Issue 2: Misdiagnosis of thyroid-related depression

Depression
Low thyroid hormone levels can cause depression symptoms. Image: “Depression,” by Poughkeepsie Day School, April 19, 2012, from https://flic.kr/p/bPyAjv

This series of 6 blog posts tells my story and outlines the six challenges I’ve faced.

This post focuses on misdiagnosis of hypothyroid-caused depression, specifically the wrong assumption that all depression must be treated with antidepressant medication.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system:

  1. Delayed diagnosis of hypothyroidism
  2. Misdiagnosis of thyroid-related depression
  3. Ignorance of Hashimoto’s autoimmunity
  4. Lack of regular (or any!) thyroid ultrasound testing
  5. Lack of testing for Free T3 and Reverse T3 levels
  6. Lack of referral to an endocrinologist who understands

Issue 2. Misdiagnosis of thyroid-related depression

Alas, the sad stories of people being treated with antidepressants and psychotherapy when the solution could have been simply to adjust their Synthroid dose. These sad stories are easy to find on the Internet.

In my own experience, when I started experiencing bizarre depressive and cognitive-slowdown symptoms while my TSH was in the “normal” range, my case was also mishandled.

When I started feeling depressed again (as described in the previous section, without any personal, social or psychological trigger for depression), I decided to do research to find out what my optimal dose might be based on gender, body weight, and my TSH before treatment.  I found out that I should probably be on a higher dose of Synthroid.

I printed out the articles and brought them with me to the doctor’s office.

I was told I should go on antidepressants. I then pointed to my research articles.

The doctor took the papers out of my hands and dropped them directly in the trash bin in the examining room without looking at them.

I remember her then telling me, in regard to the papers she threw away, something like “Those papers are what’s driving you crazy.”

She reminded me of a previous time I had googled about my symptoms of the warts on my hands, and I was wrong about my suspected diagnosis.  She said, in a nutshell, “When you are ready to trust my expertise and accept treatment for depression, come back and make an appointment.”

I left the office in tears, but I was not going to accept antidepressants until I tried what raising my Synthroid dose could do.  I resolved to immediately seek a second opinion from a different doctor.

Later that same day, I met with an old doctor who was willing to give a raise in dose a try.

The slightly higher dose of Synthroid worked.

My depression symptoms quickly went away. They came back, occasionally, over the next 8 years, a few days after missing a daily dose or two.

 

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