Whether you have a general sense of anxiety, debilitating panic attacks, depression, or another mood disorder, finding the root cause of your ailment allows you and your doctor to find the most effective mode of treatment. 

Anxiety in America

Anxiety, which includes generalized anxiety disorder, panic disorders, and social anxiety, is the “most prevalent psychiatric disorder” among Americans. (1). Although many suffer silently, a large number seek medical help. According the Anxiety and Depression Association of America, anxiety affects 40 million Americans 18 and older each year (2). 

Anxiety can be caused by having low levels of the neurotransmitter serotonin. Serotonin, in addition to regulating mood, also plays a part in regulating digestion, sleep, blood clotting, and sexual function. About 95% of serotonin is actually made in the gut (3)! As you can imagine, if your gut health is not functioning properly, this will affect your serotonin production. 

Being deficient in the amino acid, GABA (Gamma-aminobutyric acid), can also cause anxiety symptoms. GABA acts as a neurotransmitter as well and it influences how people experience stress, fear, and anxiety. Some anxiety sufferers have deficiencies in both GABA and serotonin. There are actually species of bacteria in your gut that manufacture GABA (4)! Those who have a dysbiosis (an imbalance of “good” and “bad” microbes in the GI tract) are at a disadvantage when it comes to GABA production as well as other health benefits.

Depression in America

Between 2015 and 2018, roughly 13.2% of Americans were taking anti-depressant medications (5). After the events of the last year and a half, it is a safe assumption that that rate has increased now that we are nearing the end of 2021. Low serotonin can cause depression symptoms, although depression can also be caused by having low levels of the neurotransmitter, dopamine. Dopamine affects motivation, learning, attention, sleep, and of course, mood. A substantial amount of dopamine is made in the gut, so correcting gut issues is essential if you have low-dopamine depression. Low dopamine levels are also found in those with Parkinson’s disease and other neurological disorders, so it should not be taken lightly. 

Traditional Routes to Help with Mental Health Issues 

  • Anti-depressant medications come with a long list of side effects as well as a low rate of efficacy. As many as one third of patients get no relief from symptoms (6). Common side effects are increased appetite and weight gain, fatigue and drowsiness, insomnia, constipation, anxiety, dizziness, dry mouth, and sexual problems. 
    Anti-anxiety medications have an equally disturbing list of side effects. There are three general
  • classes of anti-anxiety medications. SNRIs (serotonin-norepinephrine uptake inhibitors) can cause nausea, loss of appetite, weight loss, constipation, dizziness, headaches, and insomnia. SSRIs (selective serotonin reuptake inhibitors) can cause diarrhea, nausea, blurred vision, drowsiness, insomnia, headache, sexual problems, or a dry mouth. What is shocking is that 30-50% of patients report experiencing one or more of these side effects. Benzodiazepines are the final class and they can cause sweating, confusion, impaired coordination, headaches, insomnia, and dizziness.

How a slow or fast thyroid can cause depression and anxiety

When you are stressed and your body is pumping out the stress hormone, cortisol, your thyroid hormone receptors can lose their sensitivity and become resistant to thyroid hormones. This means that cells won’t take up the thyroid hormone needed to function properly. 

Your thyroid hormones are directly linked to neurotransmitter regulation. From serotonin, the “feel good” hormone, to GABA, the “calming” hormone, to dopamine the “reward” hormone, your thyroid has an important role in their creation. If the thyroid is out of balance, your neurotransmitters will likely become out of balance as well. As you can see, this can become of vicious cycle where the stress and anxiety lead to poor thyroid function and in turn, the reduced thyroid function leads to low neurotransmitter production. 

Panic attacks: 

An overactive thyroid is generally associated with panic attacks and anxiety, while an underactive thyroid is usually associated with depression and fatigue (7). However, there are always people that are exceptions to these generalizations.

Thyroid hormone lab testing biomarkers

In order to determine if your thyroid is causing your anxiety or depression symptoms, you will need your doctor to run a full thyroid panel, which consists of: TSH (between 1-2 is optimal), Free T3, Free T4, Total T4, Total T3, Reverse T3, T3 Uptake, as well as thyroid antibody tests to rule out or confirm an autoimmune thyroid condition (TPOs and TGBs).

Health Strategies to balance the Thyroid and Support Mental Health Issues 

  • Move your body. Exercise has been shown to be as effective as anti-depressants in alleviating depression symptoms. It is also effective for anxiety reduction. Since it helps with thyroid hormone production as well, this all makes perfect sense (8).
  • Ask for an adrenal panel: Since stress hormones play a role in both anxiety and your thyroid health, consider getting an adrenal panel. An adrenal panel will test your DHEA. This hormone, when low, is associated with depression. Stress hormones, such as cortisol, also interfere with your body’s conversion of inactive thyroid hormone in active thyroid hormone.
  • Take an adaptogen: These herbs help to reduce stress and anxiety and many can help alleviate depression symptoms as well.  Rhodiola and rehmannia are great choices for those with autoimmune disorders. Ashwaganda (Source) is another great adaptogen, but those with autoimmune disease should avoid it or use it only while under the care of a practitioner.  
  • Take fish oil: Supplementing with fish oil and eating plenty of wild-caught, cold-water fish can lessen depression symptoms (5) and improve thyroid function.
  • Take a probiotic: As you learned above, a well-balanced microbiome is crucial to optimal neurotransmitter function. It is also critical for thyroid conversion (where the body converts inactive T4 to active T3 so that it can use it). A spore-based probiotic can help with rebalancing quickly. Adding fermented food to your daylily diet  is also helpful for achieving and maintaining microbial balance. 
  • Eat foods for boosting serotonin: Protein, especially sources that are high in tryptophan, can boost serotonin production. 
  • Eat food for boosting dopamine: Dairy, nuts, veggies, and omega-3 fatty acids like fish oil can boost your body’s production of dopamine. Even indulging in a high-quality, dark chocolate can help!
  • Try yoga or meditation. Both of these methods of stress management have proven mood enhancing benefits. 
  • Try 5-HTP or SAMe: Both of these supplements have a proven track record when it comes to mood disorders, but do not take either if you are already on anti-anxiety medication since they can cause “serotonin syndrome” where the body actually has too much serotonin. 
  • Get outside: Many people report fresh air and natural light lessen anxiety and depression symptoms. For those with SAD (Seasonal Affective Disorder), getting natural light, especially in the winter, significantly alleviates symptoms of depression. 
  • Eat whole foods: Be sure to get the nutrients that your thyroid needs to function properly: iodine, selenium, magnesium, zinc, tyrosine, vitamin D, and omegas. Many of these same vitamins and minerals will boost your neurotransmitter production!
  • Try GABA: This neurotransmitter helps you relax and is available in supplement form, often as a chewable. Many night-time relaxation and sleep formulas contain it. Some high GABA foods are bananas, walnuts, and spinach. 
  • Eliminate food sensitivities, especially gluten. Food sensitivities can cause or exacerbate symptoms of anxiety and depression. Gluten in particular is associated with thyroid disorders. Try eliminating it for 4-6 weeks before reintroducing it to see if it has been causing or exacerbating your symptoms.  
  • Eliminate or reduce refined carbohydrates. When people are low in serotonin, they often reach for a cookie or other sweet treat. This makes sense because it is a form of self-medication. Eating refined carbohydrates leads to a surge in serotonin. This makes people feel great in the short term, but unfortunately leads to a worsening of other symptoms such as fatigue, weight gain, and sleep issues. 
  • Make sure your diet has adequate B vitamins. A deficiency in vitamin B6 has been linked to low serotonin. Leafy greens, liver, and avocados are high in B vitamins. 
  • Build a strong social network. Humans are social creatures. People with strong social networks of friends and family are more stress resilient and report less anxiety and depression symptoms. 


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