Why Do People with Graves’ Disease Seem Excited?

 

Why Do People with Graves’ Disease Seem Excited?

Graves’ disease is an autoimmune disorder that leads to hyperthyroidism, a condition where the thyroid gland produces excessive amounts of thyroid hormones—thyroxine (T4) and triiodothyronine (T3). These hormones regulate metabolism, energy use, and many physiological processes. When present in excessive amounts, they can overstimulate the body and mind, leading to what often appears as excitement, restlessness, or hyperactivity.

The Link Between Thyroid Hormones and Excitability

  1. Excessive Metabolic Stimulation
    Thyroid hormones increase the body’s basal metabolic rate. In Graves’ disease, this effect becomes exaggerated, resulting in elevated heart rate, tremors, sweating, and a heightened state of arousal. This state can mimic the appearance of someone who is constantly “excited.”

  2. Nervous System Overdrive
    Elevated thyroid hormones make the body more sensitive to catecholamines (adrenaline and noradrenaline). This creates symptoms such as jitteriness, irritability, and restlessness. Many patients describe feeling like they are in a constant “fight or flight” mode.

  3. Psychological and Behavioral Effects
    Graves’ disease often presents with anxiety, mood swings, insomnia, and even manic-like symptoms. Research shows that psychiatric complications, such as mania or psychosis, can occur in some individuals with untreated hyperthyroidism. This explains why some patients appear unusually excitable, talkative, or restless.

Clinical Observations

  • Mood and Personality Changes: Patients may develop irritability, reduced concentration, and even symptoms similar to bipolar mania.

  • Sleep Disturbances: Difficulty sleeping worsens irritability and makes energy levels feel abnormal.

  • Social Behavior: The combination of restlessness and mood instability may cause patients to appear overly energetic or emotionally intense in social interactions.

Conclusion

The reason people with Graves’ disease often appear excited is due to a combination of excess thyroid hormone, overstimulation of the nervous system, and psychological manifestations of hyperthyroidism. Recognizing these symptoms is important, as proper treatment—such as antithyroid medications, radioactive iodine, or surgery—usually improves both the physical and psychological signs of the condition.

📚 References (APA 7th Edition)

  1. Holmberg, M., Hällgren, J., Åsberg, M., & Törring, O. (2024). Psychiatric complications in Graves’ disease. European Thyroid Journal, 13(1). https://doi.org/10.1530/ETJ-23-0247

  2. Asif, H., Shoib, S., & Wani, M. A. (2022). Hyperthyroidism presenting with mania and psychosis: A case report. Cureus, 14(3), e22949. https://doi.org/10.7759/cureus.22949

  3. Fukao, A., Takamatsu, J., & Arishima, T. (2019). Graves’ disease and mental disorders. Neuropsychiatric Disease and Treatment, 15, 2985–2996. https://doi.org/10.2147/NDT.S214568

  4. Shoib, S., Ahmad, J., Wani, M. A., Ullah, I., Tarfarosh, S. F. A., & Masoodi, S. R. (2021). Depression and anxiety among hyperthyroid female patients and impact of treatment. Middle East Current Psychiatry, 28(26). https://doi.org/10.1186/s43045-021-00107-7

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