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Hypothyroidism 10 signs and symptoms – mindbodygreen

Myxedema is a red, swollen rash that is characteristic of thyroid problems. When your thyroid doesn't produce enough hormones, the balance of chemical reactions in your body can be upset.

Lucas Cox
Tuesday, September 18, 2018
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  • Similarly, your muscles can feel sore, tired, and heavy.

  • If you notice to weight gain notwithstanding a decent diet plan and workout plan, consult with your primary care physician. That is the reason low level of thyroid hormone made you to feel colder than others around you.

  • How Are Thyroid Issues Treated? It is most likely that others will notice this symptom first, instead.

  • Due to too little thyroid hormone production, the body burns less energy causing a decrease in body temperature and increased cold intolerance.

15 Signs of Thyroid Problems

Women are eight times more likely to develop a thyroid disorder than men. Thyroid hormone can influence whether you feel energized or tired as it controls energy balance. As an extraordinary example, animals that rest experience low thyroid levels paving the way to their long sleep. These children are also more prone to serious intellectual and developmental problems. Trouble Concentrating or Remembering.

This can make you feel hypothyroiidsm even when you are in a warm environment. In few cases, TSH levels decline, and the thyroid never gets the indication to increase formation hypothyroidism levels of thyroid hormone. Later symptoms of an underactive thyroid include: a low-pitched and hoarse voice a puffy-looking face thinned or partly missing eyebrows a slow heart rate hearing loss anaemia Page last reviewed: 10 May Next review due: 10 May What Is Subclinical Hypothyroidism? Trouble Concentrating or Remembering. Thyroid hormone interacts with other hormones that control the menstrual cycle, and abnormal levels of it can disrupt their signals. Low thyroid hormone makes hair follicles to stop reviving, prompting hair loss.

  • As a result, your body has to stretch its natural resources, which can lead to thin and brittle hair and nails.

  • A study published in the European Journal of Endocrinology notes that autoimmune hypothyroidism patients had significantly higher levels of fatigue as compared with differentiated thyroid carcinoma patients.

  • Digestive Issues This is another way that thyroid issues might present at opposite ends of the spectrum. However, people with hypothyroidism are twice as likely to feel more weak than usual, compared to healthy people 6.

If you and symptoms cold on a warm, sunny day, get your thyroid levels sihns as you may be suffering from hypothyroidism. A study published in reported that autoimmune hypothyroidism patients had considerably higher rates of tiredness as compared with ones having differentiated thyroid carcinoma. Fortunately, hypothyroidism is generally treatable with inexpensive medications. What Is Hypothyroidism? Other hormone issues can likewise cause sudden hair loss. This content does not have an Arabic version. Birth defects.

It may be something different is going on. Feeling Down or Depressed There is a link between hypothyroidism and depression. Contact Us. If you have started forgetting things and you are having difficulty concentrating, it could be due to low thyroid function.

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Hypothyroidism, or low levels of thyroid hormone, slows your metabolism and decreases growth or repair of many parts of the body. Endocrine Web. Our FREE doctor-approved gut health guide. Juliet, TN

Problems tend to develop slowly, often over a number of years. It secretes two all-important hormones that control major bodily functions including how you use energy, regulate body temperature, and digest food and organs including the heart, brain, liver, kidneys and skin. Thyroid hormones have a great influence on menstruation, pregnancy, lactation and even uterine involution after childbirth. Stay with us for our next post to discover them! July 14th, The cause of the change in your skin texture can be the reduction of blood circulation, which is one of the side effects due to low thyroid hormones. The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis.

  • Changes in Menstrual Periods Because hyperthyroidism tells your body to move faster, the menstrual cycle can become lighter and faster.

  • Since hair follicles have stem cells that have a short life expectancy and amd turnover, they are more sensitive to low thyroid levels than other tissues in body. An activist speaks about the stigma surrounding mental health in Latinx households and explains how self-care can be a radical act of community care….

  • Juliet, TN Both irregular and heavy menstrual bleeding are linked to hypothyroidism.

  • These individuals may not have signs or symptoms of the condition, but when they do, they include:.

Hypothyroidism underactive thyroid is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. They might have the option to help you adapt, whether the depression is brought about by thyroid problems or something different. Related Coconut oil: Can it cure hypothyroidism? Thyroid hormone controls energy balance and can influence whether you feel ready to go or ready to nap.

Robyn says:. Rather than burning calories for growth and activity, the measure of energy you use very still, or basal metabolic rate, diminishes. If breast milk formation hypothyroidism recently gained weight, it may be worth checking to see if you also have any of the following symptoms so you know it's time to see your doctor to get tested. You've bought the face creams, the masks, and the moisturizing lotions, but nothing seems to work. If an underactive thyroid is not treated It's unlikely that you'd have many of the later symptoms of an underactive thyroid, because the condition is often identified before more serious symptoms appear. Constipation There can be problems in your colon because of low thyroid levels.

10 signs and symptoms of hypothyroidism.

Both of these conditions can cause several problems. Because the thyroid hormones tell your body to become more active, naturally it will try to cool itself off by sweating. Favorite Integrative Sources for Hypothyroidism American Thyroid Association ATA Aside from their helpful overview pages on hypothyroid symptoms, the ATA has an extensive article about complementary and alternative medicine techniques for hypothyroidism. One of the most common symptoms of hypothyroidism is feeling worn out. Habitual daytime naps or a constant need for caffeine may also be signs of excessive fatigue related to this condition unfortunately, these practices can also make it more difficult to sleep at night.

Autoimmune disease. Cold hands and feet. Other times, TSH levels decrease, and the thyroid never receives the signal to increase thyroid hormone levels. Myxedema is more specific to thyroid problems than other causes of dry skin Philadelphia, Pa.

ALSO READ: Crackles Icd 10 Code For Hypothyroidism

Treatment with synthetic thyroid hormone is usually simple, safe and effective once you and your doctor find the right dose for hypofhyroidism. Like most cells, hair follicles are directed by thyroid hormone. Symptoms usually develop slowly and you may not realise you have a medical problem for several years. Feeling Tired You will feel tired if you have hypothyroidism. Srinath, "Hypothyroidism causes reduced clearance of cholesterol particles, so LDL and triglycerides may be elevated in a hypothyroid patient. This is on the grounds that you are burning fat or calories. Heavy or Irregular Periods.

If you have multiple signs and symptoms of this problem, ask your doctor to check your thyroid hormone levels. People suffering from hypothyroidism often yhpothyroidism muscle weakness, pain, stiffness, or cramping. On a warm and sunny day, if you feel cold, you should check your thyroid levels as you can be suffering from underactive thyroid. Many things can put you at risk for hypothyroidism, from genetic predispositions to an autoimmune disorder called Hashimoto's thyroiditis a condition that occurs in 80 percent of those with hypothyroidism in which the immune system attacks the thyroid. It may also impair certain kinds of memory. You may also like. Once thyroid levels are low, metabolism switches modes.

What Does Thyroid Testing Do?

These are signs of a hyperthyroid complication called thyrotoxic crisis. Blood pressure is directly linked to circulation. How Are Thyroid Issues Treated? In: Ferri's Clinical Advisor In other words, the thyroid regulates energy levels.

Hypothyroidism results when the thyroid gland fails to produce enough hormones. These women had been diagnosed with hypothyroidism after other symptoms had caused them to get tested These children are also more prone to serious intellectual and developmental problems. Favorite Orgs for Essential Hypothyroidism Symptoms Info Hormone Health Network From the Endocrine Society As leading professionals on all things endocrinology, the physicians and experts from the Endocrine Society offer the latest research and information on hypothyroidism. Thyroid Function Tests. Medical review by Bindiya Gandhi, M.

  • Thyroid Nation.

  • Sure, there's sleep deprivation, stress, and aging to blame, but your overall cognitive functioning takes a hit when your thyroid is out of whack.

  • Heavy or irregular periods In contrast to hyperthyroidism, hypothyroidism causes the menstrual cycle to become slower and heavier.

Summary: Thyroid hypothyroidism 10 signs and symptoms is like a gas pedal for energy and metabolism. However it happens, these antibodies affect the thyroid's ability to produce hormones. Although hypothyroidism most often affects middle-aged and older women, anyone can develop the condition, including infants. Combined with the feelings of fatigue, you can feel sluggish, experience mood swings, and see signs of depression. Thyroid nodules, as they are most frequently called, are the result of a swollen thyroid gland. It also becomes harder for your body to get moving each day.

Mosby Elsevier, Spain, A chronic skin condition can make attending summer camp unrealistic for some children. If you are experiencing irritable bowel syndrome IBSconstipation, or indigestion, this can be one of the popular symptoms of hypothyroidism. Symptoms Of Hypothyroidism — Hair Loss Hair loss is known as one of the typical symptoms of hypothyroidism. Last Updated: April 8, by Brown. In some other cases, the thyroid does not get the signal to increase thyroid hormone levels as there is a decrease in the TSH levels. Other hormone problems can also cause unexpected hair loss.

Symptoms of an underactive thyroid

In some other cases, the thyroid does not get the signal to increase thyroid hormone levels as there is a decrease in the TSH levels. High Cholesterol Levels High cholesterol levels are also known as one of the typical symptoms of hypothyroidism. In: Harrison's Principles of Internal Medicine. Everything on vkool.

One of the most common symptoms of hypothyroidism is feeling worn out. Growth on the Neck Formerly called goiters, growths on the neck are symptoms of extreme thyroid disorder. Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to hear. Rarely, muscle breakdown can also occur. Emma Loewe. Increased Sweating Because the thyroid hormones tell your body to become more active, naturally it will try to cool itself off by sweating. Medically reviewed by Kelly Wood, MD.

When your thyroid doesn't produce enough hormones, the balance of chemical reactions in your body can be upset. Fish like salmon are hypothyroidissm good source of omega-3 fatty acids, which are known to decrease the inflammation that might be contributing to your muscle and joint pain. The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis. Skin cells have rapid turnover just like hair follicles.

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Keep hypothyroodism hypothyroidism 10 signs and symptoms, your body is a complicated and intricate system that operates on many levels of performance. While these are the two most common steps in alleviating thyroid disorder, they are not the only ones. As a result, your body tends to store more calories from the diet as fat.

Fish like salmon are a good source of omega-3 fatty acids, which are known to decrease the inflammation that might be contributing to your muscle and joint pain. Another of top 10 signs and symptoms of hypothyroidism is increased sensitivity to cold. It might be a clue that something else is going on. Written by Matthew Thorpe on March 8, In a study, individuals with recently diagnosed hypothyroidism gained an average of 15—30 pounds 7—14 kg in the year since their examination. During catabolism, muscle strength decreases, potentially leading to feelings of weakness. Dry And Flaky Skin The first of top 10 warning symptoms of hypothyroidism is dry and flaky skin.

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The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone hypothyroicism. Philadelphia, Pa. This forced growth is too fast. Hypothyroidism is linked to depression. Hyperthyroidism occurs when too many hormones are being produced, which can result in a loss of weight and, at times, a detrimental increase in energy.

Advertising revenue supports our not-for-profit mission. This can lead to hair loss and coarsening of the hair. It took my Hypothyroidiem 12 months to level it out. We know constipation is an embarrassing topic that no one likes to discuss, but if you can't boot your bowel issues, it might be time to call up your doctor. Hypothyroidism, or low levels of thyroid hormone, slows your metabolism and decreases growth or repair of many parts of the body. See your doctor to get checked for high cholesterol levels, and when you're looking to change your diet to lower these levels, consider these 17 Foods That Lower Cholesterol. As an extreme example, animals that hibernate experience low thyroid levels leading up to their long sleep 2.

To report spelling errors, misinformation, or corrections in general, please contact breast milk formation hypothyroidism. Conclusion: Low levels of thyroid hormone reduces metabolism and can cause agonizing muscle breakdown. Conclusion: Hypothyroidism can create mental fogginess and trouble concentrating. The study stressed that assessing thyroid function in all individuals with menstrual disorders is to avoid unnecessary interventions such as curettage and hysterectomy. Those with high levels of thyroid hormone feel nervous and jittery.

Which People Are at Risk for Hypothyroidism?

Low thyroid hormone levels leave you feeling drained. On a warm hupothyroidism and symptoms day, if you feel cold, you should check your thyroid levels as you can be suffering from underactive thyroid. All effort is made into providing full transparency, not all available products or companies are highlighted. Our team of licensed nutritionists and dietitians strives to be objective, unbiased, and honest. Another study published in revealed that in the thyroid disorders, hypothyroidism is often linked with alopecia areata.

Muscular pain — If you feel random and mysterious tightening or numbness in your arms, hands, legs, or feet, consider that your thyroid may be the culprit. Many who experience hyperthyroidism struggle with feelings of anxiety. Last updated on January 29, In other words, the thyroid regulates energy levels. Those with high levels of thyroid hormone feel nervous and jittery. Another study of young women with mild hypothyroidism showed increased feelings of depression, which were also connected to decreased satisfaction with their sex lives

Feeling Cold. New York, N. If you find that you are unable to build toned muscle, reach out to your physician. Used for over a century, this type of thyroid medication can cause…. All of our board-certified surgeons are highly trained individuals and have many years of experience. Endocrine Web.

First, what exactly is hypothyroidism?

Juliet, TN But as your metabolism continues to slow, you may develop more-obvious problems. Habitual daytime naps or a breast milk formation hypothyroidism need for caffeine may also be signs of excessive fatigue related to this condition unfortunately, these practices can also make it more difficult to sleep at night. In one study, adults with hypothyroidism experienced physical exhaustion and reduced activity. It also means that dead skin may take longer to shed, leading to flaky, dry skin.

Fortunately, hypothyroidism does not trigger permanent cognitive dysfunction and these problems can be resolved with proper treatment. The study stressed that assessing thyroid function in all individuals with menstrual disorders is to avoid unnecessary interventions such as curettage and hysterectomy. Posted on January 28, by Sophie. It's unlikely that you'd have many of the later symptoms of an underactive thyroid, because the condition is often identified before more serious symptoms appear. The low thyroid hormones can be due to autoimmune diseases atrophic thyroiditis and Hashimoto's thyroiditisradiation treatment, surgical removal of the thyroid gland, inflammation of the thyroid gland, consumption of too much or too little iodine, congenital hypothyroidism, any type of harm to the pituitary gland as well as side effects of several medicines. Constipation And Indigestion If you are experiencing irritable bowel syndrome IBSconstipation, or indigestion, this can be one of the popular symptoms of hypothyroidism. Along with curing

Patients who receive hormone replacement therapy usually report improvement for depressive symptoms. It can even be hard to try to exercise because of the fatigue that comes with hypothyroidism. Formerly called goiters, growths on the neck are symptoms of extreme thyroid disorder. Sarah Regan.

First, some thyroid 101

Here's what dermatologists are doing to keep you safe during the coronavirus pandemic. May 25th, Read more. According to a study published in stated that thyroid hormones have direct effects to hair follicles. A sudden tingling sensation overtaking your hands, feet, or face is a fairly common complaint reported by people in the

Merck Manual Professional Version. This is because you are burning calories. Initially, it's important to make sure you're receiving the correct dose of medicine. Both of these conditions can cause several problems. Editorial Sources and Fact-Checking. Also, thyroid problems increase with age and may affect adults differently than children.

Low stmptoms hormone causes hair follicles to stop regenerating, resulting in hair loss. If you are having a hard time performing your normal daily tasks, you can be at risk for developing a possible thyroid problem. Hypothyroidism may be due to a number of factors, including:. Thyroid gland Open pop-up dialog box Close. Fish like salmon are a good source of omega-3 fatty acids, which are known to decrease the inflammation that might be contributing to your muscle and joint pain. Moreover, the low thyroid hormone production can lead to a slowed metabolism triggering to reduce sweating. The hormones play an important role in major functions of a body including how your body burns energy, digests food and regulates body temperature, to name a few.

For example, consider how hot you get when you workout. Accessed Oct. The study stressed that assessing thyroid function in all individuals with menstrual disorders is to avoid unnecessary interventions such as curettage and hysterectomy. July 14th,

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If you want to diminish hypothyroidism 10 signs and symptoms noticeable hypotjyroidism, know these 10 things before having laser treatment. Low thyroid hormone makes hair follicles to stop reviving, prompting hair loss. Join the AAD virtually as we hike across the country. We know how important making choices about your overall health is, and we strive to provide you with the best information possible.

The study also put emphasis on screening for thyroid abnormalities in patients with chronic, recurrent and extensive alopecia areata. This content references scientific studies and academic research, and is fact-checked to ensure accuracy. A low thyroid results in a lower metabolic rate that may lead to excessive weight gain. The change in skin texture and appearance is due to reduced circulation as a result of low thyroid function.

In catabolism, muscle strength reduces, conceivably prompting sensations of weakness. You can locate your thyroid gland in the wnd area of your windpipe. Tiredness And Constant Fatigue Tiredness and constant fatigue are one of top 10 warning symptoms of hypothyroidism. What Is Hypothyroidism? Below is a list of top 10 common signs and symptoms of hypothyroidism in men and women that VKool page wants to show you today. However, new, and especially increasing, weakness or aching is a good reason to make an appointment with your physician. Birth defects.

Most Recent in Hypothyroidism

Typically this will include blood tests to check the levels of T4 and T3 in your blood. Florida Hospital. Women are also more likely to develop thyroid conditions after pregnancy and following menopause.

There symptomx a link between hypothyroidism and depression. Hypothyroidism 10 signs and symptoms to a study published in highlighted that thyroid dysfunction can significantly affect lipid profile. There are over a dozen common symptoms of hypothyroidism, and weight gain is one of the most prevalent. Heavy or Irregular Periods Hypothyroidism has a connection with both irregular and heavy menstrual bleeding.

The thyroid is signs and symptoms butterfly-shaped gland found in the sykptoms of your neck. With fewer hormones, your body has a harder time heating itself up because your metabolism slows down. Overview Hypothyroidism underactive thyroid is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Babies born to women with untreated thyroid disease may have a higher risk of birth defects compared to babies born to healthy mothers.

This could cause you to feel hot flashes or experience breast milk formation hypothyroidism sweating. More than 20 million Americans suffer from thyroid disorders. Hypohyroidism or irregular periods In contrast to hyperthyroidism, hypothyroidism causes the menstrual cycle to become slower and heavier. Sometimes this is true, but more often than we expect, these seemingly innocent problems can indicate bigger medical issues. Low thyroid levels put the brakes on your colon.

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In fact, people with hypothyroidism are at a higher risk of suffering from hypothermia, a life-threatening condition when exposed to cold temperatures. Treating Hypothyroidism. According to a study published in highlighted that the most popular cutaneous feature in people with hypothyroidism is dry, coarse, and rough skin.

Women are eight times more likely to develop a thyroid disorder than men. August 21, You may have gained or lost weight for no apparent reason. Dry And Flaky Skin The first of top 10 warning symptoms of hypothyroidism is dry and flaky skin.

It may also impair certain kinds of memory. The pituitary, a tiny gland in the middle of signs and symptoms head, monitors your physiology and releases thyroid-stimulating hormone TSH. Read more. When the thyroid produces very little amount of these hormones, a medical condition called hypothyroidism occurs. This is called primary hypothyroidism, as the issue starts at the level of the thyroid gland. Importantly, none of these problems are unique to hypothyroidism. The thyroid gland plays a role as an internal thermostat for the body because it has the ability to regulate body heat.

You're Always Tired

Signs and a simple way, you can follow an oral sypmtoms treatment. Here are 5 things you can do to help your teen. This is called secondary hypothyroidism. Hence, if you are experiencing these skin changes, you should consult your doctor as soon as possible to find out exact causes for your problems.

Although your thyroid gland sits deep in your neck, your dermatologist may be the first doctor to notice signs of thyroid disease. As tiredness, constant fatigue, sleepiness and lack of energy are associated with many conditions, it is important to consult your doctor to find out the exact reason. Summary: Hypothyroidism can cause depression and anxiety. We know how important making choices about your overall health is, and we strive to provide you with the best information possible. When you have low thyroid function, your muscles which line the digestive tract containing the small and large intestines will become weak. Symptoms Of Hypothyroidism — Hair Loss Hair loss is known as one of the typical symptoms of hypothyroidism.

ALSO READ: Hyper Hypothyroidism

Your skin may even symptmos or become pale. Editorial Sources and Fact-Checking. Adults and symptoms hypothyroidism may have any of the following symptoms, according to the Mayo Clinic: 3. Heavy or Irregular Periods. Catabolism is a process that breaks down muscle and other tissue, thus leading to weakness, soreness, and pain. Have you ever wondered why your hair is falling out? Weight Management.

Patients who receive hormone sypmtoms therapy usually report improvement for depressive and symptoms. Other times, TSH levels decrease, and the thyroid never receives the signal to increase thyroid hormone levels. One of the more surprising signs of hypothyroidism? Sometimes this is true, but more often than we expect, these seemingly innocent problems can indicate bigger medical issues. Standard treatment for hypothyroidism includes oral medication, but there are natural therapies too.

While medications are the most commonly prescribed course of action, some integrative medicine doctors, like Taz Bhatia, M. Other hormone problems can also cause unexpected hair loss. Understand the link between your stress levels and your thyroid. Go to Top.

Digestive Issues This is another way that thyroid issues might present at opposite ends of the spectrum. These hormones also influence how well your body performs physically and mentally. However, if you notice hypothyroidism 10 signs and symptoms rapid heart rate and experience either a fever or deliriousness, you should call your doctor immediately. If you have signs or symptoms of myxedema, you need immediate emergency medical treatment. The thyroid gland is an important part of the endocrine system. When your thyroid gland works overtime, the hormones tell the body to work in overdrive. Schedule Thyroid Testing Today Please call us at the Medical Transformation Center in Louisville, Kentucky to schedule your thyroid testing and to check signs of thyroid problems.

Aside from feeling depressed, forgetfulness is also common in people with hypothyroidism. You might also experience difficulty with sexual performance or enjoyment. When your thyroid gland works overtime, the hormones tell the body to work in overdrive. Your hair and nails are constantly growing.

This rare, life-threatening condition is the result of long-term, undiagnosed hypothyroidism. Autoimmune disorders occur when your immune system produces antibodies that attack your own tissues. Everything on vkool. They may be able to help you cope, regardless of whether the depression is caused by thyroid problems or something else.

Hypothyroidism Underactive Thyroid. Overview Hypothyroidism underactive thyroid is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Therefore, they are also sensitive to losing growth signals from the thyroid hormone. Your doctor can help you sort out whether your hair loss is anything to worry about. It releases thyroid hormone, which controls the growth and metabolism of essentially every part of your body. Hormonal changes are closely linked to sexual function. Contact us for a test if so.

  • In This Article. Although hypothyroidism most often affects middle-aged and older women, anyone can develop the condition, including infants.

  • Srinath explains that "Depression can be related to other symptoms of hypothyroidism such as fatigue, muscle weakness, lethargy, difficulty with focus and concentration.

  • Gaining Weight.

  • Weakness and Aches in Muscles and Joints The metabolic switch flips towards catabolism if there is low thyroid hormone.

  • With hyperthyroidism, the extra hormones tell your body to increase the growth of your hair follicles and nails in a shorter period of time. This will typically improve when the thyroid issue is treated.

  • All of our board-certified surgeons are highly trained individuals and have many years of experience.

Hypothyroidism 10 signs and symptoms Thyroid Foundation. This means the outer layer of skin has been around longer, accumulating damage. This article will help hypotnyroidism recognize and understand these effects. Abby Moore is an assistant managing editor at mindbodygreen. Favorite Hypothyroid Symptom App Boost Thyroid Unlike other smartphone apps that focus on your health more generally, Boost Thyroid includes specific measurements related to your thyroid health. Hair Loss.

Along with dry skin, there may be facial puffiness especially near the eyelids and thickened skin on the lower legs with a pale or yellowish appearance. Do you know what else hurts your brain functioning? Muscle Soreness And Pain There are many common symptoms of hypothyroidism and joint pain is one of them. Low thyroid hormone makes hair follicles to stop reviving, prompting hair loss. According to a study published in stated that thyroid hormones have direct effects to hair follicles. Common symptoms include: tiredness being sensitive to cold weight gain constipation depression slow movements and thoughts muscle aches and weakness muscle cramps dry and scaly skin brittle hair and nails loss of libido sex drive pain, numbness and a tingling sensation in the hand and fingers carpal tunnel syndrome irregular periods or heavy periods Elderly people with an underactive thyroid may develop memory problems and depression.

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