Testosterone and Depression

Testosterone and Depression

Here’s what you need to know about Testosterone and Depression

  1. With regards to testosterone and depression. Doctors prescribe any of several drugs to
    treat mental illnesses. The most effective drug may be testosterone.
  2. Doctors are over-prescribing drugs to where they’re even recommending antidepressants
    to combat normal mood variations.
  3. Many studies have shown that men with low testosterone are more prone to depression.
    However, few doctors, though, do hormonal assessments on these patients.
  4. Men who suffer from Hypogonadal syndrome experience great improvements in mood
    and depressive symptoms when treated with testosterone.
  5. Low levels of thyroid hormones can cause depression, fatigue, and nervousness.

Primary care physicians and psychiatrists–partners in crime–try to treat or control a host of
mental illnesses by prescribing from their huge artillery of magic pharmaceutical bullets.

Their patients are often misdiagnosed, presumably suffering from a multitude of
psychiatric/psychological conditions including bipolar illness (running the gamut from
Bipolar I, Bipolar II to cyclothymic mood disorders), major depression, recurrent major
depression (both mild and severe), anxiety, and more.

It is odd that nowhere among these magic bullets is testosterone. It could, in many cases,
be a  powerful weapon against depression and related mental illnesses.

It’s the Hormones!

As with many medical/psychological puzzles, the answer to a large number of our mental
health challenges is right in front of us. Many psychiatric disorders have genetic, biochemical,
or environmental origins, often clinicians look in the wrong places.

The human endocrine system may hold the answer to many mental health issues. Here an
elaborate and delicately balanced mix of hormones work in synergy to keep our bodies
running smoothly. If this delicate balance is thrown out of kilter, for any of a myriad of reasons,
your physical and emotional health will be in jeopardy.

Physicians in our more sophisticated men’s health clinics are now at the forefront of exciting
new discoveries. Relationship of hormonal imbalances in a large number of mental illnesses,
including depression, bipolar illness, and anxiety, is no being found. These discoveries are
changing the way many physicians approach mental health challenges. And, as the king of
the androgen hormones, testosterone has a huge impact on our cognition and mental health.

The Relationship between Low Testosterone and Depression

Many clinical trials and studies have shown that men with below-normal testosterone levels
are more prone to depression than the general population. For example, in a 2015 study of 200
men conducted by George Washington University’s Center for Andrology, 56% of the participants
presented with significant depressive symptoms.

Dr. Michael Irwig, M.D. says more than half of the men referred because of borderline testosterone
levels suffered from depression. In addition, nearly 90% of patients suffered from erectile
dysfunction. Over 40% reported sleep disturbances, and 27% told clinicians they had difficulty
concentrating (1).

In 2014, researchers from the Department of Neurology and Psychiatry at St. Louis University
reviewed 16 clinical trials that studied the relationship between low testosterone and depression.
The trials were double-blind with placebo controls (2).

Here are the salient points from the analysis of these clinical trials:

  • Testosterone has been effective in treating depression in males. The data demonstrated
    positive effects of testosterone on mood.
  • The impact of testosterone was greatest in men less than 60 years of age. (The study yielded
    uncertain results in the ability of testosterone to improve mood in older men.)
  • Men whose testosterone levels were normal before treatment were less likely to experience
    improved moods. Those who registered low baseline testosterone levels before treatment
    showed significant improvement.
  • Testosterone works best in men with minor depression and those who suffer from
    cyclothymic depression, which shows less severe symptoms that last longer than typical
    depressive illnesses.

Incorrect Diagnoses, Bad Medicine

Despite these findings, psychiatrists are quick to prescribe anti-depressants to treat melancholia
over taking complete metabolic assessments. In fact, many psychiatrists and primary care providers
rely on their patient’s description and history of their depressive episodes.

It’s no surprise that every year the level of anti-depressant use increases dramatically.
Consider that in 2010, a study of 5639 participants by the Johns Hopkins Bloomberg School
of Public Health found that in the preceding two decades, antidepressant use in the U.S.
increased 400%, with over 10% of Americans over the age of 12 taking anti-depressant medication.

A number of experts believe that doctors are overreacting to the point that they prescribe
anti-depressants to combat NORMAL mood variations. However, these same experts overlook
the influence that hormonal abnormalities contribute to depression.

The rampant rate of misdiagnoses is due, in part, because the information that researchers and
scientists rely on is based on flawed or anecdotal data. Often a drug that’s intended to solve one
medical problem. Only to offer a better line of defense against another. For example,
Klonopin (generic, clonazepam), developed by Roche as an anti-seizure medication, is now
often prescribed for anxiety.

If you use an addictive benzodiazepine-class drug, Klonopin it can do more harm than good.
If the underlying cause of the patient’s problem is hormonal and not neurological, the medication
will never work effectively.

Testosterone and Depression

Hypogonadism, Anxiety, and Depression: The Link

Hypogonadism is a condition that causes reduced testosterone levels because of impaired
gonad function. Researchers have known of a link between hypogonadism and the onset of
anxiety and depression for over two decades.

A similar scenario of increased incidences of anxiety and depression is present in men who
undergo androgen deprivation therapy for prostate cancer.

Clinicians found that men with hypogonadism treated with testosterone replacement therapy,
experience improvement in mood, amelioration of depressive symptoms, and reduced symptoms
of depression.

Bipolar Disorder Linked to Hormonal Imbalances

Treatment of bipolar disorder (to describe the wild swings between depressive mood and
maniacal behavior) has long baffled psychiatrists. Generally, prescribing a litany of mood
stabilizers and other powerful medications in an effort to improve this destructive illness.
With little success.

These medications cause harmful side effects such as lethargy, weight gain, and cognitive
dissonance. Again, doctors are often looking in the wrong place, as mounting evidence points to
hormonal dysfunction as a contributing factor in developing bipolar disorder.

The study results do not indict hormonal imbalances as the primary cause of bipolar illness,
clinicians should note that out-of-kilter testosterone and estrogen levels can exacerbate the condition (3).

Hypothyroidism, Hyperthyroidism, and Mental Health Issues

The thyroid gland stores or secretes hormones that have an impact on every organ in our bodies.
Triiodothyronine (T3) and thyroxine (T4) are the two primary hormones produced by the thyroid.

The hypothalamus and pituitary gland work in synergy to regulate the levels of these two hormones
and abnormalities in their levels lead to several cognitive issues that often mimic the symptoms
of mental illnesses.

The two most common thyroid abnormalities are hypothyroidism and hyperthyroidism. Hypothyroidism,
characterized by reduced production of hormones, while hyperthyroidism results in greater-than-normal
hormonal production.

Symptoms of hypothyroidism include depressed affects (slumped shoulders, frowning, negative attitude)
and fatigue, along with symptoms like nervousness, hyperactivity, anxiety, and irritability. Unless a
patient receives a comprehensive thyroid blood test, misdiagnoses of these symptoms as the result
of depression or anxiety can happen.

Mental Illness: Ruling Out Hormonal Causes

Many patients who visit men’s health-optimization clinics report symptoms of lethargy, fatigue,
problems with cognition, and depression. A competent physician does not assume that these
symptoms are the result of low testosterone.

The doctor should take a complete medical history and then administer comprehensive testosterone
level blood screenings. They will rule out other reasons for the physical and emotional symptoms and
recommend treatment such as thyroid medications or TRT, either of which can improve or eliminate
symptoms of depression, anxiety, and reduced cognitive abilities.

By Dr. Christopher Senger
  1. GW Researchers Find that Men Referred for Borderline Testosterone Levels Have Higher
    Rates of Depression and Depressive Symptoms, GW School of Medicine & Health Sciences,
    July 1, 2015.
  2. Impact of exogenous testosterone on mood: A systematic review and meta-analysis of
    randomized placebo-controlled trials, Annals of Clinical Psychiatry, 2014;26(1):19-32.
  3. Hormone Imbalance, Not Bipolar Disorder: Many people diagnosed BPD are NOT,
    but have hormonal dysregulation syndromes by Jay Goodman, M.D, Psychology Today (online),
    October 15, 2013.