Friday, April 26, 2013

Myxedema Madness: When Being Crazy Isn't in Your Head, But in Your Thyroid


Your husband watches in dismay as the men in the white coats chase you about the living room. Finally, with skill befitting a giant botanist, an attendant captures you in a large net and wrestles you to the ground. The second adds his expertise to the effort, his three-hundred-fifty-pound bulk, by sitting squarely atop your skull. You now consider your rage over the fallen flapjack to have been somewhat of an overreaction.

With the straightjacket chaffing at your neck, you call to your husband for help. Though his hesitation is brief, you see the fear in his eyes. He thinks you've lost your mind. You begin to tear up but, in a flash, you see that fatally wounded flapjack laying helplessly on the kitchen floor and the nightmarish rage overtakes you once again. Feeling it all slip away as they carry you to the ambulance, you make one last desperate effort to escape the beds at Bellevue. Looking over your shoulder you spot your husband, take deep breath and shout, "It's not my fault - it's my thyroid!"

Your thyroid? Yes indeed - a condition known as Myxedema Madness mimics many psychiatric conditions.

Myxedema, the medical term for hypothyroidism, is most commonly recognized by well-known physical symptoms: weight gain, puffiness about the face, dry skin, fatigue and a general slowing of the metabolism. However, the emotional signs and symptoms are quite often overlooked. Or, even more disturbingly, are attributed to non-existent mental health and psychiatric conditions.

Myxedema Madness is a catchall phrase, coined by Dr. Richard Asher in 1940, that encompasses a broad swath of emotions ranging from minor anxieties, doubts and worries to full-blown panic attacks and classic psychiatric conditions like schizophrenia. Myxedema Madness typically manifests as a simple bout of depression and is often treated as such, with antidepressants and advice to, "Slow down - take it easy for a bit." Unfortunately, neither the pills nor the pontification strike at the root of the issue.

If let untreated, Myxedema Madness can quickly devolve into a deadly serious condition. Minor anxieties may give way to major psychoses, delusions, hallucinations and paranoia. An otherwise affable person may snap at the slightest annoyance, exhibiting a degree of rage previously unseen. The patient may be diagnosed as schizophrenic, psychotic or manic-depressive.

The risk of misdiagnosis is increased because hypothyroidism inordinately impacts women - particularly women over the age of forty. As a result, the emotional difficulties are often attributed to the "natural" process of aging, possibly due to the empty-nest syndrome, the onset of menopause or other adjustments and changes in life. The elderly, especially those already living in a group home setting, face a doubly difficult task in receiving both the proper diagnosis and treatment for this condition.

That's the bad news. The good news is that diagnosis is actually quite straightforward. A simple blood test is all that's needed to identify a thyroid problem. The best news? When properly treated with a daily thyroid hormone you'll be your old self in no time flat. No more outbursts, no more voices and no more men in white coats. Which, unfortunately, means no more shouting, "It's not my fault - it's my thyroid!"

Yes... modern medicine is a double-edged sword indeed.

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