Anxiety Disorders affect 18% of the American population every year (National Institute of Mental Health, 2009), and is characterized by disproportionate and near-constant stress and worry. Anxiety disorders can include several manifestations including, Panic Attacks, Agoraphobia, Specific Phobia, Social Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder and Generalized Anxiety Disorder (APA, 2000). To determine a diagnostic hypothesis for Anxiety Disorder, a psychology professional must differentiate between this disorder and other related disorders. Other issues, such as a general medical condition or substance use must be ruled out before determining Anxiety Disorder as a diagnostic hypothesis (First, et al., 2002, Schneider, 2001).
Hyperthyroidism is a medical condition that is caused by an overactive thyroid gland which can cause a variety of symptoms. Hyperthyroidism may mimic an anxiety disorder as symptoms can include difficulty concentrating, nervousness and restlessness which can be misconstrued as an anxiety disorder (National Institutes of Health, 2010). Additionally, the thyroid hormones elevated by hypothyroidism can cause anxiety disorders (Asland et al, 2005).
The hypothesis of hyperthyroidism and increased mental complaints is a topic studied by many researchers. In associated studies, the relationship between increased anxiety, other mental and physical disorders and hypothyroidism was researched thoroughly. A study initiated by Aslan et al. found that in patients studied, dysfunction of the tyroid is associated with mental disorder, however, there was no support for a clinical association of hypothyroidism and anxiety (2005). Interestingly, Grabe et al. and Aslan et al. who directly studied this relationship as well determined that despite their initial hypothesis, there was little relationship between hyperthyroidism and anxiety disorder (2005). Engum et al., determined through their study that despite this lack of association, a history of hypothyroidism or hyperthyroidism was associated. Additionally, it is indicated that the relationship between anxiety and thyroid disorder may still need to be studied (2002). All studies presented empirical first hand research with strong theoretical analysis of all research presented. However, as it is indicated that this topic still needs significant study to persuade. As hypothyroidism has been presented as a medical condition which can cause anxiety, it would be misguided to simply rule out the possibility. It is clear that much more studies on this topic must be completed.
Additionally Hyperthyroidism should be ruled out by a full medical evaluation before diagnosing an anxiety disorder. It is possible that a hyperthyroidism or another medical condition may be causing or mimicking an anxiety disorder.
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision, DSM-IV-TR). Washington, D.C.: Author
Aslan, S., Ersoy, R., Kuruoglu, A., Karakoc, A., & Cakir, N. (2005). Psychiatric symptoms and diagnoses in thyroid disorders: A cross-sectional study. International Journal of Psychiatry in Clinical Practice, 9(3), 187-192.
Engum, A., Bjøro, T., Mykletun, A., & Dahl, A. (2002). An association between depression, anxiety and thyroid function – a clinical fact or an artefact?. Acta Psychiatrica Scandinavica, 106(1), 27-34.
Elmore, K., Schneider, R.K. (2001). Medical Mimics of Anxiety Disorders. Retrieved from http://www.eric.vcu.edu
First, M.B., Frances, A. & Pincus, H.A. (2002). DSM-IV-TR handbook of differential diagnosis. Arlington, VA: American Psychiatric Publishing
Grabe, H. J., Völzke, H. H., Lüdemann, J. J., Wolff, B. B., Schwahn, C. C., John, U. U., & … Freyberger, H. J. (2005). Mental and physical complaints in thyroid disorders in the general population. Acta Psychiatrica Scandinavica, 112(4), 286-293
Moutier, C.Y., Stein, M.B. (1999). The history, epidemiology, and differential diagnosis of social anxiety disorder. Journal of Clinical Psychiatry, 60, 4-8.
National Institutes of Health (2010). Hyperthyroidism. Retrieved from http://www.nlm.nih.gov
National Institute of Mental Health. (1999). Mental Health: A Report of the Surgeon General—Executive Summary. Retrieved from http://www.surgeongeneral.gov
National Institute of Mental Health. (2009). Anxiety Disorders. [Online version]. Retrieved from http://www.nimh.nih.gov/
