Hormones and Brain Chemicals

Stories, signs to notice and what to do

Night Shifts and Biscuits

Neha, thirty-one, was a staff nurse in Mumbai who worked three weeks of night shifts each month. Between 2 and 4 a.m. she kept going on sweet tea and packets of biscuits. In the daytime she slept in short, broken stretches because of noise. Over the past year she had become tearful, snappy with her husband Sameer, and constantly wired yet exhausted.

One morning she snapped at a patient's relative and cried in the changing room. Her friend Dr Mehta, a colleague, gently said, 'Your body clock and your stress system are both out of rhythm.' She explained that melatonin, the hormone that tells the brain it is time for sleep, rises in darkness and falls with light. Night work, bright lights and phone screens in the daytime muddle it. Cortisol, the stress hormone made by the adrenal glands, is meant to rise in the morning and fall in the evening. When stress is constant and sleep is broken, cortisol stays high. Blood sugar, controlled by insulin, also swings with sweets, adding to the shaky, irritable feeling.

Neha made changes she could manage. She asked her supervisor for fewer consecutive nights, used blackout curtains and an eye mask for day sleep, kept a protein-rich snack and water at the station, and walked for fifteen minutes before sleep. She also saw her family doctor, who checked her blood sugar and thyroid and talked about her mood.

The changes were not perfect, but within two months she felt steadier. Sameer noticed she laughed more, and she noticed that the biscuits no longer ruled her nights.

How to recognise it

• Persistent tiredness with trouble sleeping at the right times.
• Irritability, tearfulness or anxiety linked to disturbed sleep and constant stress.
• Strong cravings for sweets and energy crashes.
• Body-clock disruption such as shift work or late-night screens.
• Symptoms lasting weeks and affecting work or relationships.

What this story explains

This story shows how hormones like cortisol, melatonin and insulin connect sleep, stress, blood sugar and mood. It illustrates the mind-body connection and the effect of daily habits on brain chemistry.

Probable root causes

• Night shift work that disrupts the body clock and melatonin.
• Continuous stress that keeps cortisol high.
• Irregular meals and sugary snacks that cause blood sugar swings.
• Poor-quality daytime sleep with light and noise.
• Little time left for movement, rest and relationships.

What to do

1. Protect sleep: dark, cool, quiet room, blackout curtains, and a regular routine as far as possible.
2. Keep light low and avoid screens before sleep.
3. Eat regular balanced meals with protein and fibre, and limit sugary snacks.
4. Add short daily movement and a stress-reducing habit such as slow breathing.
5. Discuss shift patterns with the employer or supervisor.
6. See a doctor for checks if symptoms continue.

Whom to consult

• Family doctor for blood sugar, thyroid and general health checks.
• Sleep specialist or physician if sleep problems continue for weeks.
• Counsellor or clinical psychologist if stress, tearfulness or anxiety are strong.
• Psychiatrist if low mood, hopelessness or severe anxiety develops.

Do and don’t

How to behave and communicate

• Speak kindly to a tired colleague: 'You look worn out. Want to talk after the shift?'
• Avoid judgement about their mood.
• Listen to specifics, such as which hours are hardest.
• Offer practical help, like swapping a shift.
• Ask 'What would help you most this week?'

Tired All the Time, and Not Just Sad

Kavita, thirty-eight, taught primary school in Lucknow. For almost six months she had felt tired in a way that sleep did not fix. She had put on weight despite eating little, felt cold when others did not, and her hair had begun to thin. More worrying was that she cried easily, could not concentrate on lesson plans and had lost interest in the school's annual day she once loved.

Her husband suggested she was simply depressed and should 'cheer up'. Her mother-in-law blamed her cooking. Kavita started to believe it was weakness. She felt guilty and low.

A colleague, Seema, mentioned her own thyroid problem. The thyroid is a small gland in the neck that makes hormones controlling energy, temperature and metabolism. When it is underactive, it can cause tiredness, weight gain, feeling cold and low mood. 'Please have a blood test before deciding it is only your mind,' Seema said.

Kavita visited her family doctor, who examined her and ordered blood tests, including thyroid function. The results showed that her thyroid was underactive. The doctor explained the diagnosis, the treatment plan and the follow-up tests needed. She also asked about Kavita's mood and sleep and said that if low mood continued after her thyroid levels were corrected, she could see a counsellor or psychiatrist. Over the following months, Kavita's energy and concentration returned. Her husband apologised for his earlier words, and Kavita learned an important lesson: the body and mind are linked, and sometimes the first step is a simple check-up.

How to recognise it

• Long-lasting tiredness, low mood and poor concentration without clear reason.
• Physical clues such as weight change, feeling cold, hair thinning or dry skin.
• Loss of interest and tearfulness that appear gradually.
• Others blaming the person's character or attitude.
• No obvious cause for the change in mood, or symptoms that started with body changes.

What this story explains

This story shows how hormones, here thyroid hormones, can affect energy, mood and thinking. It teaches that physical health problems may look like emotional ones and a medical check is an important first step.

Probable root causes

• Underactive thyroid affecting metabolism and energy.
• Biological factors such as family history or autoimmune conditions.
• Stress and low mood that develop alongside physical illness.
• Poor sleep and reduced activity due to fatigue.
• Delay in testing because symptoms are blamed on character or emotions.

What to do

1. Visit the family doctor and describe both physical and emotional changes.
2. Ask for relevant blood tests, including thyroid function, if symptoms fit.
3. Follow the treatment plan exactly as the doctor explains and attend follow-up tests.
4. Tell the doctor if your mood does not improve after the physical problem is treated.
5. Maintain gentle routines: regular meals, sleep and short walks.
6. Help family understand that this is a medical issue and not laziness.

Whom to consult

• Family doctor or physician for examination and blood tests.
• Endocrinologist (hormone specialist) if the condition is complicated or does not settle.
• Counsellor or clinical psychologist if sadness, worry or self-criticism continue.
• Psychiatrist if low mood becomes severe or persists after physical causes are treated.

Do and don’t

How to behave and communicate

• Speak with empathy: 'You have been struggling for a long time. Let us get you checked.'
• Listen to both body and mood complaints.
• Avoid blame and pressure.
• Offer practical help like going to the clinic together.
• Celebrate small improvements without expecting instant change.

Heat, Hormones and Hurtful Words

Lakshmi, forty-seven, ran a small tailoring shop in Madurai. Over the past year her periods had become irregular, and she woke drenched at night with hot flushes. In the daytime she felt anxious for no reason, and little things made her furious. Last week she shouted at her teenage daughter Divya over a spilled cup, then wept in the kitchen.

Divya, hurt, said, 'Amma, you have changed.' Her father muttered that this was 'women's moods'. Lakshmi felt both misunderstood and ashamed. She wondered whether she was going mad.

A neighbour who was a retired nurse told her gently, 'At your age, the hormones estrogen and progesterone start to shift. They influence serotonin and dopamine, the brain chemicals that affect mood, sleep and calm. Progesterone, in particular, has a soothing effect, and when it drops, anxiety and poor sleep can rise. This is common, and there is help.'

Lakshmi visited a gynaecologist, who asked about her periods, sleep and mood, and explained the stage of life she was entering. The doctor suggested simple steps: regular sleep, exercise, less caffeine, and a follow-up. She also asked about Lakshmi's mood and said that if the sadness or anxiety grew heavy, a counsellor or psychiatrist could help too. At home, Lakshmi explained to Divya in plain words what was happening. Divya hugged her and the family began to adjust, offering her the fan and a few quiet minutes in the evening. Her mood did not vanish, but it stopped feeling like a stranger inside her.

How to recognise it

• Irregular periods, hot flushes or night sweats together with mood changes.
• Sudden irritability, anxiety or tearfulness that feels out of character.
• Poor sleep and tiredness that magnify emotional reactions.
• Family misreading it as 'attitude' or 'drama'.
• Mood changes that become heavy, last weeks, or include hopelessness.

What this story explains

This story shows how reproductive hormones such as estrogen and progesterone influence mood, sleep and anxiety through brain chemicals like serotonin and dopamine. It teaches that life stages bring hormone changes and need understanding, not blame.

Probable root causes

• Changing levels of estrogen and progesterone around mid-life.
• Disturbed sleep from night sweats.
• Life stresses at the same time: teenage children, work, ageing parents.
• Biological sensitivity to hormone shifts.
• Lack of information and support in the family.

What to do

1. Keep a simple diary of periods, symptoms, sleep and mood for a few weeks.
2. Visit a gynaecologist or family doctor to discuss symptoms and options.
3. Maintain regular sleep, exercise, balanced meals and limited caffeine.
4. Explain what is happening to close family in plain words.
5. Take short breaks in the day for rest and breathing practice.
6. Seek mental health help if sadness or anxiety is heavy or lasts.

Whom to consult

• Gynaecologist for menstrual changes, hot flushes and hormone-related questions.
• Family doctor for general health and to coordinate care.
• Counsellor or clinical psychologist for anxiety, irritability or stress.
• Psychiatrist if low mood becomes deep, persistent or includes hopelessness.

Do and don’t

How to behave and communicate

• Use a gentle, respectful tone and avoid teasing.
• Try 'I know your body is going through changes. How can I help?'
• Listen without fixing and avoid saying 'calm down'.
• Avoid comparing with other women.
• After an outburst, repair with 'I am sorry. It was not about you.'

It Is Not Only a Chemical

Tom, twenty-nine, was an engineer in Glasgow who had been feeling flat for months. He ate takeaway at his desk, slept until noon at weekends and rarely saw friends. After a visit to his doctor, he read online that depression is 'just a chemical imbalance' and became fixated on it. 'If it is only chemicals, then nothing I do matters,' he told his sister Fiona.

Fiona said she did not think it was so simple. They looked up the simple explanation together. Brain chemicals, called neurotransmitters, carry messages between nerve cells. Serotonin is involved in mood, sleep and appetite. Dopamine is linked to motivation and reward. Noradrenaline helps with alertness and the stress response. But these chemicals are only one part of the picture. Sleep, food, exercise, stress, relationships and thinking patterns all influence them, and are influenced by them.

Tom went back to the doctor and asked what could help. The doctor listened, talked about treatment options including talking therapy and, if appropriate, medical treatment, and said that any decision about medicines would be made together. He also encouraged simple habits: daylight, regular meals, walks and contact with friends. Tom agreed to try a Saturday football kickabout with his old teammates and a weekly counselling session.

After a few weeks his sleep steadied and the flatness lifted a little. He told Fiona, 'It is not either my chemicals or my choices. It is both, working together.'

How to recognise it

• Persistent flat or low mood, low motivation and poor energy.
• Poor sleep and eating, little exercise and less social contact.
• A belief that 'it is only chemicals so nothing helps' or the opposite, 'it is only attitude'.
• Lack of pleasure in things that used to be enjoyable.
• Symptoms lasting more than two weeks and affecting work or relationships.

What this story explains

This story shows neurotransmitters such as serotonin, dopamine and noradrenaline and the mind-body connection. It teaches that brain chemistry is influenced by sleep, nutrition, exercise, stress and relationships, so both medical care and lifestyle matter.

Probable root causes

• A mix of biology, including brain chemistry and family history.
• Poor sleep, diet and low physical activity.
• Stress, isolation and loss of routine.
• Unhelpful thinking such as 'nothing matters'.
• Misleading messages that make it seem like a simple fault to fix.

What to do

1. See a doctor and describe symptoms honestly.
2. Ask about all options: talking therapy, lifestyle changes and, if appropriate, medicines.
3. Build simple daily habits: daylight, regular meals, movement and sleep.
4. Reconnect with at least one friend or activity each week.
5. Challenge extreme thoughts like 'nothing helps' with a trusted person.
6. Review progress with the doctor and do not stop any treatment on your own.

Whom to consult

• Family doctor as the first step for assessment and referral.
• Psychiatrist for diagnosis and decisions about medical treatment.
• Clinical psychologist or counsellor for talking therapy.
• Emergency number or nearest hospital if there are thoughts of ending life.

Do and don’t

How to behave and communicate

• Use a warm, non-judging tone: 'I can see this is hard. Let us look for what helps.'
• Explain simply that body and mind work together.
• Listen without trying to fix.
• Avoid 'snap out of it' or 'just be positive'.
• Invite small shared activities such as a walk or meal.

This book is for education and general awareness. It does not replace diagnosis or treatment by a qualified professional. If anyone is in danger, contact your local emergency services.