Do Hormones Influence Mental Health?

When we think about and discuss psychiatric disorders, the brain is typically the first organ that we look to for answers.  What went wrong up there that caused a change in behavior?  In emotions? We know that the brain controls so much of our thoughts and feelings, but it is not the only major factor that contributes to our overall mental well-being.  The body comprises many different body systems that each play a different role to our mental health as a whole, and one of those systems is the endocrine system.  The endocrine system is made up of all the different hormones in our bodies, and it is in charge of regulating various biological processes.  Moreover, the hormones that our bodies produce (or do not produce) have a major impact on the way our minds work and how we regulate symptoms related to mental health.  As mental illnesses are becoming better researched, clinicians are better able to determine the causes and influences that lead to a mental illness diagnosis, and the physiological aspect of our health is an important piece to this puzzle.  In this blog, we will discuss the role of various hormones on the development and manifestation of different psychiatric disorders.

What is the Endocrine System?

To brush up on some biology knowledge, we will briefly go over the main parts to know about the endocrine system.  The endocrine system1, also known as the hormone system, is found in almost every living organism.  In humans, the endocrine system consists of glands located all over the body.  Within these glands, hormones are produced and released into the bloodstream or other cells.  When the hormones get to their targeted destination, receptors in different tissues and organs are able to interact with the hormones and respond accordingly.

Now you may be wondering: what does this have to do with mental health? Well first and foremost, hormones are important because they have the ability to regulate and control so many different biological functions and processes within the body.  There are over 50 hormones within the human body, and each one plays a unique role in controlling certain processes.  For example, the development of the brain and nervous system is controlled by hormones.  Our blood sugars are controlled and regulated by hormones.  Puberty and the development of reproductive organs are controlled by hormones.  Even the growth of a child into an adolescent into an adult is controlled by hormones!  With how much influence hormones have on the physical aspect of the body, it is important to recognize how different hormones can affect  mental health as well.

Hormones Affect Your Mental Health

The Thyroid Hormones

Thyroid hormones play a role in neurological development, metabolism, and the functioning of various organs. Hypothyroidism2, also known as an underactive thyroid, is the most prevalent endocrine disorder across the world, with a prevalence of over 315 million individuals.  This diagnosis refers to when the thyroid is unable to produce enough thyroid hormone to meet the needs of one’s body.  Various studies have shown that there is a high prevalence of mood disorders, especially depression, among those with thyroid dysfunction. A 2019 study showed that among a group of 56 patients with hypothyroidism, 33.9% of patients were clinically depressed to a varying degree.2  Some common symptoms that patients experienced included memory issues, fatigue, loss of hair, and gland enlargement. In another study completed in 2013, 60 patients were diagnosed as clinically mildly depressed, moderately depressed, and severely depressed were assessed for thyroid dysfunction.  Patients were tested on their respective levels of different thyroid hormones, including T3, T4, and TSH.  Overall, results showed that the mean value of total T3 hormone for the depressive group was significantly lower when compared to a control group.  Total T4 was also elevated in the depressive group when compared to controls.  TSH did not have significant differences across either group. With these results, researchers have discovered that treatment outcomes of depression can relate to thyroid status and vice versa.  Therefore, studies have shown that depression is a prevalent diagnosis among patients who suffer from hyperthyroidism.

Insulin

Insulin is another crucial hormone in the body that is responsible for turning food into energy and for lowering glucose in the blood.  For individuals with type 2 diabetes, their bodies either lack enough insulin to process glucose or they cannot process the insulin that is created by the pancreas.  These individuals are said to be ‘insulin resistant’.  In fact, nearly 1 in 3 individuals are insulin resistant. This can be attributed to an excess of caloric intake, stress, lack of sleep or exercise. According to scientists at Stanford Medicine, those with insulin resistance have an increased risk of developing major depressive disorder.4 Furthermore, a 2021 Dutch study wanted to confirm this relationship in a longitudinal, 9-year program.5  In this study, patients with no history of of depression or anxiety disorder were measured for three markers of insulin resistance over the course of 9 years: triglyceride-HDL ratio, fasting plasma glucose level, and waist circumference. At the end of the 9-year follow up, 14% of samples developed major depressive disorder. Numbers indicated that having higher triglyceride-HDL ratios, higher plasma glucose levels, and higher waist circumferences were all associated with an increased risk of major depression.  More specifically, a moderate increase of insulin resistance was linked to an 89% increase in the rate of new major depressive disorder cases; while every 5-cm increase of abdominal fat or waist circumference can increase the rate of depression by 11%.5 In addition, patients who developed pre-diabetes at the 2-year followup were positively associated with major depressive disorder as well.  These results demonstrate the close relationship between the hormone insulin and the risk of developing depression over one’s lifetime.

Cortisol

Cortisol, also known as the stress hormone, is another essential hormone to the human body.6 During perceived threats, the body goes through something called ‘fight or flight’ mode. The hypothalamus sends nerve and hormonal signals to the endocrine system.  Subsequently, adrenaline and cortisol are released.  While adrenaline causes our heart to beat faster and blood pressure to go up, cortisol increases sugar in our bloodstream.  It also acts to slow the function of our immune system, digestive system, reproductive system,  and other growth systems.  The body’s stress response is typically regulated very tightly, and hormones are able to return to homeostasis on their own.  However, with the onset of prolonged stress, the ‘fight or flight’ response is always on and the body’s stress response system is activated in a long-term way.  With cortisol consistently released, the body is susceptible to a myriad of health issues, such as: depression, anxiety, headaches, sleep issues, weight gain, and issues with focus or memory.  In addition, research shows that the constant release of cortisol into the bloodstream alters the functioning of neurotransmitters such as serotonin (the ‘happy’ chemical) and is also associated with acute and severe forms of major depressive disorder.7 Given this information, it is important to realize that stressful events occur in life no matter how much we practice mindfulness and emotional management.  Understanding that stress can exacerbate or trigger mental health symptoms is the first step in learning how to combat difficult feelings and thoughts as they come.

Staying on Top of Hormonal Dysregulation

The few hormones mentioned above are just a quick and succinct dive into the vast pool of hormones that influence mental health.  While many hormones have significant relationships with mental health diagnoses such as major depressive disorder and anxiety, hormones are also instrumental in affecting our moods and emotions in a fluctuating way.  Hormones can cause other mental health symptoms such as mood swings, memory loss, brain fog, fatigue, and others. Of course, the only way to truly know if your hormones are functioning properly is to get your levels checked by a medical professional.  There are ways to promote a well-balanced lifestyle that can promote a less stressful, in-control way of living.  Some ideas to develop a holistic style of living include:

• Staying active and exercising on a regular basis
• Developing a self-care routine
• Prioritizing time with loved ones
• Setting aside time to unwind and recharge from work/life obligations
• Developing consistent sleep habits
• Visiting your healthcare providers in a routinely fashion

Numerous pieces of evidence suggest that hormones and hormone imbalances can affect mental health.  Keeping this in mind, it may be a wise idea to make sure you and your loved ones are monitoring and screening for any hormone imbalances with your primary care physician, endocrinologist, or internal medicine physician.  When dealing with mental health, hormones are not typically the first thing that many people contribute to psychiatric illnesses or disorders.  However, knowing which of your hormones are balanced or not can be important in the prevention and control of various mood and anxiety disorders.  Whether you think hormones may or may not be affecting your mental health or the mental health of someone you love, keep in mind that your mental health is just as important as your physiological health.  It is truly all connected and important to stay on top of.