I have done PMs with many guys here. Some get good T levels, have their estrogen controlled and lack energy, can't get things done. Apathy about many things can be a dominate issue.
Some doctors suspect a thyroid issue and prescribe, even if levels are otherwise quite decent. This can make one feel agitated but not do anything about the apathy and energy levels.
This situation can be a type of depression, characterised, no surprise, by low energy, not getting things done and apathy. In these situations there does not need to be any "profound sadness" that is typical in may depressions.
I bring this up, because I have gone through this as well as some others that I am aware of.
I think that SSRIs would be a really bad route for many. Wellbutrin can eliminate most symptoms quickly. For me, I changed profoundly and am busy doing things all day.
Sleep problems can reinforce the above type of depression. And some prescription or OTC sleep aids may create problems when these are used long term. I found trazodone to work very well, and it has some good anti-depressant effects as well... $4.00 per month at Walmart or Sam's. You sleep aids/drugs may be a major issue. I had been using a antihistamine type non-benadryl sleep aid for years. I think that that was messing things up, but one does need to sleep. The first night on traz gave me a deep sleep and I felt fantastic and energized the next day. I was stunned.
These things were transforming for me and I wanted to share my experiences in case some others might recognize some of these things in themselves.
Elevated estrogen can also be a huge factor and getting that under control may be critical in dealing with things like depression. Estrogen may strongly contribute to depression.
Sexual sides: Wellbutrin has a reputation for enhancing libido. For me, I don't see much of that. That reputation would certainly be true for those who have been chemically castrated by SSRIs. Both Wellbutrin and trazodone are known to, for some, increase erections. Trazodone has a warning about erections that will not go away, go the the hospital ASAP etc. So no sexual downsides for many.
If you have something to say about this that you are not comfortable posting here, you can PM me.
Thanks to Dr.PowerClean who helped me understand some of this and what the drug options were. Part of the problem is that one does not know that they have [this form of] depression. Dr.PowerClean helped me understand that these things happen.
It is all too theoretical, but when your life gets obviously turned around for the better in one week, this all takes on a different level of meaning. I had some good local support to help me, but I needed some context and understanding so I could be less than passive with my Doc.
Edit: minor changes