The relationship between low testosterone and depression in men can be a complex one. The two conditions may be co-occurring or separate, and sometimes one can trigger the other. However, sometimes depression may be misdiagnosed as low testosterone and vice versa because they share some similar symptoms.

Men who are affected by one or both of these conditions will experience a range of overlapping symptoms that can affect their quality of life, yet often they can remain undiagnosed or put down to the effects of getting older. However, they are both treatable conditions and it’s helpful to understand more about the causes and main symptoms.

What is testosterone deficiency?

Testosterone deficiency, sometimes called low-T, occurs when the body does not produce enough testosterone, which is a hormone that plays a key role in male health. Low levels of testosterone can lead to loss of bone density and muscle strength, changes in body fat distribution and weight gain, and a lowered libido.

Low testosterone can also cause erectile dysfunction (ED), which is difficulty achieving or maintaining an erection long enough for a satisfactory sexual experience. It may also cause mood swings, irritability, and a lack of motivation, which can sometimes be confused with depression. It may also cause poor concentration and memory problems.

How is testosterone deficiency diagnosed?

Low testosterone is diagnosed via a blood test. There are different forms of testosterone in the body and some tests can distinguish between the two different types. Most testosterone is attached to proteins, but some is known as ‘free’ testosterone because it actively moves around the body.

According to an article in The Times, overall testosterone levels may be diagnosed as normal, but free testosterone levels can be low. This is an important distinction because this may be the cause of unexplained ED, lack of sex drive and low mood.

Sometimes men may be misdiagnosed with depression when they may respond better to testosterone boosters or an ED treatment such as tadalafil, which temporarily relaxes the blood vessels in the penis. As we will see, the symptoms of depression and low testosterone can present in a similar way in men.

What is depression?

Depression is a mood disorder that persists for at least two weeks, but often it can last for weeks, months, or even years. It’s characterised by low mood and the inability to take pleasure in activities but is different from normal feelings of sadness that everyone experiences from time to time.

The main symptoms of depression include constantly feeling low; a lack of motivation or loss of interest in activities that were previously enjoyed; weight loss or gain without trying; changes to sleep patterns or insomnia; fatigue; feelings of worthlessness, shame or guilt; and poor concentration.

Depression may also cause a loss of libido and it can also be a contributing factor in ED. Many of these symptoms overlap with those of low testosterone, so men may not always receive the correct diagnosis or be offered the most appropriate treatment.

Mild to moderate cases of depression may respond well to lifestyle changes, including taking more exercise, eating a healthy diet, and cutting back on smoking and drinking alcohol. Making time for hobbies or socialising can also help to ease the symptoms of milder cases of depression.

Mental health disorders often have complex causes that are often rooted in traumatic past or ongoing experiences, and everyone’s experiences will be different and unique to them. It can be difficult for people affected by more severe depression to summon up the motivation to make lifestyle changes or seek the help that they need.

Depression can be treated with medication, talking therapies such as cognitive behavioural therapy, or a combination of both of these methods.

In conclusion, men who are concerned about low energy levels, loss of sex drive, low mood, or weight gain should consider their overall health profile carefully to get an accurate diagnosis.

It is thought that at least a quarter of all men are affected by testosterone deficiency that is impacting their quality of life. It’s a treatable condition and therefore men should feel confident that they are being taken seriously by their doctor and that any physical causes of their symptoms are ruled out before they are diagnosed with depression.