I think lots of us seem to be in the same boat here w some form of depression or anxiety. And if you guys are like me you have tried everything, assuming our TRT protocols are in check, would like to hear any additional meds/supplements that are working for you along with your t regiment, not just the typical vit d/ fish oil blah blah. I mean is it celexa, lithium, deplin, what? ECT, lol... I could name the exact side effect with every class of med I had.
It is very difficult on a site of strong muscled men to respond to this subject, as even replying makes them seen as weaklings.
At my age I am having thoughts of "I don't want to die, I don't want to die" all too often, as of recent. When healthy virile men get to my age, they find their wives, lady friends are no longer interested in sex. The female may still love the guy, but that something special is just not there in any kiss or hug, and we feel as if they really do not fully care. At that point a lot of our motivation to remain physically & mentally motivated in life is difficult to maintain.
I recently handled a situation where a man had visited a spa which is a bordello for years on end. The man was condemned as not loyal to his wife etc. What the man had been denied for years on end was the feeling, sexually that someone cared, part of orgasm mental satisfaction. We all know the wife could have found a way for this situation to never have happened, but you know no one is talking with her about HRT, just condemning him. No this is not me. The dumbest thing anyone can say is "they should have talked about this". You can bet your ... that this was discussed several times.
At an absolute minimum, in these type of situations the men can keep things working with tings like proanthanol bio complex, L arginine, a really good Endocryn DHEA and top of the line multi vitamin mineral.
Also too many men have lost contact with their religious needs resulting in a certain emptiness. There are so many things we can do, but the secret is we have to do them, all of them. 30 minute walks right after breakfast etc etc.
Many here have had mood issues and ones though patterns can go there when T deficient and those thought patterns become a rut and one can get stuck there. Many other things can contribute such as thyroid/iodine issues, stress, cortisol/Adrenal_Fatigue etc. As Phillip states very articulately, all of this is tied into ones love life and other social factors; and that is also affected by ones mood history and hormone and other health issues.
Stress can wear you down and been in a dark/moody space is stressful as well, creating a trap.
I suggest tackling the easy health issues first, if you can get motivated to do that. Thinks that do not involve drugs such as iodine status, diet/supplements and sleep hygiene should be tried first. If one needs thyroid meds, then they can make a big difference. One might need cortisol and hopefully that is not needed later after other issues are resolved.
Then you can try been pharmaceutically assisted. If you simply feel dull and find little pleasure in anything, including good food, you probably need an boost in dopamine. Wellbutrin would be a good first try and it avoids the nasty problems that all SSRI's have. If you have panic attacks, a small amount of an anti-anxiety med can make a wall of pain slide away. You would want to limit the duration of that to as little as possible as the effects can deepen some aspects of an underlying depression.
Wellbutrin is also a bit stimulating and that can be useful. If that interferes with sleep, adjust timing of doses to earlier in the day. Some need melatonin to get to sleep. That should be time release to avoid wakefulness later after the half-life. I find that trazodone is very good for sleep and when dosed right, it does not have drowsy drag-over the next morning.
There has been a large shift in focus here, at least by be, concerning thyroid function and iodine deficiency. You can check your overall thyroid function by checking your body temperature WHEN you first wake up AND mid-afternoon. See the thyroid basics sticky for more on body temperatures. You also need to have had a steady identifiable source of iodine for years in your diet, from iodized salt and/or vitamins that list iodine. As selenium deficiencies are a serious risk factor for thyroid autoimmune diseases, make sure your multi-vits list that as well.
You can also list your lab work with ranges and other details as per the advice for new guys sticky.
In my personal experience, wellbutrin is a bit dangerous if you have anxiety, unless you have a benzodiazepine at hand as a rescue medication.
HRT helps a lot with my overall sense of well-being, my get-up-and-go, my confidence in being capable of handling things. I've tried dropping my SSRI but that hasn't gone well. Still, HRT helps in a lot of ways, and I'm not about to go back to living with low T. For depression, nothing beats lexapro for me. I take 10 mg per day. It's perfect except that it does cause anorgasmia.
I used to take low-dose buspirone to counteract that, with some success, but since October I've been taking Yohimbine HCL and it's way way better. I take 15 mg per day. That's the recommended dose, but I wouldn't start there. I started at 2.5 mg per day and slowly worked up. As a nice side-effect, it's helping a lot with appetite suppression.
hrt is dialed in with hcg+ arimidex, labs damn near perfect. I without question feel better on TRT. Just have the tendency to get down occasionally and it doesn't seem to be situational, maybe I'm just built like this mentally, very sensitive as well. I mean don't get me wrong this isn't a can't get out of bed deal, just more of a down mood that comes and goes pretty quickly. Estrogen is always 20-27 range.
Ksman- tried the trazadone before and was groggy as hell at a low dose, ambien works like a charm but I have a theory that that gaba suppression makes the anxiety and depression worse in the long run but I literally won't sleep for days without it. any thoughts on that?
seek- wellbutrin worked at one point for me very well and oddly enough didn't make my anxiety worse but that was glaxo brand name and these generics seem to be complete horse shit with terrible efficacy?
neveralone- any libido suppression on the lexapro with it being a serotonin agent?
I do think my problem is dopamine related, any other ideas on dopamine agents? Caber? ??
Change your life before you go throwing in more drugs to fill the gaps. You need personal goals and motivation based on your own happiness. Too many people are motivated entirely by outside forces such as their girlfriend, their friends, family and so on. Make the goal about yourself and not outside reinforcement and you'll be a much happier individual. Sounds selfish but to a certain degree you need to be selfish.
Yes, lexapro does suppress libido for me but Yohimbine HCL counteracts that. I honestly think my libido is higher right now than before I was on lexapro. Yohimbine is new for me, I'm crossing my fingers that this keeps up (no pun intended). I had thought that the prosexual effects of Yohimbine were all about blood flow, but apparently not. It works also on increasing norepinephrine and epinephrine which balances out the serotonin increase from SSRIs and helps with libido.
If Wellbutrin worked well for you though, then I'd go with that.
I'd stay away from Cabergoline if you are looking for a long-term option. There's a condition called dopamine agonist withdrawal syndrome (DAWS) that I've read is horrendous.
A lot of people think TRT or HRT fixes mood issues. I have had gene testing done. Which has shown mutations in my serotonin transporter, dopamine degradation, and the always fun methylfolate gene mutation.
These things are completely outside of testosterone. More or less T won't fix them. Lowering my e2 wont't fix them.
If you suffer from these issues I would advice gene testing as well as blood work. Getting the hormones right is only half the battle. You also have to have the right balance of neurotransmitters in your brain.
ALSO............. Don't do any AAS if you have mood, anxiety, or depression. If you do, if anything worsens in your mood, you have only yourself to blame. And explaining recreational drug use to a doctor is always tricky.