, or you can use mail-order pharmacies like PillPack or Honeybee Health.
If you need to pay out-of-pocket to stock up on critical scripts, use free resources like SingleCare and GoodRx to find the best self-pay price.
Stay connected to people who matter
Social distancing does not mean emotional distancing. Emotional connectedness is critical to fighting off loneliness and depression. Use technology like Skype, Zoom, FaceTime, email, or text message to connect with people who matter to you. Practice active and reflective listening to hear their concerns and be ready to share your own. This equal exchange may help to ease your own anxieties or fears.
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Eat well for a healthy mind
Make healthy eating a priority during this time. The thyroid is sensitive to changes in the gut microbiome. A well-balanced gut supports metabolic functions and helps to manage stress. Research shows that imbalance and inflammation in the central nervous system can cause mental illnesses like anxiety and depression.
Eat an anti-inflammatory, nutrient-rich diet. Vitamins A and D, zinc, and probiotics may help to support the immune system and thyroid functions. You can work with a nutritionist to identify any dietary triggers and reverse nutritional deficiencies.
Get adequate sleep
Sleep is a necessary human function. Getting a good (or bad) night of sleep affects everything from how your body processes food, to how it regulates blood sugar, remembers information, controls inflammation, and more.
Inadequate sleep can affect mood, memory, and judgment. 21% of adults even report feeling more stressed when they do not get enough sleep. We recommend you aim for seven to nine hours of sleep per night.
Stay active during quarantine
Research suggests that people who exercise regularly are more resilient against stress, which may protect them from diseases or flare-ups related to stress. Move your body for 30 minutes, three to five times per week.
If you experience muscle weakness or aches a thyroid symptom, you may feel uninspired. Don't overcomplicate it! Short bouts of physical exercise can add up to the weekly recommendations. Dancing, playing with your kids, yoga on YouTube, or doing chores like cleaning and gardening are excellent ways to stay active at home.
Do something to relieve stress
Like any other system in your body, the endocrine system is sensitive to stress. Too much stress can throw our endocrine system out of balance, including the levels of thyroid hormones produced. Do something(s) to relieve this stress.
Of course, there is no one-size-fits-all coping strategy. It can be helpful to find a coping strategy that easily fits into your (new) "normal" routine to increase the likelihood of maintaining that practice. Solutions-focused coping is when you try to find a direct solution to a stressor. Emotion-focused coping is when you work to regulate your reaction to a stressor. And wellness-focused coping is more holistic, looking at all the dimensions of wellness.
For wellness-focused coping, you might consider:
- Exercise for the physical dimension
- Reading or mind games for the intellectual dimension
- Money management for the financial dimension
- Spending time outside for the environmental dimension
- Practicing prayer or meditation for the spiritual dimension
- Therapy for the emotional dimension
- Connecting with friends and loved ones for the social dimension
- Establishing work/life boundaries for the occupational dimension
A note from Paloma Health
It is natural to experience stress and anxiety. Having an awareness of the interplay between your thyroid condition and these stressors better positions you to address them adequately. If you need additional support, please reference the reliable mental health resources listed below.
Resources:
- SAMSA Disaster Distress Help: 1 (800) 985-5990
- NAMI Helpline: 1 (800) 950-6264
- Crisis Text Line: Text HOME to 741741
- National Suicide Prevention Lifeline: 1 (800) 273-8255
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