Psychology for Everyone

Thyroid, Not Just Nerves

Marta, thirty-eight, an accountant in Warsaw, had been anxious for months. Her heart raced, her hands trembled, she lost weight, and she could not concentrate at work. She was convinced she had a serious anxiety problem …

Marta, thirty-eight, an accountant in Warsaw, had been anxious for months. Her heart raced, her hands trembled, she lost weight, and she could not concentrate at work. She was convinced she had a serious anxiety problem and was ashamed. She nearly cancelled her visit to the family doctor.

The doctor listened to the whole story and then asked about her sleep, her appetite and any physical illness. She examined Marta, checked her pulse and blood pressure, and ordered blood tests for thyroid function, blood count, vitamins and sugar. 'Because physical illness can mimic or cause mental symptoms,' she explained, 'we always look at the body as well as the mind.'

The tests showed an overactive thyroid. Marta was relieved and puzzled. She was referred to the right physician for the thyroid, while the doctor also taught her some calming practices and arranged a review of her anxiety after the thyroid treatment had begun.

Marta asked, 'So, am I not anxious?' The doctor said both could be true, since many people have more than one condition, and the plan would address all of them. She added that diagnosis rests mainly on a careful interview and observation, supported by questionnaires and physical checks. Marta left with a clear plan for body and mind.

How to recognise it

  • Anxiety symptoms such as racing heart, tremor, and weight loss that may have a physical cause.

  • Poor concentration and sleep that could come from many conditions.

  • Sudden or unusual changes with no clear life reason.

  • Shame and fear of being told 'it is all in the mind.'

  • More than one condition occurring at the same time.

What this story explains

This story shows that physical illness can mimic or cause mental symptoms, which is why blood tests and physical checks matter, and that comorbidity, having more than one condition, is common.

Probable root causes

  • An underlying physical illness such as thyroid disease.

  • Stress, which can make symptoms worse.

  • Sleep disturbance and heavy workload.

  • Overlap of symptoms between mental and physical conditions.

  • Delay in seeking help because of shame.

What to do

  1. Tell the doctor about all physical symptoms, not only emotional ones.

  2. Allow blood tests and a physical examination.

  3. Bring a list of medicines, supplements and substances used.

  4. Ask whether anything physical could explain the symptoms.

  5. Follow the plan for both body and mind.

  6. Return for review if symptoms do not improve.

Whom to consult

  • Family doctor first, for examination and blood tests.

  • Physician or endocrinologist for the physical condition.

  • Psychiatrist or clinical psychologist if anxiety or mood symptoms continue.

  • Emergency service or hospital if there is chest pain, severe breathlessness or thoughts of self-harm.

Do and don’t

Do Don’t
Do mention physical changes. Don't assume it is only nerves.
Do have the tests. Don't skip tests out of fear.
Do ask about overlap. Don't use online remedies instead of care.
Do follow up both conditions. Don't stop treatment when you feel better.
Do be patient with the process. Don't blame yourself.

How to behave and communicate

  • Say to the doctor, 'I am worried that something physical may be going on.'

  • Listen carefully to explanations and ask for plain words.

  • Avoid 'it is all in your head.'

  • To a friend: 'Let us get this checked properly.'

  • Use a calm tone and keep your questions written down.