How hormones affect your mental state?

Are you feeling depressed and anxious? Are you experiencing lack of motivation, mood swings, and troubles concentrating? Remember also “that time of the month” when you become short-tempered and irritable, searching for fast relief with chocolate or ice-cream?

Some of you will assume that frequent anxiety and low mood feelings must be depression, and you could most likely walk away from your GP with a prescription for antidepressants. Others will presume that PMS (premenstrual syndrome) that sometimes severely affect your mental state is an inevitable event that accompanies every woman during her reproductive years. Hence, you have to live with it.

Do you know that hormonal imbalances can affect your mental state?

Almost every hormone can directly or indirectly affect the neurotransmitters in our brain involved in our mood, concentration, cognition, emotional stability, perception of the environmental stimuli etc. A considerable amount of clinical data now supports the biological probability of hormones’ effect on our mental state.

When hormone levels are out of balance, you may experience symptoms that are associated with psychiatric disorders but does not mean you have a psychiatric disorder:

– low mood, sadness

– anxiety

– mood swings

– irritability, anger

– fatigue (morning/ afternoon/ permanent)

– brain fog, trouble concentrating

– restlessness

– lack of motivation, loss of zest for life

– low libido

It is clear that estrogen is closely linked with a women’s emotional well-being. As many as 90% of women experience unpleasant emotional symptoms before their periods.

Depression and anxiety affect women in their reproductive, estrogen-producing years. Estrogen fluctuation is linked to mood disruptions – namely, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and postpartum depression.

Changes in estrogen levels that happen before the second phase of the menstrual cycle may be responsible for the onset of PMS symptoms (Schmidt et al.). In addition, the interaction between estrogen fluctuations and serotonin, a neurotransmitter heavily involved with depression, may affect the mood (Steege et al.). Research is now clear that the estrogen hormone itself can increase serotonin and the number of serotonin receptors in the brain, and stimulates the effects of endorphins, the “feel-good” chemicals, but the fluctuation of estrogen is  the problem.

The massive presence of xenoestrogens in our environment that are interfering with our estrogen receptor by mimicking its action are responsible for the alarming increase in PMS. In integrative medicine doctors are much more aware of this environmental effect, inadequate xenoestrogen detoxification, estrogen- progesterone balance, and estrogen dominance, that all may affect the mental state of female patients. One needs to understand that curing PMS will need finding the cause rather than treating these patients with artificial hormones (birth control pill) and antidepressants. Birth control pills do not address the real cause of the hormone imbalance, but only attenuate the symptoms and mask the real problem.

Furthermore, it has been observed that the reduction of thyroid hormone (underactive thyroid) is directly linked to low serotonin levels (Cleare et al.). It is not a surprise that most patients suffering from hypothyroidism (autoimmune Hashimoto being the most prevalent one) are experiencing low mood, low energy, and anxiety. If treated only with antidepressants, these patients usually don’t improve, as this condition can only be reversed with adequate thyroid treatment.

For a delicate balancing of thyroid hormone, especially in the autoimmune condition, it is often not enough to use a T4 hormone monotherapy. A medication containing T4 hormone, usually prescribed by conventional physicians, is given to hypothyroid patients indefinitely. The conversion of non-active T4 hormone into active T3 hormone is the most critical event that needs to happen in the body to diminish symptoms of low thyroid. The study concluded that a sufficient amount of T3 hormone is crucial for serotonin balancing in the brain and combating depression. The integrative medical approach uses interventions that ensure adequate conversion from T4 into T3 and that identify and treat the cause of low thyroid. The imperative here is to restore the healthy thyroid function (and subsequently cure depression) and not to keep the patient on thyroid medication forever, accompanied with antidepressants.

Another hormone that is linked to feeling depressed is high cortisol. High cortisol levels, that are usually measured at 23h, contribute to low moods. Ongoing stress with a high adrenalin level can lead to anxiety. Patients who are suffering from stress related anxiety and depression usually try to relieve it with alcohol or binging on high carbohydrate foods. Both are detrimental to adequate detoxification (methylation) that only perpetuate the problem leading to more anxiety. Our capacity to clear adrenalin drops significantly with alcohol intake. Scientific data has shown that we have specific areas in our brain that are more sensitive to adrenal hormones in genetically predisposed individuals. These genes are now easy to identify, giving us the opportunity to prevent stress related depression and anxiety with genetic cancelling. Interestingly enough, some of  the “anxiety genes” are seen from the evolutionary biology point of view as beneficial, protecting us from possible danger by predicting and anticipating it. Some of these genes are permanently “switched on”  in a modern stressful society leading to high cortisol, ongoing anxiety and a viscous circle.

Progesterone plays an important role in a women’s’ mental state, and is often called the “feel good hormone”.  It has mood-enhancing and anti-depressant effects. Optimum levels of progesterone promotes feelings of calmness and well-being, while low levels can cause anxiety, irritability, and anger. However, in recent years, it has not been easy to keep an optimal level of progesterone. Frequent anovulatory cycles, that used to be exclusive to perimenopausal years and puberty are now present in all generations. Every anovulatory cycle will be missing the optimal level of progesterone leading to anxiety. Integrative medicine physicians are fully aware of environmental toxicity affecting our ovulation, that requires medical detoxification, nutritional correction and comprehensive lifestyle changes, after temporary prescription of bioidentical progesterone. Again many of these women will be treated for anxiety when in essence progesterone balance should be achieved.

Insulin resistance and PCOS (polycystic ovarian syndrome) can cause mental disturbances such as irritability, bursts of anger, and bad temper, especially in women with very high testosterone. Depression is also a part of Insulin resistance syndrome.

Patients with Type 2 Diabetes  are 2 to 3 times more likely to have depression than those without diabetes. The relationship between depression and diabetes emphasises the need for screening for diabetes in people with depression and screening for depression in those with diabetes. Diagnosing for possible co-occurrence of these two conditions is important, as many cases remain undiagnosed, leaving patients to suffer with the burden of both diseases without adequate clinical support.

A common scenario is seeing PCOS patients being put on chronic therapy : antidepressants, birth control pills and Type 2 diabetes medication without any improvement and potential reversal of PCOS. Finding the cause of Insulin resistance and PCOS would be the first step towards reversal and that’s what the Integrative medicine approach would achieve.

Hormone imbalance is such a frequent cause of mental instabilities in women of all ages, and  balancing hormones should be the priority in restoring mental equilibrium.

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Disclaimer: Treatment results will vary on a patient to patient basis. No guarantees can be made.