Source: # Tired, Low and Forgetful at Forty *Sunita Patil, forty-two, a school teacher in Kolhapur, had been feeling flat for most of a year. She was exhausted by lunchtime, felt cold when others were warm, and her hair was thinning. She gained weight without eatin…* Sunita Patil, forty-two, a school teacher in Kolhapur, had been feeling flat for most of a year. She was exhausted by lunchtime, felt cold when others were warm, and her hair was thinning. She gained weight without eating more. Worst of all, her mind felt foggy: she lost words in class and forgot errands. She wondered if she was depressed, or going mad. Her husband tried to cheer her up with outings, but she had no energy to go. Her sister, a nurse, asked a simple question: 'When did you last have a blood test?' Sunita realised it had been years. At the clinic, the doctor listened to everything, including the sadness, and ordered a thyroid test along with other basic checks. The thyroid, a small gland in the neck, sets the speed of the body's engine. Hers was running slow. The doctor explained that low thyroid can cause tiredness, low mood, slowed thinking and weight gain, and that it can be treated. She was started on treatment and told to come back for review. Over the following months, her energy and mood returned, and the fog lifted. The doctor also said that an overactive thyroid can do the opposite, bringing anxiety, a racing heart and shaky hands. 'That is why a feeling in the mind is sometimes a message from the body,' she said. ### How to recognise it - Long-lasting tiredness, low mood, feeling cold, dry skin or hair thinning, and unexplained weight gain. - Slowed thinking, forgetfulness or poor concentration that feels out of character. - The opposite pattern: anxiety, racing heart, sweating, weight loss and trouble sleeping, which can suggest an overactive thyroid. - Symptoms that develop gradually over months and do not improve with rest or cheering up. - Family history of thyroid problems. ### What this story explains The chapter's section on thyroid function shows that both low and high thyroid can look like depression or anxiety. A simple blood test can reveal a treatable body cause. ### Probable root causes - Thyroid gland working too slowly or too quickly, often because of an immune condition. - Changes after pregnancy or at certain ages, especially in women. - Lack of iodine or other nutrients in some regions. - Family history, and sometimes other medical conditions. ### What to do 1. Write down the symptoms, when they began, and any family history. 2. Visit your doctor and mention both physical and emotional symptoms. 3. Have the blood tests the doctor recommends, including thyroid function. 4. Follow the doctor's treatment and attend review appointments. 5. Keep supporting sleep, food and gentle activity while recovering. ### Whom to consult - Family doctor for blood tests when tiredness, low mood or anxiety come with physical changes. - Endocrinologist (hormone specialist) if a thyroid problem is confirmed or the doctor refers you. - Psychiatrist or counsellor if low mood continues after the body problem is treated. - Emergency services or nearest hospital if there are thoughts of ending your life. ### Do and don’t **Do** | **Don’t** | Do ask for a full physical check when mood changes arrive with body symptoms. | Don't assume it is only stress or weakness. | Do keep a symptom diary. | Don't start or stop thyroid medicine without medical advice. | Do take any treatment exactly as your doctor directs. | Don't self-diagnose from the internet. | Do be patient; recovery takes weeks. | Don't skip follow-up tests. | Do tell your doctor about all supplements you take. | Don't ignore low mood that stays after treatment. | ### How to behave and communicate - Say it with care: 'This does not sound like you. Let's have you checked, not blamed.' - Avoid 'you're just lazy'; try 'I can see how tired you are.' - Listen to the physical complaints as well as the emotional ones. - Offer to accompany them to the appointment. - Celebrate small improvements. 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