I ticked down the list: Fatigue, early morning waking, fuzzy head, forgetfulness, no patience, irritability, weepiness, and an anxious buzz in my chest. My life is good. I love my work. I have a great marriage to the quintessential great guy. Finances, o.k. Even politics are better, with the change of administration. Yes, Iraq. Yes, Darfur, Yes, W. But it didn’t bring me down so much before. It must be chemical. I’ll join the rest of my family on anti-depressants. Sigh.

Actually it’s Graves Disease, Hyperthyroidism: too much thyroid output. The strange thing is, that I have swung from Hypothyroidism, too little thyroid, and have been on drugs for it for years. As my friend Karen says, "welcome to the roller coaster."

Click here for more information. I’ll let the experts do the deep explaining. Here’s what you most need to know: If you’ve got a client who is uncharacteristically lethargic, anxious or speedy, do think depression, anxiety, or mania.  Also think about thyroid disease. If your client is female, think twice. If her hair is brittle, her skin dry, her mood, irritable, or her eyes are bothering her, there’s unexplained weight loss (hyper) or weight gain (hypo) send her to an endocrinologist immediately. Even if it’s long term, untreatable dysthymia. You may have a slightly hypothyroid case. Not every doctor will give the right blood tests, so send your clients to someone who has a clue. Tell them that borderline low is worth medication. It can change lives. I’ll vouch for that.