Is It Depression or Low Testosterone? The Hidden Truth in Men’s Mental Health
- Dr Rui Graça
- Mar 15
- 3 min read
Updated: Jul 16
By MHI Editorial Team | Medical review: Dr Rui Graça, MD, Urologist & Founder | 15 March 2025
Real case insight:
David, 44, battled constant fatigue, mood swings, and brain fog for years. Doctors prescribed antidepressants, but relief never came.
Was it truly depression, or was his body hiding a deeper hormonal secret? A surprising discovery transformed his life completely.
Is It Depression or Low Testosterone? The Hidden Truth in Men’s Mental Health
Scene 1: When “Depression” Didn’t Add Up
“Doctor, I’m beyond exhausted,” David confessed, sinking into the chair in Dr. Rui’s clinic. “I sleep, but I wake up drained. I’m moody, irritable, and honestly, everything feels pointless.”
Dr. Rui listened empathetically, nodding. “Have you sought medical help before?”
“Yes, my GP diagnosed depression and prescribed SSRIs. They numbed my emotions, but I still felt deeply fatigued. Could it really just be depression?”
At MHI, we see this pattern all too often. What many of these men are truly experiencing is hormonal misalignment - not a chemical imbalance of serotonin, but a slow erosion of drive, resilience, and vitality due to low testosterone.
Nearly 25% of men diagnosed with depression after 40 may actually have low testosterone -often missed by standard health assessments. Misdiagnosed and mistreated, these men remain trapped in cycles of fatigue and emotional distress.
Scene 2: Real Questions, Real Clues
Dr. Rui probed gently: “How’s your libido, motivation, memory?”
David sighed deeply, “Honestly, everything’s faded away.”
Recognising these common markers, Dr. Rui recommended detailed hormonal testing:
Why Testosterone Testing? Crucial for mood, energy, libido, and cognitive function. What is SHBG? A protein that binds testosterone, making it unavailable. Elevated SHBG means less active testosterone. Cortisol: A Chronic stress hormone, amplifies fatigue and emotional issues.
Your Next Step: From Guessing to Clarity
If your energy, hormones, or performance feel off, blind guessing won’t cut it.
Start by answering 12 simple questions to uncover your most likely imbalance:
(It’s free, confidential, and gives you an instant self-assessment)
Scene 3: The Diagnosis That Changed Everything
Two weeks later, David returned for results.
Dr. Rui explained clearly: “Your free testosterone levels are significantly low, and elevated SHBG further restricts availability. Your cortisol is high, signalling chronic stress.”
“So this might all be hormonal?” David asked, astonished.
“Precisely,” Dr. Rui confirmed. “Low testosterone can mimic depression symptoms. I recommend Testosterone Replacement Therapy (TRT) along with lifestyle adjustments to address your stress levels.”
Low testosterone often mirrors depressive symptoms, causing emotional instability, fatigue, and cognitive decline. Unlike antidepressants, TRT restores hormonal balance, offering substantial improvement in mood and mental clarity.
Scene 4: Follow-Up & Unexpected Twist
After eight weeks on TRT, David felt revitalised but encountered a setback.
“Your recent test shows slightly elevated haematocrit, meaning your blood is thickening,” Dr. Rui explained calmly. “This can occasionally happen with TRT.”
David grew concerned, but Dr. Rui quickly reassured him, adjusting his dosage. “Small modifications are normal and will stabilise your levels safely.”
Resolution: Improvements After 12 Weeks
Three months later, David returned, visibly transformed.
“I feel incredible - my energy is back, my mood is stable, and I’m genuinely happy again. I can’t believe the difference compared to when I was on antidepressants.”
Dr. Rui smiled knowingly, “Hormonal balance was the missing piece. Now you can fully enjoy life again.”
Quick Takeaways: - Persistent fatigue and emotional distress in men may signal hormonal imbalance, not just depression. - Comprehensive hormonal testing can unveil issues overlooked by traditional depression treatments. - TRT, monitored closely, offers lasting relief and significant mental health improvements compared to antidepressants alone.
Disclaimer: This article is for educational purposes only and does not constitute medical advice. Consult a licensed physician for personalised care. Clinical details are composite and privacy-protected. Story reviewed by Dr Rui Graça, MD.
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