Hypothyroidism & social anxiety


Have you noticed how much harder it is to be sociable when your energy levels are low?

How about when you’ve just finished doing something that has unexpectedly depleted the lion’s share of your energy for the day?

If you’re living with hypothyroidism, you know what I mean when I talk about low energy levels and brain fog. But what about social anxiety?

If you’re an extrovert, maybe social time restores your energy and makes you feel better.

If  you’re an introvert, on the other hand, low energy usually means staying home and doing something restorative with as little company – and as few irritants – as possible.

It might also make it harder to get any reading or studying done.

In college, I couldn’t just sit and read a textbook without my brain shutting down after a few seconds, so I learned to turn study time into a handwriting exercise. And it worked.

I’d buy a stack of index cards and start looking for things in the textbook to write down. I could spend hours filling out index cards, and even if I never looked at them again, writing out what I needed to remember helped me to focus and to retain enough do well on my tests.

I remember filling out index cards ’til 4 a.m. one night. I was kicking myself the next morning – thinking I’d bomb the test, because I was sleep-deprived. But I actually did pretty well.

That’s how I survived college.

That and keeping to myself most of the time. My roommate referred to me as “the hermit.” I wasn’t unfriendly, but I wasn’t exactly sociable, either. Being sociable was too draining, and it made thinking harder. It made everything harder.

So, I didn’t do much of it.

Fast forward about ten years, and a psychiatrist wrote me a slip for Effexor XR, which he told me would be particularly effective for “your social anxiety.” I never saw my social avoidance as social anxiety. To me, it was a matter of survival. I had less energy to begin each day with, and I needed to save as much of it as possible for the things that mattered most to me.

And socializing … well, it was pretty low on the priority list.

I knew from experience by then that when I spent a half hour or so socializing, it drained me so much, I couldn’t even think about studying. I needed to do something restorative.

Like writing. Or reading something entertaining.

And whatever it was, I needed to do it alone.

Hence my college nickname.

How on earth can hypothyroidism cause anxiety, though, anyway?

While it’s usually more common with hyperthyroidism, even hypothyroid folks can get anxious. CalmClinic.com explains it in a way that makes sense:

“The thyroid hormone is directly linked to the regulation of very important neurotransmitters. From GABA to serotonin to norepinephrine, thyroid hormone plays a crucial role in their creation and regulation.

“When your thyroid hormone is not functioning properly, these neurotransmitters tend to go haywire, causing not only anxiety, but also frequent panic attacks. This is made worse by the physical symptoms that are often associated with hypothyroidism, often causing people to worry that something is wrong with their health.”

I had one of my most memorable panic attacks while I was taking Effexor XR. I don’t have them very often, anymore, but I’ve learned to recognize the triggers – not that a panic attack is inevitable if certain conditions are met. It just makes it easier to apply as early as possible the coping strategies I’ve learned.

Hypothyroidism has far more symptoms – physical and psychological – than most people know about when they’re first diagnosed or when they learn that someone they love has been diagnosed. And every person is different.

Check out this list of symptoms on HypothyroidMom.com“300+ Hypothyroid Symptoms…Yes, really!” It’s an eye-opener.

So, one person with hypothyroidism can’t say to another, “Well, don’t have panic attacks, so if you’re having panic attacks, it can’t be because of your thyroid issues.”

Which is sorta like when a doctor looks at your TSH test results and says, “Well, your test was normal, so whatever symptoms you’re still experiencing can’t be thyroid-related. Because according to the blood test, your thyroid is working just fine (or your dosage is right on the money).”

Some of us are better at handling that than others, but suffice it to say each one of us needs to be his or her own best healthcare advocate. Because your doctor will most likely NOT be that advocate. It’s not that doctors don’t care; it’s just that most of them don’t have the time.

Here’s another article on Hypothyroid Mom – “New study reveals why 1 in 6 hypothyroid patients still feels bad on Levothyroxin.” – that addresses this issue, though I suspect more than 1 in 6 still feel crummy even when their TSH test comes back “normal.”

For the past few months, my free T4 has been in the normal range, but my free T3 levels have been low. I’m due for another thyroid panel, and I requested a test for Reverse T3, as well as the usual tests for TSH, free T4, and free T3. Sometimes, T4 is converted to Reverse T3 instead of free T3, and Reverse T3 actually impedes conversion of T4 to the T3 our bodies need.

And poor conversion is one of the factors that lead to hypothyroid symptoms.

I can’t say this for everyone, but when I’m feeling crummy, I’m even less inclined to socialize than usual. My college nickname still suits me pretty well.

Not all hypothyroid folks are introverts, but some of us are. Introverts, as a rule, find the social scene exhausting, and they need more alone time to restore their energy.

Some of us just need more alone time – and other restoratives – to get through the day. But is that the same thing as social anxiety?

What do you think?

Have you ever been told you have social anxiety? Did you agree?

Or did you find yourself arguing, “No, it’s not social anxiety. I avoid people because when I’m around them for half an hour or more, I feel worse — not better. I feel used up and cluttered inside. And I need to be alone to get better.”

It sounds messed up to some people, but that doesn’t make it less true.


3 thoughts on “Hypothyroidism & social anxiety

  1. I’ve been told I have social anxiety, but I can’t tell if it’s just general anxiety and worrying about everything or if some of it is specifically social. All I know is that since I started taking Zoloft, I have gotten a lot less uncomfortable in social situations. And it’s become easier to recognize when I start getting pumped full of adrenaline for no good reason, and to stop and take some deep breaths.

    Liked by 1 person

    1. I remember when a former doctor of mine (who specialized in internal medicine) told me I probably have “Generalized Anxiety Disorder.” We were talking about that & other types of anxiety as he described the medication options available – which included Zoloft and Effexor XR. I ended up taking the Effexor, because that was what the psychiatrist I talked to recommended, for the social anxiety. Honestly, I think he went more by the questionnaires I filled out than by what he really knew about me. According to the tests I took, I had “moderate to severe ADHD – Combined Type,” but he was more concerned with my level of anxiety, as well as my score on the depression questionnaire.
      Neither of the drugs worked for me, because they didn’t treat the underlying problem, which was thyroid-related. I’m glad the Zoloft is helping you, though. We need to do what works, and that’s different for each person.
      Thank you so much for sharing your own experience. Taking deep breaths has helped me at least to get to a safe place when I couldn’t completely stop a panic attack. I could at least get to a parking lot before I fell apart. Then I could put myself back together and get to work or to wherever I was heading. So, I know it helps. Writing ha also been a huge help, but I can’t always stop what I’m doing to write something down (for example, when I’m driving). Sometimes music helps, too. Other times, it pushes me over the edge – depending on the music.
      Take care, and have a great weekend! 🙂

      Liked by 1 person

      1. Yeah, I did the questionnaire thing in college at the free campus health center and the suggestion of medication totally freaked me out then. I also didn’t take that advice because it was the end of the school year and I could escape into summer vacation. It’s the only time I’ve spoken with an actual psychiatrist and that was only for about ten minutes. After college, I’d been working with a therapist for about a year or two before asking my GP about medication. I’ve only had one and a half panic attacks – one in the ER while I was being checked out after a traffic accident (I was fine except for some bruising) and sort of again once while I was driving on the freeway. Music and deep breaths helped.

        You have a great weekend too!

        Liked by 1 person

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