Thyroid Function and Subtypes of Depression ?
Q.depression for over ten years, a few months ago had a miscarriage, followed by "thyroid storm" and then extreme mood swings, panic attacks, trips to the ER and finally, a diagnosis of Hashimoto's disease.
A.There are definitely deep and obscure connections between the inflammatory cytokines of the immune system, and the hypothalamo - pituitary - adrenal/thyroid endocrine set-up; John H knows a lot more about this than I do. The reason it's not well understood is not anybody's conspiracy but the fact that it's ruddy hard to understand. The first traces of sub-clinical thyroid changes in normal-thyroid depressives is one indictor of this. Thyroid disturbance and depression associated with pregnancy is another related area (one I know very little about). I am less inclined now to cry conspiracy (though pharmaceuticals are not absolved and if on their part there is no conspiracy it is only because they did a cost-benefit-analysis and found that active conspiracy has a lower yeild than reckless marketing) but I do wonder: what about all the people out there with a dx of Depression who don't know that the Endocrinology ass'n revised its guidelines for hypothyroidism? What if they had their thyroid checked before 2001 (when the guidelines were changed) and their doc said "well, it's not your thyroid, so it's Depression?" How will they ever find out they have been grandfathered into the thyroid disorder group? Will they will be stuck in the psychiatry group (like me) until a real health crisis? And do you think there is a way to educate shrinks and get their cooperation in helping people who may be misdiagnosed? The general principle is that giving lowest-level stimulants for every kind of exhaustion even due to depression works very badly; same as giving lowest-level depressants for apparent anxiety. The stuff not only loses effectiveness... I suppose what I object to isn't capitalism, but unchecked greed that leads to irresponsible marketing and overprescribing of drugs, and thereby may obscure (and complicate)a person's true diagnosis. The responsibility here lies(in my mind)with physicians who want to preserve the hierarchy that places them far above the person whose body they are tampering with. I know it is hard for doctors to give up the feeling that (after the grueling years of med school and residency) they are entitled to no attitude other than abject obedience and adoration from patients, but any responsible doctor MUST shake this off if he or she wants to truly serve a patient's needs. Even though recommended changes to clinical laboratory standards were announced last year, the American Association of Clinical Endocrinologists (AACE) identified changes early this year, Until recently, the standard was that the normal range for TSH at most laboratories has fallen in the 0.5 to 5.0 range, with hyperthyroidism being below .5, and hypothyroidism above 5.0. There is something of a spectrum from people who think (unless they are rabidly anti-capitalist) that e.g. Ford Motor company are on the whole a worthwhile organisation producing a worthwhile product and do not actually need abolishing, although from time to time they needed their arse kicked for doing some absolutely vile things in terms of abusing employees, neglecting product safety, etc. Other people may precisely think that Ford, and manufacturing industry in general, are the scum of the earth -- quite possibly evil aliens infiltrated to control or destroy us -- and need to be abolished, demolished, and the ground where they stood ploughed with salt. Of course they do wrong things, because everything they do is wrong, they need wiping out. Much the same applies to doctors and medicines. If you are taking the former line then I would agree with you. However, Scientologists take the latter view on (mental health) doctors and (mental health) medicines, including the belief that they are evil space aliens who have been infiltrating Earth for many centuries, and that I find to be baking mad.
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