ABSTRACT
This chapter provides a case of a 37-year-old woman who presents to her general practitioner (GP) complaining of feeling 'tired all the time'. This has come on over the last 6 months and she believes it is related to coping with three children ages 12, 7 and 5. She says that her self-esteem has been low recently and this is made worse by having no work. Her eye contact is within normal limits. She looks tired and her skin is dry. She describes her thoughts as slow and her mood as intermittently low. She is happy to chat and there is no evidence of thought disorder, thought passivity, hallucinations or delusions. Investigations would tend to depend on the full systematic enquiry but would include thyroid function tests, full blood count tests in the first instance. Treatment for hypothyroidism would include thyroid replacement therapy and careful monitoring of progress including mental state.
