October 2024

Is There a Link Between Hypothyroidism and Bipolar Disorder? Bipolar disorder is a complex mental health condition distinguished by extreme mood shifts. Hypothyroidism is a state in which a person suffers from abnormally low thyroid gland activity, resulting in metabolic changes in adults. The symptoms between these two illnesses are remarkably similar, which leads to misdiagnoses and improper treatment.  Our holistic approach to mental health encourages us to consider how underlying physical conditions, like hypothyroidism, might impact mental health disorders. By understanding how hypothyroidism can exacerbate or even mimic symptoms of bipolar disorder, we gain new insights into the importance of a whole-body approach to managing mental health. Understanding the Connection Between the Thyroid and Mental Health The thyroid gland, located at the base of the neck, produces hormones that regulate energy, metabolism, and mood. The body’s ability to regulate these essential functions diminishes when the thyroid is not performing sufficiently, as in hypothyroidism. Common symptoms of hypothyroidism include fatigue, depression, memory problems, weight gain, and slowed cognitive function.   Thyroid dysfunction can directly impact mental health by disrupting neurotransmitter balance, affecting mood stability and cognition. Since neurotransmitters are essential for mood regulation, an underperforming thyroid can lead to symptoms that overlap significantly with mood disorders like bipolar disorder. This overlap can often result in misdiagnoses, where individuals with hypothyroidism might be diagnosed with bipolar disorder when, in reality, addressing their thyroid dysfunction could alleviate their mental health symptoms. In the case that hypothyroidism is a comorbidity, addressing the thyroid gland can significantly lower bipolar symptoms. Symptoms Overlap Between Hypothyroidism and Bipolar Disorder There is a significant overlap in symptoms between hypothyroidism and bipolar disorder, particularly in the depressive phase. Many symptoms of hypothyroidism—such as fatigue, irritability, cognitive slowing, and depression—can also be present in bipolar disorder.This overlap can be particularly challenging when it comes to diagnosis. For instance, during a depressive phase, a person with bipolar disorder may experience severe fatigue, weight changes, and low mood—all of which are also common in hypothyroidism. Conversely, untreated or undiagnosed hypothyroidism may cause mental health symptoms that are wrongly attributed to bipolar disorder, leading to treatment that addresses symptoms without tackling the underlying cause. Unfortunately, in cases where hypothyroidism is undiagnosed, individuals might receive mood stabilizers or antidepressants, which can be ineffective or even counterproductive if thyroid issues remain unaddressed.  Hypothyroidism’s Impact on Neurotransmitters and Mood One key area of research in modern psychiatry is the role of neurotransmitters, such as serotonin, dopamine, oxytocin, and norepinephrine, in mood regulation. Hypothyroidism affects the brain’s ability to produce and regulate these neurotransmitters, leading to emotional instability and cognitive difficulties, which may present as symptoms similar to bipolar disorder.  Low thyroid hormone levels can cause a reduction in dopamine, the neurotransmitter that contributes to feelings of motivation and pleasure. This decrease in dopamine can result in anhedonia — a loss of interest in enjoyable activities—, low motivation, and feelings of hopelessness. Meanwhile, low serotonin levels, often seen in hypothyroidism, contribute to depression and anxiety. This hormonal imbalance can create the emotional rollercoaster that individuals with bipolar disorder frequently experience.  A Holistic Path to Healing In conventional medicine today, endocrinologists will administer medication and supplements like selenium for individuals with hypothyroidism. At BP Harmony, we are a proponent of integrative, root-cause medicine, advocating for approaches that consider the whole person rather than merely treating symptoms. We argue that conventional treatments often overlook underlying physical causes, like hypothyroidism, that may be contributing to mental health issues.  Hence, we recommend a comprehensive approach for those diagnosed with bipolar disorder that involves screening for thyroid dysfunction alongside other underlying health conditions that might be influencing mental health. Our approach includes working with integrative medicine physicians, making nutritional changes, detoxification, and lifestyle modifications supporting thyroid and mental health.  Nutritional Support for the Thyroid: Diet is one of the foundational elements we emphasize for supporting thyroid health. We suggest minimizing processed foods, refined sugars, and inflammatory substances, which can contribute to hypothyroidism. Instead, a diet rich in whole foods, notably those high in iodine, selenium, and zinc, can support thyroid function. Sea vegetables, seafood, nuts, and whole grains offer nutrients that boost thyroid health, which may positively impact mood stability. Moreover, consider eliminating gluten and dairy, as these two food types are often at the root of thyroid dysfunction. Learn more about the best diet for bipolar disorder here. Detoxification: Toxins such as heavy metals and endocrine disruptors (often found in household chemicals and certain foods) can impair thyroid function. We encourage reducing exposure to these toxins by opting for natural cleaning products, avoiding plastic containers, and choosing organic foods when possible. Detoxification practices such as sweating through exercise or sauna use and consuming antioxidant-rich foods can help the body eliminate these harmful substances. Mindfulness and Stress Reduction: Chronic stress negatively affects both thyroid and mental health, with elevated cortisol levels inhibiting thyroid hormone production. BP Harmony’s approach includes stress-reduction techniques like meditation, yoga, and deep breathing exercises to lower cortisol levels and support thyroid health. By reducing stress, individuals can foster an environment where mental and thyroid health can improve. Addressing Nutritional Deficiencies: Hypothyroidism is sometimes linked to deficiencies in essential nutrients like vitamin D, B12, and iron. The latest medical research from Harvard Medical School and Cleveland Clinic recommends getting tested for deficiencies and supplementing as necessary, as these nutrients play a critical role in thyroid function and neurotransmitter synthesis. Addressing these nutritional needs through food and supplements if they are incredibly deficient can support overall mood stability and energy levels. The Path Forward This blog post begins to shed light on the intricate relationship between hypothyroidism and bipolar disorder. By understanding how thyroid health can influence mood and mental well-being, individuals with bipolar disorder may have the opportunity to address an underlying physical cause of their symptoms, potentially improving mood stability and overall quality of life.If you or someone you know has bipolar disorder and exhibits symptoms of hypothyroidism, it may be worthwhile to explore this connection with a

Severe Psychosis & Bipolar Disorder – Are They Linked? The experience of bipolar disorder can be summarized by the vacillating, dizzying highs of mania and the crushing, murky lows of depression. The focus of this blog post is to highlight an extreme byproduct of bipolar disorder: psychosis.  Someone who experiences mania for the first time without a diagnosis or any prior history might think they are extra productive, super confident, and utterly invincible. These feelings lead to little to no sleep, thoughts of grandeur, excessive spending possibly, and more irregular behaviors. The dangers of staying in this heightened state are many, but when mixed with things like stress, substance abuse, and trauma, a person can tip over into psychosis. This complex dynamic between bipolar disorder and psychosis can make an already difficult condition even more challenging to navigate. To understand this connection, let’s explore the key elements linking these experiences. Panic Amid the Chaos: A First Look at Bipolar Disorder and Psychosis The Oxford Dictionary defines psychosis as, “a severe mental condition in which thought and emotions are so affected that contact is lost with external reality.” It is this loss of contact with reality that tells if a person experiencing mania has also reached a clinically psychotic state.  For anyone dealing with bipolar disorder, the cycle between mania and depression is disorienting. Imagine, then, the added confusion when panic sets in—not just from the swings themselves but from losing touch with reality. This is what happens when bipolar disorder manic episodes are paired with psychotic features. A person experiencing psychosis may find themselves trapped in a whirlpool of fear and misunderstanding, where they cannot differentiate between what is real and what is imagined. Panic becomes the overriding emotion. People often describe feeling chased by thoughts, images, or sounds that aren’t there, leading to behaviors that are out of character, unpredictable, and often harmful. Psychosis and Mania When we talk about bipolar disorder, especially in its most extreme forms, we’re not just talking about mood swings. In some cases, mania can evolve into something far more severe—bipolar mania with psychotic features. This type of mania doesn’t just involve elation, irritability, or hyperactivity; it can also include episodes of psychosis, where, as mentioned above, individuals lose touch with reality. For some, it means hearing voices or seeing things that aren’t there. For others, it involves delusions—firmly held false beliefs. Imagine believing you are the president of a country, when in fact you are sitting in your living room. Or perhaps you think you’ve been chosen by a higher power to save the world. These delusions and hallucinations are entirely real to the person experiencing them, even though those around them may be baffled by what’s happening. Witness accounts recount how clinically psychotic people believe cryptic messages are coming from the government in the forms of lights, colors, numbers, and even recorded videos on the internet. One can only imagine the chaotic rabbit hole a person experiencing psychosis may go down and find it difficult to come back. What’s important to recognize is that bipolar mania with psychotic features is not uncommon. It’s a significant symptom for many individuals living with bipolar disorder.  Psychosis and Depression While psychosis occurs more commonly with manic episodes, it sometimes occurs during severe depressive episodes. In other words, an individual might cycle between major depressive episodes and manic episodes, sometimes with psychotic features on both ends of the spectrum. During these major depressive episodes, individuals may experience deep hopelessness, guilt, or worthlessness. When psychosis enters the picture, these feelings can evolve into delusions of persecution or hallucinations that reinforce negative thoughts. For instance, a person might believe that they are responsible for a catastrophic event or that voices are urging them to commit harmful acts. They may see or hear traumatic memories play in front of them, sending them into a state of fear and panic as if they were experiencing the event all over again.  The severity of these mood swings and their psychotic features can make bipolar disorder particularly unpredictable and dangerous. It’s not just about moving from mania to depression; it’s about dealing with the potential of losing touch with reality during both phases, a fact that makes this condition much more than a simple mood disorder. Guardrails to Protect Against Psychosis For those living with bipolar disorder, especially when psychosis is part of the equation, effective management is key. Medication, including mood stabilizers and antipsychotics, plays a central role in conventional psychiatric care. Psychotherapy, too, can help individuals recognize triggers and develop coping strategies for dealing with episodes of mania, depression, and psychosis. At BP Harmony, we advise people in the psychotic individual’s life (ie their community) to find a person whose opinion the individual respects and to consider the following steps:  This person must listen to the psychotic individual and identify those aspects of the person’s thinking that reflect a disconnect with reality.  Then ask if the person has always had these thoughts or if they are recent. If they are recent, then consider emphasizing that they didn’t see things their current way before. This will identify that there is some change in the person that others are noticing.  Express concern for the individual and invite them to consider the changes in their life due to the state they are in.  Reassure that you will be there to figure things out with them as opposed to suggesting that they need help. This may turn them away and cause them to reject help. The tricky challenge is to somehow get the person who is deeply caught in a false reality to realize on their own they have lost connection with reality. This is where a trusted person, psychiatrist, and therapist can effectively work together. In the meantime, the safest route is to get the person under the right medication or even admit them to a hospital to prevent harm to themselves and others.  Conclusion The connection between bipolar disorder and psychosis