Mental health right now, is more relevant than ever. Technology and the digital age have given these issues the correct and necessary exposure. People are more comfortable speaking about their struggles with mental health – no matter how big or small – via digital means, like social media. But social media is also a major root to the problem. It has exacerbated a large proportion of cases where people are experiencing psychological strain – especially within younger circles. In fact, a study from 2017 demonstrated that 12.8% of young people aged five to nineteen, have experienced at least one mental disorder.[1] It is an increasingly worrying statistic, that seems destined to grow as social media continues to do so. While we now automatically associate mental health with what we see on our phones, there are still other causes. It is not entirely external; it can materialise intrinsically. And it is important to recognise and understand these.

Many people within the general public still believe mental health is about severe mental illness (SMI) such as psychosis, clinical depression etc, and even more would not place substance use disorder under the same umbrealla as mental health. This demonstrates that there is still a deficit of awareness of the complexity of mental health. Hormones are simply another forgotten and moving part in understanding such complexity. This blog seeks to readdress that balance and bring more awareness to the links between hormones and mental health.

Hormone Imbalance

In recent years, huge steps have been taken in the study of the relationship between the nervous system and the endocrine (hormone) system. Subsequently, we now understand far more about how our hormones and neurotransmitters affect our mental health.[2] Hormones are chemical messengers released into the bloodstream, which then communicate between various glands and organs in the body.[3] Like most things in our body, hormones are regulated and dependent on balance and consistency. When this balance is disrupted, it can have a significant impact on other systems within the body.

This imbalance impairs our body’s equilibrium, known as the homeostasis. When this is dysregulated, our mental state is susceptible to change. The relationship between hormones and mental health is complex and needs understanding. It affects both men and women, but women are far more sensitive to hormonal fluctuations. They experience more hormonal events in their lives like menstruation, pregnancy and menopause. Here, we take a look at the different types of hormonal imbalances, and how these affect both men and women’s mental health.

Insulin Hormone

Insulin is incredibly important. It is what guards and regulates the amount of glucose in the blood.[4] Muscles, livers and fat all rely on it for energy. If it fails to regulate these energy levels, then high or low blood sugar levels occur. High blood sugar is more than fizzy drinks and hyperactivity; it is a far more serious condition and has a number of psychological implications. Bloody sugar levels have to be elevated considerably for any symptoms to materialise significantly (hyperglycaemia), but when they do they can cause people to have: poor concentration, ADHD, depression, anxiety and panic, insomnia and in some cases Alzheimer’s. Similar symptoms may also occur when bloody sugar levels are low (hypoglycaemia). Again, like high levels of blood sugar, depleted blood sugar levels are more than feeling tired and lethargic. When the brain is starved of energy, it can have a serious impact on how we function mentally. Symptoms include brain fog and fuzzy thinking; anxiety and irritability; depression or aggressive outbreaks; poor concentration and attention; dizziness and at times insomnia.[5] The physical symptoms of insulin are more commonly known. But the psychological implications can be just as severe.

Sex Hormones

There are three main sex hormones: estrogen, progesterone and testosterone. Like insulin, when these hormones experience extreme fluctuations, both men and women’s mental health can be severely affected. Another hormone associated with these sex-related hormones is oxytocin. This is released during things like sex and breast feeding. It is invariably linked to serotonin, and each enhances the other’s production. Oxytocin is direct access to pleasure and joy. When these levels are low, people are unable to attain this feeling of elation. Instead they may feel anxious or depressed.[6]

The main sex hormone for women is estrogen. When estrogen levels are dysregulated, women may feel emotional or overwhelmed. Estrogen is a key regulator of serotonin – the feel good factor – described by Dr Sara Gottfried refers as ‘Nature’s Prozac.’[7] Understandably, when this is depleted a number of mental implications occur. These include loss of pleasure and motivation, limited cognitive function, poor memory, anxiety, low libido and unpredictable moods. High levels of estrogen produce very similar symptoms. Similarly, progesterone is a ‘feel good’ and calming hormone which aids sleep and cognitive function.[8] Again, when this hormone is dysregulated, women are likely to experience sleep issues, anxiety, irritability, depression and stress.

For women, all of these symptoms are exacerbated during menstruation, child-birth and postpartum, and peri-to-post menopause. The emotional strain of hormonal imbalance is far more common for women, as they experience more severe fluctuations. For women with existing mental health issues, these fluctuations merely heighten their volatile mental state. In fact, studies reveal that 64% of women with major depression said their symptoms got worse five to ten days before their period starts.[9]

Testosterone is commonly associated with men. Women also produce it, however, they require much smaller quantities than men. Testosterone is another hormone that propagates ‘feeling good.’ It is great for confidence, lowers stress and generally provides people with a much more positive sense of well-being. As with all hormones, it has a direct effect on mental health when the balance is impaired. Symptoms for both excessively high and low levels of testosterone include increased anxiety, indecisiveness, irritability, aggressiveness insomnia, low confidence and memory loss – sometimes even Alzheimer’s.

Stress Hormones

We are all familiar with stress. Whether it is at work or at home, stressful situations produce stress hormones – the main being cortisol and the other being adrenaline. When we are in high-pressure or stressful situations, we produce more of these hormones. This can lead to an imbalance and cause a number of mental health symptoms. When we experience high levels of stress, we may be susceptible to feelings of depression, anxiety, insomnia and irritability to name a few. No stress is good. But chronically low levels of stress and cortisol are in fact detrimental. A life with practically no stress, sounds good. It’s important, however, to remember that with hormones, everything is about balance. Therefore, chronically low levels of stress include psychological symptoms such as fatigue, impaired concentration, limited cognitive function and depression.

Thyroid

The thyroid is a small gland at the base of the neck, which produces hormones T4 (thyroxine) and T3 (thyroid stimulating hormone).[10] The thyroid regulates cell activity, metabolism, controls mood and our sensitivity to other hormones like cortisol and estrogen.[11] When the thyroid hormones experience an imbalance a number of mental health symptoms occur, such as exhaustion, depression, insomnia, irritability and poor memory, among many others. Imbalances in thyroid hormones can be caused by a number of factors. It may be stress, aging or take place during child birth and postpartum. Thyroid abnormality is extremely common among pregnant women. In one study it was revealed that 80-90% of women who experience postpartum depression were associated to thyroid imbalance. These hormones are fairly unknown in popular conversations, compared to more renowned hormones like estrogen and testosterone. The psychological symptoms are, however, just as severe.

In the modern world, it is important to understand our mental health. It is a topic that is becoming more recognised and discussed in the correct context. While it is great to see an increased awareness of mental health, it is vital that we explore all avenues. It is not just a modern-day issue, introduced and spread by social media; it is part of every-day life, and for many unavoidable and inevitable. If we are to really tackle mental health we must treat it as a intrinsic issue. Technology is not the only factor.

Sources:

[1] NHS Digital. 2018. Mental Health of Children and Young People in England, [online], available at: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017 [accessed 12 June 2020].

[2] Neuro-endocrinology. 2017. Endocrinology & Metabolic Syndrome, [online] available at: https://www.omicsonline.org/scholarly/neuroendocrinology-journals-articles-ppts-list.php) [accessed 12 June 2020].

[3] Vitti, A. 2013. Woman Code. New York. Harper Collins [accessed 12 June 2020].

[4] Hyman, M. 2008. The UltraMind Solution. New York. Scribner [accessed 12 June 2020].

[5] Holford, P. 2004. Patrick Holford’s New Optimum Nutrition Bible. London. Piatkus [accessed 11 June 2020].

[6] Scott, T. and Daniel, K. 2015. Real food for Anxiety: Butter, Broth and Beyond. [online] available at: http://season3.theanxietysummit.com/. [accessed 11 June 2020].

[7] Gottfried, S. 2013. The Hormone Cure. New York: Scribner [accessed 10 June 2020].

[8] Robertson, C et. al. 2015. Progesterone for neuroprotection in pediatric traumatic brain injury [online] Pediatric Critical Care Medicine, 16 (3) available at: https://www.ncbi.nlm.nih.gov/pubmed/25581631 [accessed 11 Jun 2020].

[9] Web Md. Blog. 2005. Depression Symptoms Worsen Before Menstruation, [online], available at: https://www.webmd.com/depression/news/20050128/depression-symptoms-worsen-before-menstruation#1 [accessed 11 June 2020].

[10] https://www.mindhealth360.com/contributor/hormonal-imbalances/thyroid-hormone-imbalances/ [accessed 12 June 2020].

[11] Gottfried, S. (2013). The Hormone Cure. New York: Scribner [accessed 10 June 2020].