In June of 2018, I wrote an article about strength training and depression. Rip and I talked after I submitted the article, and I got my testosterone checked as a result. At this point, I was out of therapy with a few big issues resolved. I wasn't perfect, but I was better, and I wasn't having panic attacks three to eight times a day anymore. My disposition about myself, my family, and life in general was greatly improved.

I didn't think I needed testosterone treatment, because I had improved mentally a lot over the last two years, but I wanted to check just to know. I was tested three times, because my doctor wanted to "make sure" I was clinically low. The results for total T came back as follows:

• 6/19/2018 - 239.6ng/dL
• 7/11/2018 - 476.8ng/dL
• 11/5/2018 - 246.5ng/dL

It is quite obvious from dates that testosterone varies a lot day to day. Additionally, "low T" depends on the individual. A man could be at 400ng/dL (or even 600ng/dL) and have symptoms of low testosterone. Another man could be at 300ng/dL and be just fine. The reference ranges are not the hard rules for medical treatment. Total T is also relevant, although I don't have my original lab values.

So, Rip was right.

I decided not to get treatment right away, because I wanted to get off of my SSRI: Effexor. A doctor client of mine always referred to it as "side-effexor," and for good reason. It was causing me to sweat in my sleep, and caused some emotional numbing. I don't regret taking it, because I believe I needed it to get through that time in my life. I was better at the time, and I decided to get off of it. My doctor told me not to just stop taking it, but that we would titrate the dose down. We went with a three-quarter dose for the first two weeks, then a half-dose for two weeks, then a quarter dose for two weeks. I asked my doctor if I should expect any withdrawal symptoms. She said it was uncommon and with titrating, it should be minimal. I suspect she had never titrated off of SSRIs before, because she was wrong, as my friends who had been on SSRIs informed me.

I never wanted to kill myself or hurt anyone else, but I was a zombie for almost two months. I barely remember that time because it was such an emotional dead zone. My wife said I had never been like that in my life and she is glad I'm never going to have to go through that again. Two anecdotes are extremely characteristic of my time in withdrawal. I was horribly paranoid the entire time, and for about two weeks, I thought my wife was going to stab me to death in my sleep, and I didn't care enough to do anything about it.

I was also emotionally erratic. One day, I was putting dishes away. I got to the last cup, and it didn't fit in the cabinet. I stood there for two seconds thinking, “If I can't make something simple like organizing all of my dishes in a single cabinet work, how am I going to make anything else in my life work?” Then I started crying, and I couldn't explain why. It must have looked ridiculous to my wife who saw me putting dishes away silently, pausing, and then bursting into tears for no apparent reason.

I tell these stories, because they're funny to me in hindsight, but also to illustrate the difficulties for me of getting off of Effexor. I don't regret taking SSRIs for almost two years, and I don't regret getting off of them. I needed them at the time, and they served their purpose.

Getting treatment

I sort of forgot about the problem until 2021 when I started feeling unfocused, unmotivated, foggy, anxious, and depressed again for no particular reason. Everything in my life was going well. I had quit my job to work full time on something I was passionate about. I had gotten my highly-coveted SSC after failing to do so three times prior. A friend and mentor referred me to a private hormone-treatment clinic. I got tested (still low) and got on a treatment plan that suited my needs and life goals.

After three weeks, my new coach and employee mentioned that it seemed like I was in a pretty good mood lately. I noticed the same thing, but I wasn't sure if it was my imagination or because of the increased testosterone. Everyone thinks the best thing about testosterone treatment is the sex drive. It's not. The best thing was that tasks and events that would normally cause me anxiety didn't. They were just tasks that needed to be done, and I wasn't stressed out about them. I was consistently in a good mood even when stressful things were happening around me. I could focus better, and I was more motivated than ever.

My lifting improved, but not as much as people speculate it would. The key difference was that instead of feeling sluggish and beaten down the entire workout, I felt empowered. I felt strong. My perceived ability to complete the set improved. I don't believe this was a physiological result at the time, because my bar speed was the same before and during treatment. My recovery certainly improved though, and I was able to make consistent progress. Workouts don't stress me out any more. I look forward to them, and I know I can do it. It reminds me of the feeling of taking 300mg of caffeine prior to a workout. I feel awake. Motivated. Strong.

Regrets

I don't regret going to therapy. I don't regret taking SSRIs. I don't regret getting off of them. The actions in my life I regret are the ones I didn't take. Not the ones I did take.

What I do regret is not trying testosterone therapy first, before antidepressants. It would have been so cheap and easy to get tested and treated. I would have known in under a month if it worked. If it hadn't worked, I would have gone through all of the same things.

This is a follow up to a previous article, not instructions on how I think anyone should live his or her life. However, like I said, I don't regret much. I do regret not getting my low testosterone treated earlier, even if it was just to check and see what happens. My doctor didn't know my life would be so much better. The nurse didn't know. I didn't know, and I wish I had.

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