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How Thyroid Eye Disease Can Affect Your Mental Health

Strategies for coping with the emotional and mental burden that can accompany thyroid eye disease.

How Thyroid Eye Disease Can Affect Your Mental Health

Thyroid eye disease (TED) is a condition that occurs in people who have an autoimmune disorder called Grave’s disease. As with other autoimmune disorders, Grave’s disease occurs when the body’s immune system attacks healthy tissues—in this case, the thyroid gland, a hormone-producing gland in the throat. As a result of this attack by the immune system, the thyroid gland becomes enlarged and produces excess amounts of thyroid hormone.

Normal amounts of thyroid hormone are vital to the normal functioning of the human body. But excessively high levels can interfere with the normal functioning of numerous organs and processes throughout the body.

In some people, these abnormal antibodies also attack the tissues surrounding the eyes. It is not known why some people with Grave’s disease develop TED and others do not, and the exact cause of TED is unknown.

Symptoms of TED can vary from person to person, but may include redness, pain, irritation (described as a dry, gritty feeling), puffiness around the eyes, bulging eyes, decreased vision, and headaches that worsen with eye movement. These symptoms will also vary in severity from person to person.

Many people with TED experience a significant decrease in quality of life. The physical symptoms of both Grave’s disease and TED are often accompanied by negative emotions and feelings, such as:

  • Social withdrawal
  • Low self-esteem
  • Anxiety
  • Loss of independence
  • Insecurity about appearance

Because TED is a different experience for every person, the ways it impacts mental and emotional health will also vary. A person with bulging eyes may feel self-conscious about their appearance, and may withdraw from friends, family, and work as a result. Everyday activities can be much more difficult due to changes in vision, causing a person to become frustrated and feel like a burden to those they rely on. Accompanying this are the many frustrating symptoms that can occur as a result of Grave’s disease—weight changes, loss of sexual functioning, sleep disorders, hair loss, heat intolerance, changes to mood, and low energy levels.

Making mental health a priority
If you have Grave’s disease, TED, or both, it is important to make mental and emotional wellbeing a part of your treatment plan. This starts with your healthcare provider—any condition that affects your thyroid requires treatment, and there are a number of therapies that can help with Grave’s disease and TED, including medications and surgeries that can improve the function and appearance of the eyes. Some strategies that may help:

  • Write it down. In order to provide you with the appropriate care, your healthcare providers need to know the specific ways that Grave’s disease and/or TED are impacting your life. Keep notes or a journal and bring these to your appointment.
  • Work with a mental health practitioner. A therapist or counselor can help you address feelings such as self-consciousness, depression, and anxiety.
  • Maintain a healthy diet. Some foods may worsen symptoms of hyperthyroidism. Ask your healthcare provider which foods you should avoid.
  • Exercise. Once your symptoms are under control, exercise can help improve muscle function, especially resistance training.
  • Quit smoking. Smoking can make Grave’s disease and TED worse, and also puts you at risk for many other serious health conditions.
  • Consider joining a support group. There are groups for TED, Graves’ disease, vision support, and thyroid disease that offer group therapy and a chance to find a community of people who share your concerns and frustrations.

It’s also important to stay connected with your friends and family. Reach out to loved ones and consider asking for help when you need it—for example, if chores or errands have become difficult on your own, or if you need someone to accompany you to an appointment. At the same time, let your loved ones know the ways in which maintaining independence is important to you.

Medically reviewed in May 2021.

Sources:
Penn Medicine. "Thyroid Eye Disease (Graves' Disease)."
National Institute of Diabetes and Digestive and Kidney Diseases. "Grave's Disease."
Michigan Medicine Kellogg Eye Center. "Thyroid Eye Disease (TED or Graves Eye Disease)."
National Organization for Rare Disorders. "Thyroid Eye Disease."
Stephanie Estcourt, Anthony G Quinn, and Bijay Vaidya. "Quality of life in thyroid eye disease: impact of quality of care." European Journal of Endocrinology, 2011. Vol. 164.
Yao Wang. "Survey highlights mental health impact of thyroid eye disease." Endocrine Today. August 6, 2020.
Yao Wang, Anu Sharma, et al. "Physician-Perceived Impact of Thyroid Eye Disease on Patient Quality of Life in the United States." Ophthalmology and Therapy, 2021. Vol. 10.
Mohsen Bahmani-Kashkouli, Farzad Pakdel, et al. "Quality of Life in Patients with Thyroid Eye Disease." Journal of Ophthalmic & Vision Research, 2009. Vol. 4, No. 3.
TED Impact. "Beyond the orbit: TED damage is also psychosocial."
British Thyroid Foundation. "Your Guide to Thyroid Eye Disease."
Kelb Bousquet-Santos,, Mario Vaisman, et al. "Resistance Training Improves Muscle Function and Body Composition in Patients With Hyperthyroidism." Archives of Physical Medicine and Rehabilitation, 2006. Vol. 87.
Danielle L. Weiler. "Thyroid eye disease: a review." Clinical and Experimental Optometry, 2016. Vol. 100.
Ming Hui Lee, Yip Han Chin, et al. "Risk Factors of Thyroid Eye Disease." Endocrine Practice, 2021. Vol. 27, No. 3.
ThyroidEyes.com. "Thyroid Eye Disease and Vision Support Groups."

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