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Thread: Training with depression? Long term prognosis?

  1. #51
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    Quote Originally Posted by BenM View Post
    No but I'd argue that that's something that needs to be discussed with the patient first, as well as the potential other options, so that they can make an informed decision.
    Have I suggested that it not be discussed???

    Yes it's a serious question - you can't just keep dosing him with 400mg of test every 3 days. And once he goes back to a 'normal' TRT dose, he might feel like shit again.
    The 400mg is the "loading dose." It is not the regular therapy.

    As far as the HPT axis goes, there are cases where it won't recover (especially in older guys) and while it is recovering, the guy will suffer from all the low test symptoms and more. This is why enhanced bodybuilders do PCT afterwards.
    This is why you keep taking your TRT. Like your insulin.

    What I want is for people to get healthy in the most sustainable way, and for medicine to properly diagnose and treat issues rather than taking the 'throw darts at the board and see what sticks' approach, which is what you seem to be advocating.
    If TRT fixes the problem, what was the problem? Maybe low T?

    Hang on, you just accused me of wanting him to get off test and feel terrible again. But now you're saying that's what he should do. This is somewhat confusing.
    Hey, you're the one that wants the old lady PG. If he's shooting blanks, he'll need to come off. Or maybe he can hire you.

    Spend some time on TRT forums like Excel Male and have a look. You should have lots of great knowledge to contribute, you are on it as well aren't you? I am. I went right down the rabbit hole before I started.
    So you're not going to share?

    Having suffered from depression in the past (and taken SSRIs for it) I can assure you I am not. Testosterone did help me. But I had to do lots of other things in conjunction with it and I still suffer from bouts of the blues - it is dangerous to suggest that it's a magic hormone that will magically rid someone of the black dog for good.
    I have not said it was the magic hormone for all depression. If it were not for straw men, you'd have no men at all. And I'm beginning to recognize your style of argumentation.

    Sure. About as stupid as an aging strength coach in his own private fiefdom postulating opinions about the way the medical system should operate, just so he can enjoy berating and insulting anyone who may (even slightly) disagree with him.
    My private fiefdom seems to be free, and your attendance here is at your own discretion. How about changing that decision?

    It probably went straight over your rhynophymic head, but I am not actually disagreeing with you that testosterone can be very helpful in treating depression for those who have low T. I'm just arguing that it needs to be prescribed with some caution, as part of a holistic approach, and not as a first line treatment.
    I know what you're saying. We've heard it before, and it's tiresome. You don't know what either you or I am talking about.

  2. #52
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    Quote Originally Posted by BenM View Post
    No but I'd argue that that's something that needs to be discussed with the patient first, as well as the potential other options, so that they can make an informed decision.
    I'm not following you. Rip was talking with a doctor here on this very thread???

    I have been on this board for quite a few years and I have never seen Rip advocate a patient not talk to his doctor...ever.

    Quote Originally Posted by BenM View Post

    Yes it's a serious question - you can't just keep dosing him with 400mg of test every 3 days. And once he goes back to a 'normal' TRT dose, he might feel like shit again.
    Rip advocated an initial dose of 400mg because the guy is probably quite low and needs an initial boost to see if it will work at all. After that he will go back down to the normal dose that most people are on--if it works.

    Quote Originally Posted by BenM View Post
    As far as the HPT axis goes, there are cases where it won't recover (especially in older guys) and while it is recovering, the guy will suffer from all the low test symptoms and more. This is why enhanced bodybuilders do PCT afterwards. What I want is for people to get healthy in the most sustainable way, and for medicine to properly diagnose and treat issues rather than taking the 'throw darts at the board and see what sticks' approach, which is what you seem to be advocating.
    How you interpreted Rip as advocating to "throw darts" is beyond me. He is advocating a "test" to see if it works. Isn't ANY prescription from a doc initially a "test" to see if it will work?

    Quote Originally Posted by BenM View Post
    Hang on, you just accused me of wanting him to get off test and feel terrible again. But now you're saying that's what he should do. This is somewhat confusing.
    Actually, I'm confused by what you have written.

    Quote Originally Posted by BenM View Post
    Having suffered from depression in the past (and taken SSRIs for it) I can assure you I am not. Testosterone did help me. But I had to do lots of other things in conjunction with it and I still suffer from bouts of the blues - it is dangerous to suggest that it's a magic hormone that will magically rid someone of the black dog for good.
    First, I'm glad it helped you. I really am. It has helped a lot of us. That said, Rip never suggested T will "magically rid someone of the black dog for good." He said he has seen it help many people--not ALL people.

    Quote Originally Posted by BenM View Post
    Sure. About as stupid as an aging strength coach in his own private fiefdom postulating opinions about the way the medical system should operate, just so he can enjoy berating and insulting anyone who may (even slightly) disagree with him.

    It probably went straight over your rhynophymic head, but I am not actually disagreeing with you that testosterone can be very helpful in treating depression for those who have low T. I'm just arguing that it needs to be prescribed with some caution, as part of a holistic approach, and not as a first line treatment.
    Ben...take a chill pill. Ad hominem attacks are not helping anything. Rip is arguing that it is prescribed with caution--remember the guy has presented to a doc with problems so he's not advocating sticking it in the ass of everyone who walks into his gym or into a doctor's office.

    I think Rip is simply having a conversation with the good doc (and fortunately the rest of us). He simply asked why the doc doesn't prescribe T when the patient presents with depression. The doc answered he really doesn't want to because he isn't trained for it. It is an entirely reasonable question and a very reasonable answer from the Doc.

    Keeping with the discussion, the link between hypothyroidism and depression in women is pretty well established (as I understand it). Doesn't it follow that men could have hormonal issues with depression as well? For men, from the link below, "There are several lines of evidence, both clinical and research, that support the idea that testosterone and similar androgens may be useful in the treatment of depressed men."

    Hormone treatment of depression

  3. #53
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    Quote Originally Posted by Mark Rippetoe View Post
    Have I suggested that it not be discussed???
    No, granted. No more than I said SSRIs should be handed out like candy either (hint - I think they should be prescribed with caution too). But the way your post was worded implied that the conversation would be quite short - 'Oh you're depressed? Here, have a shot of this!' without much discussion on the lifelong consequences.

    The 400mg is the "loading dose." It is not the regular therapy.
    There is no 'loading dose' in any commonly used TRT protocol I'm aware of. And like I said, if that 400mg dose works, then who's to say that once levels are brought back to normal he'll still feel fine? He probably won't. Also, a supraphysiological dose like that could just as easily cause someone to become more anxious/depressed or even so emotional as to be suicidal, just as easily as it could make them happier. There is a reason most TRT clinics worth their salt actually start at the lower end of the accepted doses and titrate up as needed. More is not always better. And these days there really seems to be a shift towards lower doses more frequently rather than higher, infrequent doses - less peaks and troughs, and often less side effects.

    This is why you keep taking your TRT. Like your insulin.
    Unless maybe it renders you infertile and you want to have kids, which you said might cause someone to need to come off... or unless you can't handle the side effects... etc etc.

    If TRT fixes the problem, what was the problem? Maybe low T?
    Maybe, but low T is actually quantifiable with blood tests so doctors don't need to administer a test shot just to see if it helps. And ask any bodybuilder on anabolics - massive doses of testosterone can make you feel invincible even if you weren't depressed beforehand. And make no mistake 400mg is well above an accepted TRT dose, it's a cycle.

    Hey, you're the one that wants the old lady PG. If he's shooting blanks, he'll need to come off. Or maybe he can hire you.
    Nah, I've been there and done that, which is why starting TRT was less of a dilemma for me than someone younger or in a different life situation. My point being, it's not the same for everyone like your post implied.

    So you're not going to share?
    I don't really see the point, because I don't think it would change your mind anyway. But I know that many guys find it takes a long time to determine a TRT protocol that works for them and their individual physiology, which is why I don't like your one size fits all approach.

    I have not said it was the magic hormone for all depression. If it were not for straw men, you'd have no men at all. And I'm beginning to recognize your style of argumentation.
    Perhaps you should have been a little clearer in your post then. Your comment:
    So, I don't really understand the reluctance to try TRT on patients that come in the office complaining of symptoms of depression. Seems to me that the sensible thing to do would be to go to the meds locker, get out 400 mg of test cypionate, stick it in the guy's asscheek, talk to him some more, and tell him to call you back Friday with a report.
    At what point in that post did you mention some diagnostic questions about symptoms, some discussion about the multifactorial causes of depression and anxiety including possible lifestyle factors, some other possible treatment options and questions about whether the person is willing to undertake hormone therapy for life, etc? Sounded to me like you're advocating for a testosterone injection as the first port of call which is just irresponsible in my view.

    My private fiefdom seems to be free, and your attendance here is at your own discretion. How about changing that decision?
    I'm happy to leave if that's what you want. But for someone who claims to be open minded, it sure seems like anyone who doesn't agree with you gets banned, abused, or told to leave. If that's the way you choose to run a 'discussion' forum you may as well just close this place, start a blog and be done with it.

    I don't see myself changing your mind anyway, so not much point continuing regardless. Good luck with your fiefdom.

  4. #54
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    This is a wonderful restatement of your previous blather.

    Now for everybody else, what is the opposite of "depression"? Is it euphoria, or aggression, in the sense of "forceful and sometimes overly assertive pursuit of one's aims and interests"?

  5. #55
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    Quote Originally Posted by BenM View Post
    I'm happy to leave if that's what you want. But for someone who claims to be open minded, it sure seems like anyone who doesn't agree with you gets banned, abused, or told to leave. If that's the way you choose to run a 'discussion' forum you may as well just close this place, start a blog and be done with it.
    This is ironic given there's literally posts inside this thread where Rip has deferred to and asked questions to a practicing psychiatrist and they'd have back and forth in terms of discussion.
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  6. #56
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    The only people who get banned from this board are trolls who disrupt, or shills who are recruiting. Fulcrum is still here, right? So stop whining and try to make better sense.

  7. #57
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    Quote Originally Posted by BenM View Post
    I don't see myself changing your mind anyway, so not much point continuing regardless. Good luck with your fiefdom.
    I doubt you’re changing anyone’s mind with this ignorant and argumentative bullshit that you’re spouting.

  8. #58
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    Quote Originally Posted by BenM View Post
    Maybe, but low T is actually quantifiable with blood tests so doctors don't need to administer a test shot just to see if it helps.
    Did you miss the part of this thread where the quantifiable levels have been found lacking in several anecdotes?

  9. #59
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    Quote Originally Posted by Mark Rippetoe View Post
    Now for everybody else, what is the opposite of "depression"? Is it euphoria, or aggression, in the sense of "forceful and sometimes overly assertive pursuit of one's aims and interests"?
    Aggression. Hmmm. I can think of a few definitions:

    Wanting to get out of the cave and find something to eat for you and your family.

    Wanting to defend your family from cold, bears, and other threats.

    Wanting to build shelter for you and your family.

    Wanting to make your life better requires you get off the couch, put your damn phone down, and actually DO something.

    All of the above activities must be “aggressively” pursued for you to be successful.

    That all sounds pretty much like the opposite of depression to me. Those of us who have loved ones who suffer from depression know it’s an evil demon that must be aggressively battled every day.

    David

    p.s. I know several men on T and every one of them are extremely nice men. I’ve never seen or heard of Roid-Rage in any of them. In fact, they are all happier because they aren’t depressed and are out building and accomplishing things. This isn’t hard to understand. I’ve never heard of any adverse side effects. That doesn’t mean there aren’t any—it just means I haven’t heard of any in my circle of friends who pretty much all use it. I do know they all know pretty quickly when they forget because life gets pretty tired pretty quickly. And when you are tired, depression is probably lurking right around the next corner or bump in the road.

  10. #60
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    Quote Originally Posted by Mark Rippetoe View Post
    This is a wonderful restatement of your previous blather.

    Now for everybody else, what is the opposite of "depression"? Is it euphoria, or aggression, in the sense of "forceful and sometimes overly assertive pursuit of one's aims and interests"?
    The second. I would call the opposite of depression "being a willing and active participant in one's life."

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