There’s an intricate relationship between hormones and mental health. Hormones are chemical messengers produced by various glands in the body, and they play a crucial role in regulating physiological processes. Imbalances or dysregulation of hormones can significantly influence mental health and contribute to the development of mental illnesses. In this post, I will explain the main hormones that impact mental health, their functions in the body, and their potential role in mental illness.
Cortisol and Mental Health
Cortisol is commonly known as the stress hormone. Produced by the adrenal glands, cortisol helps the body respond to stress by increasing blood sugar levels, suppressing the immune system, and regulating metabolism. Prolonged or excessive cortisol secretion due to chronic stress may contribute to anxiety disorders, depression, and impaired cognitive function. (Reference: Sapolsky, 2015)
Cortisol is a hormone produced by the adrenal glands, located on top of the kidneys. It is involved in several essential functions, including regulating metabolism, immune responses, blood pressure, and anti-inflammatory actions. Cortisol follows a diurnal pattern, with levels typically highest in the morning and gradually declining throughout the day.
In response to stress, the body releases cortisol as part of the fight-or-flight response. Cortisol helps mobilize energy, increases blood sugar levels, and suppresses non-essential bodily functions to prepare the body for immediate action. This response is crucial in acute stressful situations.
When stress becomes chronic or prolonged, the body may experience dysregulation in cortisol production, leading to elevated or disrupted cortisol levels. Chronic exposure to high levels of cortisol can contribute to various mental health conditions, including
Elevated cortisol levels have been associated with increased anxiety and heightened vigilance. Prolonged cortisol exposure may disrupt the balance of neurotransmitters involved in anxiety regulation, such as serotonin and gamma-aminobutyric acid (GABA).
Chronic stress and elevated cortisol levels have been linked to depressive symptoms. High cortisol levels can affect neurotransmitter systems, such as serotonin, dopamine, and norepinephrine, which are essential for mood regulation.c. Cognitive Impairment: Prolonged cortisol exposure can impact memory, attention, and cognitive function. Elevated cortisol levels may disrupt the hippocampus, a brain region involved in memory formation and regulation.
Prolactin Levels and Symptoms
Prolactin is synthesized and secreted by the pituitary gland, a small pea-sized gland located at the base of the brain. Its primary function is to promote breast development and lactation in females. Prolactin levels typically rise during pregnancy and breastfeeding, and they are regulated by a complex feedback mechanism involving the hypothalamus. Prolactin also influences the reproductive system by suppressing ovulation and fertility in females and regulating testosterone production in males.
Hyperprolactinemia refers to abnormally high levels of prolactin in the blood. It can occur due to various factors, such as prolactin-secreting tumors (prolactinomas), certain medications like antipsychotics, stress, and hypothalamic dysfunction. Research suggests that high prolactin levels may contribute to mental health disturbances, including:a. Depression: Some studies have found an association between hyperprolactinemia and depressive symptoms.
Elevated prolactin levels may affect the brain’s neurotransmitter balance, particularly dopamine, which is closely linked to mood regulation. I have elevated prolactin levels myself due to being on psychotropic medications. High prolactin levels can cause a lack of menstrual cycle in women, breast lactation in both men and women and infertility.
Prolactin has been implicated in anxiety disorders, although the precise mechanisms are still being investigated. High prolactin levels may contribute to increased anxiety by altering the activity of various neurotransmitter systems.
Hyperprolactinemia can lead to sexual dysfunction, including decreased libido and difficulties with arousal and orgasm. Prolactin’s inhibitory effects on the hypothalamic-pituitary-gonadal axis can disrupt normal sexual function.
Hyperprolactinemia and its associated mental health effects can often be managed through medical interventions. The primary treatment approach involves addressing the underlying cause, such as surgical removal or medical management of prolactinomas.
Dopamine agonists such as bromocriptine or cabergoline, are the most commonly prescribed medications to lower prolactin levels and alleviate associated symptoms.
If you experience symptoms of depression, anxiety, or sexual dysfunction, it is essential to consult with healthcare professionals, such as your psychiatrist. They can evaluate hormone levels, conduct appropriate diagnostic tests, and develop tailored treatment plans to address the underlying causes and associated mental health concerns.
Estrogen and Progesterone
Estrogen and progesterone are sex hormones primarily produced by the ovaries in women. Fluctuations in estrogen and progesterone levels during the menstrual cycle can contribute to premenstrual syndrome (PMS) and mood disorders such as premenstrual dysphoric disorder (PMDD). Moreover, hormonal changes during pregnancy and menopause can also influence mood and contribute to mood disorders. (Reference: Freeman et al., 2019)
Estrogen plays a crucial role in regulating mood, cognition, and emotional well-being. Its effects are mediated through interactions with various neurotransmitter systems, including serotonin, dopamine, and norepinephrine. Estrogen’s influence on mental health conditions is particularly evident in the following areas:
Estrogen fluctuations during the menstrual cycle, pregnancy, and perimenopause can contribute to depressive symptoms. Estrogen affects serotonin receptors, neurotransmitter transporters, and the hypothalamic-pituitary-adrenal (HPA) axis, all of which play a role in mood regulation.
Estrogen’s modulation of the GABA system, which is involved in anxiety regulation, may contribute to its anxiolytic effects. Fluctuations in estrogen levels during the menstrual cycle can influence anxiety symptoms.
Estrogen has neuroprotective effects and promotes neuronal growth and synaptic plasticity. Declining estrogen levels during menopause have been associated with cognitive changes, including memory difficulties and decreased executive function.
Progesterone, predominantly produced during the menstrual cycle and pregnancy, influences various aspects of mental health. Progesterone’s effects are mediated through interactions with gamma-aminobutyric acid (GABA) receptors, which have inhibitory effects on the central nervous system.
Key areas of progesterone’s impact on mental health include:
Fluctuations in progesterone levels during the menstrual cycle can influence mood symptoms, including irritability, mood swings, and premenstrual dysphoric disorder (PMDD). Progesterone’s metabolites, such as allopregnanolone, enhance GABAergic neurotransmission, potentially contributing to its mood-stabilizing effects.
Progesterone’s interactions with GABA receptors contribute to its anxiolytic properties. Adequate progesterone levels may help reduce anxiety symptoms and improve stress resilience.
Hormone therapy, including estrogen and progesterone supplementation, can be used to alleviate mental health symptoms associated with hormonal fluctuations. In cases of hormone-related mood disorders, such as premenstrual dysphoric disorder or perimenopausal depression, hormone therapy may be considered as part of a comprehensive treatment plan. The use of hormone therapy requires careful evaluation, individualized treatment decisions, and ongoing monitoring of potential risks and benefits.
Thyroid Hormones And Mental Health
Thyroid hormones, including thyroxine (T4) and triiodothyronine (T3), regulate metabolism, growth, and development. An underactive thyroid (hypothyroidism) can cause symptoms such as depression, fatigue, and cognitive impairment. Conversely, an overactive thyroid (hyperthyroidism) can lead to anxiety, irritability, and mood swings. (Reference: Bauer et al., 2019)
Hypothyroidism refers to an underactive thyroid gland that produces insufficient thyroid hormones. Inadequate levels of thyroid hormones can have profound effects on mental health, including:
Hypothyroidism has been associated with depressive symptoms, including low mood, fatigue, and decreased interest or pleasure in activities.
Thyroid hormones play a role in regulating neurotransmitter systems, such as serotonin, dopamine, and norepinephrine, which are involved in mood regulation.
Thyroid hormones are essential for optimal cognitive function. In hypothyroidism, cognitive impairment can manifest as difficulties with memory, attention, and processing speed. These cognitive changes may impact daily functioning and quality of life.
Severe and prolonged hypothyroidism can lead to myxedema psychosis, characterized by delusions, hallucinations, and profound mental status changes. However, this condition is rare and typically occurs in severe cases of untreated hypothyroidism.
Hyperthyroidism refers to an overactive thyroid gland that produces excessive thyroid hormones. The impact of hyperthyroidism on mental health includes:a. Anxiety and Irritability: Hyperthyroidism can lead to increased anxiety, restlessness, and irritability. Elevated thyroid hormone levels can overstimulate the central nervous system, contributing to these symptoms.b. Mood Instability: Hyperthyroidism can cause mood swings, emotional lability, and heightened emotional reactivity. These fluctuations in mood may be related to alterations in neurotransmitter levels and sensitivity.c. Cognitive Symptoms: In hyperthyroidism, individuals may experience difficulties with concentration, attention, and memory. Rapid thoughts and racing mind are common cognitive complaints. These symptoms can significantly impact daily functioning and overall mental well-being.
The treatment and management of thyroid-related mental health conditions involve addressing the underlying thyroid dysfunction. For hypothyroidism, thyroid hormone replacement therapy is the primary treatment. Treating hypothyroidism with appropriate thyroid hormone supplementation can often alleviate associated mental health symptoms. In hyperthyroidism, treatment may involve medications, radioactive iodine therapy, or surgery to normalize thyroid hormone levels and reduce mental health symptoms.
Hormones play a vital role in maintaining mental health and well-being. Imbalances or dysregulation of hormones can significantly impact mental health, potentially contributing to the development of various mental illnesses. Understanding the complex interplay between hormones and mental health is crucial for identifying and managing these conditions effectively. Further research is needed to deepen our understanding of the intricate relationship between hormones and mental health, which can pave the way for more targeted therapeutic interventions.
If you need to get your hormone levels checked you can schedule an appointment here at mytelemedicine. They are available online 24/7. You can find a practitioner that can get your levels checked for you.
References:
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Bauer, M., et al. (2019). Thyroid Hormone and Mood Regulation. Journal of Clinical Psychiatry, 80(4).
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McEwen BS. Stress, Adaptation, and Disease: Allostasis and Allostatic Load. Ann N Y Acad Sci. 1998;840(1):33-44.
Ribeiro RS, Abucham J. Management of Prolactinomas: A Focus on Clinical Pharmacology of Dopamine Agonists. Expert Opin Pharmacother. 2016;17(14):1903-1914.
Sapolsky, R. M. (2015). Stress and the Brain: Individual Variability and the Dark Side of Adaptation. Annual Review of Neuroscience, 38, 367-395.