Training with depression? Long term prognosis? Training with depression? Long term prognosis? - Page 2

starting strength gym
Page 2 of 8 FirstFirst 1234 ... LastLast
Results 11 to 20 of 77

Thread: Training with depression? Long term prognosis?

  1. #11
    Join Date
    Mar 2019
    Posts
    581

    Default

    • texas starting strength seminar september 2020
    • wichita falls texas december seminar 2020
    Is it just me, or are the vast majority of doctors anti TRT? My own doc wonít prescribe it despite my levels meeting the criteria of a medical condition, yet heís happy to prescribe any SSRI I want.

    Even Baraki responds in a rather annoyed tone when asked about TRT for elderly trainees.

    Seems to me that all of the current research (testosterone trials 2018) is showing the pros of TRT far outweigh the cons.

    It seems like the stigma just wonít go away ó
    Is there some sort of unspoken agreement in the medical community that men need to be kept docile instead of strong, confident and healthy?

  2. #12
    Join Date
    Feb 2018
    Posts
    472

    Default

    Itís important to distinguish between ďdepressionĒ as a symptom, as in low mood, and Major Depressive Disorder. The symptom of depression may appear in all sorts of contexts, including hypogonadism (with low T), sleep apnea, anemia, etc. In those cases, treating the underlying disorder is essential and may resolve the depression symptom.

    If your depression resolves with testosterone replacement, then by definition you do not have MDD. And Psychotic Depression, aka MDD with psychosis is nothing to fuck with.

    So, sure, try testosterone. If it helps, excellent. But even if it does, if I am the OP I would be very very careful with coming off antidepressants and antipsychotic medication.

    Rip, I donít think we fundamentally disagree, but have different perspectives. I am sure you have seen more middle-age guys who donít have a history of depression but have lost their mojo than I have. And I have likely seen way more guys hospitalized with psychotic episodes than you have, given that you run a gym and barbell coaching empire and I work in a psychiatric hospital.

    Hopefully the OP will spend more time with someone like you than with someone like me, but he may need us both.

  3. #13
    Join Date
    Jul 2007
    Location
    North Texas
    Posts
    42,545

    Default

    The difference in perspective is a profound factor. I don't deal with psychosis, and my comments here are not to be construed as advice for people with this disorder. I see the standard depression that normally gets treated carelessly with SSRIs, which have far greater potential for negative effects than testosterone. I'm suggesting that TRT is underappreciated and underutilized in the treatment of low-level depression, and probably should be prescribed before antidepressants and antipsychotics have a chance to make them obviously dangerous to withdraw from.

  4. #14
    Join Date
    Oct 2017
    Location
    Uk
    Posts
    1,148

    Default

    Im reading this thread with interest to see where it went. I've had bouts of severe depression and anxiety all my life. It runs in my family with both my mother, sister and younger brother having to take medication at times. This isn't 'low mood' as jfsully points out in his post. It doesn't appear to be anything to do with low T, though, none of us have ever been checked for that problem. All of us began these episodes comparatively young in life, when that is unlikely to be an issue anyway and of course there are two females.

    I've never taken medication, I've got through cycles of anxiety mostly with the support of my wife. Personally I think Barbell training helps, though my sense is that the greatest advance was the study of Aristotlian logic, which sorted out a jumble of conflicting ideas which were having a war which I wasn't consciously aware of. The logic study was essentially a Barbell directly for my mind and it's reinforced with the physical barbell in my hands. To date, since starting training two years ago I've been free from all symptoms.

    I don't want to imply here that BB training, or studying Aristotlian Logic is the panacea. It just worked for me. My own experience of what I can only describe as 'mental illness' is that it's extremely complex and there isn't likely to be a one box solution. It might even exacerbate the symptoms to train, or to study such subjects as logic, we are so far from understanding the human consciousness at this point that we probably know more about black holes.

    I would like to say to the O.P, to reassure them, they are far from being alone, although it will often seem so.

  5. #15
    Join Date
    Feb 2018
    Posts
    472

    Default

    Quote Originally Posted by Mark Rippetoe View Post
    The difference in perspective is a profound factor. I don't deal with psychosis, and my comments here are not to be construed as advice for people with this disorder. I see the standard depression that normally gets treated carelessly with SSRIs, which have far greater potential for negative effects than testosterone. I'm suggesting that TRT is underappreciated and underutilized in the treatment of low-level depression, and probably should be prescribed before antidepressants and antipsychotics have a chance to make them obviously dangerous to withdraw from.
    OP reported having depression with psychosis, which is why my comments were focused on that. It's really a different entity than the dysthymia or mild depression we see in Low T. So for the vast majority of guys reading this thread, your advice is decent, but for OP I think that testosterone is 99.44% not going to be the whole story.

    I disagree with the "check your T then take the testosterone no matter the result" approach, but I do see your point that reference ranges are not the be-all-end-all (and I do know that's not exactly what you said). I do agree that "throw an SSRI at anyone who seems kind of unhappy" approach to this is misguided, but we should not replace that with "throw testosterone at every guy who's tired, no matter his T level." (again, I exaggerate to make a point. You didn't say that.) The risks of testosterone supplementation are very low, but are not zero. All of this stuff requires some homework and consideration on the part of each of us, and I assume your encouragement has led to plenty of guys having productive conversations and helpful treatments from their doctors. It's not too hard to find a doctor willing to prescribe testosterone in most places these days. But if you ask your doctor for TRT, and you take the treatment, you own the result, so you should know what you're getting into.

    Withdrawing from antidepressants and antipsychotics is never truly dangerous, unless you have a condition where it is dangerous to be off your medication. It can be annoying and unpleasant to abruptly withdraw from these meds, sure, which is why it should always be done in consultation with a prescribing doctor or clinician.

    Quote Originally Posted by Nockian View Post
    Im reading this thread with interest to see where it went. I've had bouts of severe depression and anxiety all my life. It runs in my family with both my mother, sister and younger brother having to take medication at times. This isn't 'low mood' as jfsully points out in his post. It doesn't appear to be anything to do with low T, though, none of us have ever been checked for that problem. All of us began these episodes comparatively young in life, when that is unlikely to be an issue anyway and of course there are two females.

    I've never taken medication, I've got through cycles of anxiety mostly with the support of my wife. Personally I think Barbell training helps, though my sense is that the greatest advance was the study of Aristotlian logic, which sorted out a jumble of conflicting ideas which were having a war which I wasn't consciously aware of. The logic study was essentially a Barbell directly for my mind and it's reinforced with the physical barbell in my hands. To date, since starting training two years ago I've been free from all symptoms.

    I don't want to imply here that BB training, or studying Aristotlian Logic is the panacea. It just worked for me. My own experience of what I can only describe as 'mental illness' is that it's extremely complex and there isn't likely to be a one box solution. It might even exacerbate the symptoms to train, or to study such subjects as logic, we are so far from understanding the human consciousness at this point that we probably know more about black holes.

    I would like to say to the O.P, to reassure them, they are far from being alone, although it will often seem so.
    Nockian: glad to hear of your success! I agree that training, and barbell training may be superior to other forms of exercise for this, is helpful for depression, and it is certainly better for you than taking medication. Personally I would prefer post-structural philosophy to Aristotelian logic, but to each his own on that one. I think Aristotle would probably be more popular around these parts.

  6. #16
    Join Date
    Jan 2011
    Posts
    1,065

    Default

    I bet the cost of Test and diagnoses is a contributing factor to why it's not prescribed more. When I was a kid a Doc prescribed me Prozac without any testing, just a few questions and in 5 minutes I was walking out with a brown paper bag filled with a years worth of Fluoxetine, and it cost me about $11. Everyone's individual case is different, but I found that situation pathetic.

    OP, as far as I have found in my reading and talking to Doctors there are no mechanisms between SSRIs and weight gain beyond increased appetite, so if that's your primary concern just need to chart your calories and not rely on your feelings.

  7. #17
    Join Date
    May 2017
    Posts
    29

    Default

    Have you considered MAOIs? They are not even as dangerous as some docs think they are, way more effective and have less overall side effects. Most people just have to make small changes to diet, the only medications you have to completely avoid are other SRIs (serotonin reuptake inhibitors), like Tramadol, Prozac and some street drugs. After 3 weeks my daily negative and self destructive thoughts vanished. You can't train properly if you have biological depression and isn't medicated, I learned it the hard way, always leaving my begginer progression and losing all gains when anergia and ahedonia hit. Read Dr. Ken Gillman website if you need to know more, I highly recommend then from personal experience. The only downside is that they cause postural hypotension during the first weeks/months so it would affect traning.

  8. #18
    Join Date
    Jul 2007
    Location
    North Texas
    Posts
    42,545

    Default

    Which seems more likely to you: low serum levels of testosterone, a natural hormone, or low serum levels of Monoamine Oxidase inhibitor, a pharmaceutical?

  9. #19
    Join Date
    Jul 2019
    Posts
    440

    Default

    Funny that a natural and useful biological phenomenon has been vilified in this way.

    Depression is a natural response to environmental factors. It is often absolutely necessary to motivate people to make positive changes in their lives.

    The modern paradigm seems to be the result of financial incentive for medical providers and a strong desire from the customers to avoid individual responsibility or accountability.

    To clarify: That would be the difference between "biological depression", which is normal and "clinical psychotic depression" which is not normal and may merit medical treatment.

    In its most basic sense, the problem may be an inability to accurately distinguish between biological depression and clinical depression; A normal depressive response caused by low T may resemble clinical depression closely enough that they appear the same and thus the receive the same diagnosis from medical professionals. Given the potential inability to produce an accurate differential diagnosis, which course of treatment should be followed?

  10. #20
    Join Date
    Feb 2018
    Posts
    472

    Default

    starting strength coach development program
    Quote Originally Posted by Yngvi View Post
    Funny that a natural and useful biological phenomenon has been vilified in this way.

    Depression is a natural response to environmental factors. It is often absolutely necessary to motivate people to make positive changes in their lives.

    The modern paradigm seems to be the result of financial incentive for medical providers and a strong desire from the customers to avoid individual responsibility or accountability.

    To clarify: That would be the difference between "biological depression", which is normal and "clinical psychotic depression" which is not normal and may merit medical treatment.

    In its most basic sense, the problem may be an inability to accurately distinguish between biological depression and clinical depression; A normal depressive response caused by low T may resemble clinical depression closely enough that they appear the same and thus the receive the same diagnosis from medical professionals. Given the potential inability to produce an accurate differential diagnosis, which course of treatment should be followed?
    Current diagnostic criteria distinguish between Major Depressive Disorder vs. Depressive Disorder Due to Another Medical Condition (which would include low T). I am not sure where you got the term "biological depression," as all psychiatric conditions have biological (brain) correlates. Maybe you want to distinguish between sadness or grief (normal adaptive responses to circumstances) and depression (an illness that interferes with function and can shorten and/or reduce quality of life)? The illness of Depression, by definition, may be a natural phenomenon like disease states in general, but it is not useful.

    I'm going to leave it alone after this (hopefully) but my agenda in this thread is to encourage OP to work with his psychiatrist to find a med or med combination that works for his depression and psychosis without causing intolerable side effects, start or continue psychotherapy, and keep training.

    The OP has reported having Psychotic Depression, which has a specific definition (ie, it's not just Really Bad Depression), and is a fairly distinct subtype of Major Depressive Disorder. It is not like sadness, being bummed, or feeling wrung out from low T. Untreated, or with inadequate or improper treatment, it can be dangerous and destructive. To give uninformed medical advice, or to suggest changing to an alternate class of medications, like MAOi, without any rationale other than "works for me" is potentially harmful to OP. This is probably not a helpful place to advance theories about the nature of mental illness or whether the drug companies overmedicalize normal experiences for profit, though that stuff is definitely worth discussing.

    Sorry to be on a bit of a high horse, but this is an area that is important to me personally and professionally, and I have expertise to share. When it comes to strength training, I'm a grateful student around here and mostly read and learn, so I try to contribute when I do have an informed opinion. As a psychiatrist, I feel able to pull rank in a discussion like this, just as a professional barbell coach can and should school me all day about barbell technique and programming.

Page 2 of 8 FirstFirst 1234 ... LastLast

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •