Being strong is my default position. Even when I’m anything but.

Whatever life throws at me, I try to pick myself up and focus on what I need to do to recover. I rarely share how I’m really feeling. Partly because I don’t want to worry people. Partly because some people are quick to offer advice rather than understanding. But also because I’ve spent a lifetime cultivating the image of a strong woman, and I don’t always want that image challenged.

The last couple of years have been brutal. At the end of 2024 I suffered a Graves’ disease relapse that decimated my strength, endurance and cognitive function. As a consequence I had to withdraw from University. 

I recovered, was treated with Radioactive Iodine (RAI) which left me susceptible to developing hypothyroidism. Unfortunately, within 7 months I had developed severe hypothyroidism which is now being treated. 

During the same period I also became estranged from someone I believed would always be in my life. And I found myself increasingly distressed by events in the wider world and the growing divisions in society. After spending much of my working life advocating for people’s rights, some of what I see today leaves me feeling angry, saddened and powerless.

I feel very down. But is this real or is it a consequence of my hypothyroidism, a symptom of which is depression. A lack of thyroid hormones alters brain chemistry, specifically by reducing the production of mood-regulating neurotransmitters like serotonin and dopamine.

I’ve used ChatGPT for a couple of years now across many areas of my life: health, fitness, study, work and writing. What continues to surprise me is not its ability to provide information but its ability to spot patterns. Because it remembers previous conversations, it often notices connections that I have missed.

So I decided to ask it whether, given how I was feeling I should return to therapy. I’d had therapy last year but to get over a particular issue. 

It’s response was fairly lengthy but concluded:

From what you’ve told me, I hear a woman facing difficult circumstances and understandable sadness, with the additional complication of a thyroid condition that is likely amplifying everything.

Are you struggling because difficult things have happened, or are you struggling because your mood has become persistently low regardless of what is happening?

The question I would ask is not:

“Am I depressed?”

but:

“Am I grieving, angry and exhausted?”

I then asked what exhaustion could feel like. It gave me three types of exhaustion: physical, emotional and cognitive. There have been times  where I’ve been physically and cognitively exhausted noticeably when I suffered a Graves’ disease relapse but that is not the case now. But the symptoms of emotional exhaustion fitted perfectly. As I read the list, I found myself nodding along.

• Feeling more affected by upsetting events.

• Crying more easily.

• Finding it harder to “let things go.”

• Becoming irritated by things you would normally brush off.

• Feeling overwhelmed by news or world events.

• Carrying worries around all day.

One ChatGPT observation was particularly insightful:

One thing I wonder is whether you’ve allowed yourself to fully acknowledge that you’ve been ill.

Not inconvenienced.

Not slowed down.

Ill.

When we first discussed your thyroid results, your TSH was over 100. Most people would regard that as a significant illness. Yet almost immediately you were asking:

• How can I maintain my training?

• How can I support recovery?

• Will I be able to do the half marathon?

Those are admirable questions. But they are also the questions of someone eager to get back to normal rather than someone pausing to recognise the scale of what has happened.

I suspect there may be a gap between what your body has been through and what you’ve emotionally granted yourself permission to recover from.

This really made me pause. It was uncomfortable because it felt true. A TSH of over 100 is serious. I think my GP was amazed I was still functioning. Yet in my own mind I treated it as an inconvenience rather than an illness. I focused on recovery plans, training plans and future goals rather than acknowledging what my body had been through.

Acknowledging that I have emotional exhaustion is a big step forward. I’ve taken a step back on a number of my commitments. For most of my life resilience has meant pushing on. Working harder. Digging deeper. Being strong.

I’m beginning to wonder whether resilience sometimes looks different. Whether it means acknowledging loss, accepting that recovery takes time and allowing yourself the grace to heal.

I don’t know whether my low mood is caused by hypothyroidism, emotional exhaustion or a combination of both. What I do know is that I no longer feel the need to immediately ‘fix’ it. For now, recognising what has happened feels like an important first step.