Summary ~ Thyroid hormones can be altered by physical or emotional stress ~ Thyroid hormones via the HPT axis are intertwined with the HPA-Axis –dysfunction in one produces dysfunction in the other ~ Many cognitive, affective and behavioral symptoms commonly seen in behavioral health settings may have some underpinnings in thyroid dysfunction ~ Mental health clinicians can educate patients about the far-reaching impact of thyroid hormones; help them address cognitive and emotional stress and trauma and address sleep and circadian rhythms.