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 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.

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)

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.

Other Signs of Thyroid Disease

Thyroid disease can also have physical symptoms.

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.

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)

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)

Summary

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

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

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.

People with hypothyroidism can experience emotional distress such as depression, anxiety, and anger.

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.

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.