Chances are you know the difference between occasional sadness and depression. But here's a fact you may not know: Hypothyroidism, a common thyroid disorder, can cause symptoms indistinguishable from depression.

The signs of depression in adults include persistent sadness, reduced pleasure and motivation, low self-esteem, poor concentration and memory, altered sleep and appetite, fatigue and suicidal thoughts.

"Any adults experiencing depression for the first time should have their thyroid checked," says Philip T. Ninan, M.D., a psychiatrist in Atlanta, Ga.

The butterfly-shaped thyroid gland wraps around the front of your windpipe at the base of your neck. It produces hormones that regulate metabolism and organ function. But problems arise if your thyroid is underactive (hypothyroidism) or overactive (hyperthyroidism).

In hypothyroidism, the thyroid doesn't make enough thyroid hormone. Women over the age of 35, postpartum women, people with Down syndrome and the elderly are at higher risk for the development of hypothyroidism. Two common causes of hypothyroidism are Hashimoto's thyroiditis, a condition in which the body's immune system attacks the thyroid gland, and treatment of a hyperactive thyroid. Some medications can affect thyroid function, causing hypothyroidism.

Early symptoms of hypothyroidism can be difficult to identify because they can have causes other than hypothyroidism. They include always feeling tired, intolerance to cold temperatures, headaches, weight gain, constipation and dry skin. Women of childbearing age may have problems with fertility. If hypothyroidism is not detected and treated in the early stages, other symptoms develop. These include forgetfulness and difficulty concentrating (especially true for elderly people); depression; dry, coarse skin and hair; hoarseness; muscle cramps; and weakness. Hashimoto's thyroiditis and other conditions that affect the thyroid can cause the thyroid gland to enlarge, a condition called a goiter.

"If you suspect you have symptoms of hypothyroidism, see your doctor," says Stanley Feld, M.D., an endocrinologist in Dallas. If you have a problem, your doctor will perform a simple blood test that measures thyroid-stimulating hormone (TSH or thyrotropin), which is the most sensitive indicator of hypothyroidism. 

With hypothyroidism, says Dr. Feld, a pill a day supplies the missing hormones, usually synthetically produced thyroxin (triiodothyronine). The dosage is adjusted to make the patient “euthyroid,” meaning maintaining a level of thyroid hormone that would be present with a normally functioning thyroid gland.  Treatment varies for other thyroid conditions.

Medical Reviewer: [Akin, Louise RN, BSN, Chang, Alice MD, Godsey, Cynthia M.S., M.S.N., APRN, Lambert, J.G. M.D.] Last Annual Review Date: 2008-02-06T00:00:00-07:00 Copyright: © Health Ink & Vitality Communications

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People with depression are just feeling sorry for themselves and would be able to snap out of it if they'd just try.