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

Visit the family doctor and describe both physical and emotional changes.
Ask for relevant blood tests, including thyroid function, if symptoms fit.
Follow the treatment plan exactly as the doctor explains and attend follow-up tests.
Tell the doctor if your mood does not improve after the physical problem is treated.
Maintain gentle routines: regular meals, sleep and short walks.
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

Do	Don’t
Do get a check-up for long-lasting tiredness.	Don't say 'cheer up' or 'it is your attitude'.
Do tell the doctor all symptoms.	Don't change or stop treatment without the doctor.
Do be patient; recovery takes time.	Don't self-diagnose with internet tests.
Do share the diagnosis with family.	Don't ignore physical signs.
Do continue treatment as advised.	Don't blame the person's cooking, housework or character.

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.