Type D Personality and Hypothyroidism

In this article

• What is a Type D personality?
• Quiz: Do you have a Type D personality?
• Health implications of a Type D personality
• Type D personality and autoimmune disease
• Type D personality and hypothyroidism
• Strategies to counteract negative effects of Type D personality
• A note from Paloma

In recent years, research has increasingly highlighted the complex relationship between personality traits and chronic health conditions. Among these, the link between Type D personality—a pattern characterized by high levels of distress and social inhibition—and hypothyroidism, a common thyroid disorder, has received increasing attention. Individuals with Type D personality are more likely to experience persistent negative emotions, which can worsen health issues, including those related to thyroid function.

Understanding this connection is crucial, as it may provide new insights into the holistic management of hypothyroidism, emphasizing the importance of addressing both psychological and physiological factors to improve patient outcomes and quality of life. Ahead, a look at the connection between Type D personality and hypothyroidism.

What is a Type D personality?

Type D personality, also known as the “distressed” personality, is a psychological construct that describes individuals who tend to experience negative emotions and inhibit the expression of these emotions in social situations. Belgian psychologist Johan Denollet first introduced this personality type in the 1990s, and since that time, it’s gained significant attention in the field of health psychology.

Two main traits characterize type D personality:

Negative affectivity: Individuals with Type D personality tend to experience a high level of negative emotions across various situations. They are more likely to feel worried, irritated, or gloomy, even without obvious stressors. This persistent negative emotional state can significantly impact their overall well-being and quality of life.

Social inhibition: The second key trait of Type D personality is the tendency to inhibit the expression of emotions and behaviors in social interactions. These individuals often feel tense, insecure, or uncomfortable in social situations, leading them to suppress their true feelings and avoid potential disapproval or rejection from others.

Here are some key signs of a Type D personality:

Emotional traits

• Feelings of worry and anxiety
• Sadness and depression
• Irritability
• Pessimistic outlook
• Negative self-talk
• Tendency to experience strong negative emotions

Social behaviors

• Avoidance of social situations
• Social inhibition and discomfort
• Difficulty expressing emotions to others
• Fear of rejection
• Lack of self-confidence in social settings

Other characteristics

• Preference for routine and dislike of change
• Diligence and attention to detail
• Compassion and caring nature
• Tendency to suppress feelings
• Low self-esteem
• Perception of low social support

People with Type D personality tend to experience high levels of emotional distress while simultaneously suppressing the expression of these emotions in social interactions. This combination of negative affectivity and social inhibition is the hallmark of the Type D personality. While Type D individuals are often hardworking and compassionate, they frequently struggle with pessimism, worry, and difficulty connecting with others socially.

Quiz: Do you have a Type D personality?

Here’s a 10-question quiz to evaluate if you have a Type D personality. Each question is answered on a scale from 1 (Strongly Disagree) to 5 (Strongly Agree). The scoring instructions are included at the end. (Note: This quiz is a general guide and should not be used as a diagnostic tool. If you are concerned about your mental health, consider consulting a healthcare professional.)

Instructions

For each of the following statements, rate how much you agree or disagree on a scale from 1 to 5, where:

1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree

Questions

1. I often feel unhappy.
2. I find it difficult to express my feelings to others.
3. I tend to worry a lot about things that might go wrong.
4. I feel uncomfortable when I am the center of attention.
5. I often feel tense and stressed.
6. I prefer to keep my thoughts and feelings to myself.
7. I frequently feel insecure or self-conscious.
8. I find it hard to make decisions due to fear of failure.
9. I often feel irritable or angry, even over minor issues.
10. I tend to avoid social interactions whenever possible.

Scoring

• Negative Affectivity (NA): Add the scores for questions 1, 3, 5, 7, and 9.
• Social Inhibition (SI): Add the scores for questions 2, 4, 6, 8, and 10.

Interpretation

• NA + SI Score of 30 or above: You likely have a Type D personality, characterized by high levels of both negative affectivity and social inhibition.
• NA + SI Score between 20 and 29: You may exhibit some traits of a Type D personality but may not entirely fit the profile.
• NA + SI Score below 20: You are unlikely to have a Type D personality.

Health implications of a Type D personality

Type D personality, characterized by negative affectivity and social inhibition, has significant implications for both physical and mental health. This personality type is associated with  a range of adverse health outcomes and behaviors that can impact an individual’s overall well-being.

Physical health implications

Type D personality has been linked to an increased risk of cardiovascular problems. Individuals with this personality type are more likely to experience poor outcomes in coronary heart disease and have a higher mortality rate from cardiac events. The chronic stress and negative emotions associated with Type D personality may contribute to elevated blood pressure, inflammation, and other physiological changes that can damage the cardiovascular system over time.

Additionally, Type D personality is associated with poorer health behaviors. Research shows that people with Type D personality are less likely to engage in regular physical activity, maintain a healthy diet, or adhere to medical treatments. This tendency towards unhealthy lifestyle choices can exacerbate existing health conditions and increase the risk of developing chronic diseases.

Mental health implications

The impact of Type D personality on mental health is equally significant. People with this personality type are, according to research, more prone to experiencing symptoms of anxiety and depression. The combination of negative affectivity and social inhibition can lead to increased psychological distress and difficulty in coping with life’s challenges.

Studies have reported that Type D individuals often report lower quality of life across various domains, including emotional and physical well-being. They may struggle with social relationships, experience more work-related stress, and have difficulty finding satisfaction in their daily lives.

Health-related behaviors

The health implications of Type D personality are further compounded by its influence on health-related behaviors. These individuals have been shown to be more likely to engage in maladaptive coping strategies, such as emotional eating or substance abuse, which can have detrimental effects on their health.

In addition, Type D personality is associated with poor treatment adherence and reluctance to seek medical help when needed. This can lead to delayed diagnoses, inadequate management of chronic conditions, and overall poorer health outcomes.

Long-term consequences

The cumulative effect of these health implications can be significant over time. Type D individuals may face an increased risk of developing chronic diseases, experience more severe symptoms of existing conditions, and have a lower overall life expectancy compared to those without this personality type.

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Type D personality and autoimmune disease

There has been some research into the relationship between Type D personality and autoimmune diseases. Specifically:

Inflammation and immune response

Type D personality has been associated with higher levels of inflammation, which is a crucial factor in many autoimmune diseases. Individuals with a Type D personality may have an overactive immune response, contributing to the development or exacerbation of autoimmune conditions.

Stress and immune dysfunction

Chronic stress, which is more common in individuals with a Type D personality, can lead to immune dysfunction. Stress is known to exacerbate autoimmune diseases, so the stress-related traits of Type D personality might indirectly influence the course of autoimmune disorders. This connection is thought to be mediated through stress-triggering psychobiological pathways.

Anxiety and depression

Individuals with Type D personality are more prone to anxiety and depression, which have also been linked to the worsening of autoimmune diseases. The interplay between mental health and autoimmune conditions might be more pronounced in those with a Type D personality.

Specific autoimmune conditions

Some studies have explored the link between Type D personality and specific autoimmune diseases. For example, research has suggested a potential link between Type D personality and conditions like rheumatoid arthritis, where stress and emotional factors can play a significant role in disease severity and progression.

Type D personality and hypothyroidism

A study published in 2024 in the Journal of Clinical Endocrinology & Metabolism revealed a significant occurrence of type D personalities among people with hypothyroidism. Hypothyroidism is a condition where the thyroid gland is underactive, and doesn’t produce enough thyroid hormones. Despite receiving treatment and reaching normal hormone levels, 10 to 15% of those affected continue to experience lingering hypothyroidism symptoms with unclear underlying causes.

In this study, researchers surveyed over 3,500 individuals with self-reported, treated hypothyroidism. They found that more than half exhibited type D personality traits. The survey aimed to gain insights into the participants’ quality of life and understand some patients' dissatisfaction with their treatment results.

The study confirmed that people with hypothyroidism and type D personality appear to experience more negative treatment outcomes compared to those without type D personality. Specifically:

• They report higher levels of anxiety and depression
• They express greater dissatisfaction with care and treatment
• They experience more persistent symptoms despite treatment
• They report a poorer quality of life

Also, while the studies did not focus exclusively on Hashimoto’s thyroiditis, it’s relevant to note that:

• Hashimoto’s or autoimmune thyroiditis was the most common cause of hypothyroidism (36.5%) among study participants.
• There are shared immunological mechanisms between autoimmune thyroid disorders like Hashimoto’s and mood disorders.

The study also found that 66.1% of those with type D personality reported somatic symptom disorder, compared to lower rates in other groups.

Researchers propose two potential explanations for this relationship:

1. Shared underlying causes: Type D personality and hypothyroidism may have similar root causes.
2. Perception differences: People with type D personality may perceive their treatment outcomes more negatively.

Somatic symptom disorder and hypothyroidism

Somatic symptom disorder is a mental health condition characterized by an excessive focus on physical symptoms that causes significant distress and impairment in daily functioning.

Somatic symptom disorder is diagnosed when the following characteristics and behaviors are present:

• One or more distressing physical symptoms that disrupt daily life
• Excessive thoughts, feelings, or behaviors related to the physical symptoms, including at least one of the following:some text
  • Disproportionate and persistent thoughts about the seriousness of symptoms
  • Persistently high anxiety about health or symptoms
  • Excessive time and energy devoted to symptoms or health concerns
• Symptoms that persist for at least 6 months, though specific symptoms may vary

The key features of somatic symptom disorder include:

• Physical symptoms may or may not have an identifiable medical cause
• The person’s response to symptoms is excessive or out of proportion
• Symptoms are not intentionally produced or feigned
• Often begins before age 30
• More common in females

The key distinction in somatic symptom disorder is the excessive and disproportionate response to physical symptoms rather than the symptoms themselves. Proper diagnosis and treatment can help individuals better manage symptoms and improve their quality of life.

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Strategies to counteract negative effects of Type D personality

While having a Type D personality can pose challenges, there are several types of treatment strategies that you can adopt to mitigate its negative effects and improve your overall well-being.

Stress management

Practicing stress management techniques is crucial for individuals with a Type D personality to counteract their tendency towards negative emotions and social inhibition.

Practicing mindfulness and meditation can help patients with Type D personality manage their stress levels and negative thought patterns. These techniques can:

• Reduce rumination on negative experiences
• Increase awareness of present-moment experiences
• Promote emotional regulation

Regular mindfulness practice can lead to decreased anxiety and improved overall well-being.

Seek social support

Building a solid support network is essential. Despite their tendency to avoid social interactions, Type D individuals are encouraged to seek connections with friends, family, or support groups and build a support network. They can:

• Start with small, manageable social interactions
• Gradually expand their social circle
• Join support groups or community organizations

Sharing experiences and feelings with others can help reduce feelings of loneliness and isolation and improve self-esteem.

Challenge negative thinking

Type D individuals can benefit from challenging their negative thought patterns. Practicing gratitude and focusing on positive experiences can help shift their mindset. Journaling about personal strengths and achievements can also foster a more positive outlook on life.

Cognitive behavioral therapy (CBT)

Therapy, particularly cognitive-behavioral therapy (CBT), can be highly beneficial for those with a Type D personality. A mental health professional can provide tools and strategies to manage negative emotions and improve coping skills. CBT can be an effective tool for Type D individuals to:

• Challenge and reframe negative thought patterns
• Develop healthier coping mechanisms
• Improve social skills and reduce social inhibition

Therapy can help individuals develop healthier ways to express emotions and build stronger social connections.

Working with a therapist can provide additional support and tools to manage negative emotions and improve mental health.

Self-care

Incorporating self-care activities into daily routines can help alleviate the distress associated with Type D personality. Prioritizing self-care is essential for Type D individuals. This can involve:

• Ensuring adequate sleep
• Maintaining a balanced, nutritious diet
• Engaging in enjoyable hobbies or activities

Regular self-care activities such as mindfulness meditation, arts and crafts, or spending time in can improve overall well-being and resilience to stress, promote relaxation, and foster a sense of peace.

Self-compassion

Type D people tend to be self-critical. Cultivating and practicing self-compassion can boost confidence in social settings and counteract some of the adverse effects of a Type D personality. Practicing self-compassion involves cultivating a kinder relationship with yourself, especially during challenging times. Essential techniques include mindfulness, which helps you become aware of self-critical thoughts without judgment, and recognizing common humanity, which fosters a sense of connection by understanding that everyone faces struggles. Speaking to yourself like a friend, responding to challenges with compassion, and engaging in behavioral self-care activities can also enhance your self-compassion practice.

Additionally, mirror work and journaling can reinforce positive self-talk and help process your emotions. Incorporating guided meditations focused on self-compassion, such as loving-kindness meditation, can further support your journey. By integrating these strategies into your daily routine, you can build emotional resilience and improve your overall well-being, leading to a more compassionate and understanding relationship with yourself.

Physical exercise

Engaging in regular physical activity is crucial for Type D individuals. Exercise can:

• Release endorphins, improving mood and reducing stress
• Boost confidence and self-esteem
• Provide a healthy outlet for negative emotions

Activities like walking, running, swimming, or joining fitness classes can be particularly beneficial.

Time management and prioritization

Effective time management can help Type D individuals reduce work-related stress. Strategies include:

• Breaking large tasks into smaller, manageable steps
• Setting realistic goals and deadlines
• Learning to delegate tasks when possible

These techniques can help prevent feeling overwhelmed and reduce work-related stress.

Medications

In some cases, especially for people with somatic symptom disorder, antidepressants or anti-anxiety medications may be particularly helpful when depression and anxiety get in the way of managing chronic hypothyroidism.

A note from Paloma

Type D personality is a complex psychological construct characterized by negative emotions and social inhibition. While it can lead to significant mental and physical health challenges, adopting effective coping strategies can help you manage these effects. By practicing stress management, seeking social support, challenging negative thoughts, engaging in therapy, and prioritizing self-care, people with a Type D personality can improve their quality of life and mitigate the risks associated with this personality type.

In managing hypothyroidism, understanding your unique personality type is a factor in optimizing your wellness. At Paloma Health, we recognize the importance of personalized care, especially for those with a Type D personality. As a Paloma member, you benefit from a comprehensive approach that provides not just expert healthcare guidance but also convenient home testing, the opportunity for personalized health and nutrition coaching support, and a strong and active community of fellow patients. These integrated resources help you navigate the challenges of hypothyroidism, ensuring that your care plan is tailored to your needs so you can thrive with confidence in your health journey.

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