Disorders of the endocrine system and psychological symptoms
The endocrine system is a network of glands that secrete substances called hormones into the bloodstream. The hormones regulate the body’s metabolism. If the body has too much or too little of a certain hormone, the feedback system signals the proper gland or glands to correct the problem. A hormone imbalance may occur if this feedback system can’t maintain the right level of hormones in the bloodstream, and may lead to endocrine disorders. There are many different types of endocrine disorders.
- Diabetes is the most common endocrine disorder diagnosed in the United States.
- Adrenal insufficiency. The adrenal gland releases too little of the hormone cortisol and sometimes, aldosterone. Addison’s disease is a type of adrenal insufficiency.
- Cushing’s disease. Overproduction of a pituitary gland hormone leads to an overactive adrenal gland.
- Gigantism and other growth hormone problems. If the pituitary gland produces too much growth hormone, a child’s bones and body parts may grow abnormally fast. If growth hormone levels are too low, a child can stop growing in height.
- Hyperthyroidism. The thyroid gland produces too much thyroid hormone. The most common cause for an overactive thyroid is an autoimmune disorder called Grave’s disease.
- Hypothyroidism. The thyroid gland does not produce enough thyroid hormone.
- Hypopituitarism. The pituitary gland releases little or no hormones.
- Multiple endocrine neoplasia I and II (MEN I and MEN II). These rare, genetic conditions are passed down through families. They cause tumors of the parathyroid, adrenal, and thyroid glands, leading to overproduction of hormones.
- Polycystic ovary syndrome (PCOS). Overproduction of androgens interfere with the development of eggs and their release from the female ovaries.
- Precocious puberty. Abnormally early puberty that occurs when glands tell the body to release sex hormones too soon in life.
Testing for endocrine disorders is performed by an endocrinologist. The symptoms of an endocrine disorder vary widely and depend on the specific gland involved. However, most people with endocrine disease complain of psychological symptoms like depression, fatigue and weakness. There are many other areas of interaction between physical disorders and psychotic disorders. Below are some examples:
- Hypoglycemia (low blood sugar) symptoms can include delirium or coma, palpitations, anxiety, tremor.
- Hypotyroidism is accompanied by psychiatric symptoms of depression, anxiety and cognitive impairment.
- Hyperthyroidism produces symptoms as anxiety, fatigue, insomnia, mood swings, decresed concentration, decreased memory, major depression.
- Adrenal disorders Cushing syndrom mimic depression.
- Diabetis is accompanied by fatigue, memory impairment, depression.
- Hypothyroidism (underactive thyroid) causes a general slowing of all body functions. Patient complains of depresion and fatigue.
- Hyperthyroidism or thyrotoxicosis: usually associated with anxiety but may present as depression, especially in the elderly who may have few classical signs of thyroid disease.
- Adrenal hypofunction (Addison’s Disease): often presents with weakness and fatigue.
- Adrenal hyperfunction (Cushing’s Disease): either depression or mania.
- Hyperparathyroidism: lassitude, anorexia, weakness, and depressed mood.
The close relationship between psychiatry and endocrinology was recognized many years ago by many great psychiatrists including Sigmund Freud. In general, endocrine disorders may lead to depressive syndromes. Depression in the context of endocrine disease may be more difficult to treat or may respond only when the endocrine disorder is addressed. Also, the course of endocrine disease may be adversely affected by depression. Doctors often do not take enough time with patients to get to the root cause of their issues. There is a very real possibility that what seems to be a psychiatric problem is caused by some physical illness. In order to decide if a
physical disorder exists, the psychiatrist and doctor must have comprehensive information. For example, a patient complaining of depression with decreased energy level, is also complaining of increased weight, cold intolerance, and extremely dry skin. Therefore, the patient must have physical exams before making psychological diagnosis, as thyroid problems or any other medical problems might be potentiating his depression. Thus the importance of physical exams before making any diagnosis is crucial.
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