Low Testosterone: The Men’s Mental Health Connection
One of the most overlooked health topics in modern medicine is the low testosterone – mental health connection in men. One major reason this isn’t discussed is men are indeed less likely than women to talk to someone about their mental health. If they aren’t seeking help and if we as a community aren’t talking about it, it goes unreported and untreated. Society has told men for decades that depression or talking about low self-esteem is “not manly.” So, many men hide their mental health struggles to appear they’ve got it all together and can take care of themselves. It shouldn’t be this way.
More than 6 million men are diagnosed with depression every year and suicide has continued to rise among men in America. This troubling statistic is likely related to another, and that’s the fact that most men start to experience a decline in testosterone levels after the age of 30.1 Despite these troubling statistics, there is good news. Men can naturally support healthy testosterone levels through diet and lifestyle changes which can positively impact their mental health.
Since June is Men’s Health Month, I am going to talk about the low testosterone-mental health connection, tell you about the 5 common mental health problems that affect men, the signs of low testosterone, and how you can promote testosterone production, even after the age of 30.
Men and their Mental Health
Even though we’ve made great strides to do away with the stigmas attached to mental health conditions, men are still impacted by the social stereotypes that prevent them from talking about having low self-esteem, depression, or anxiety.
At a young age, men are taught (directly or indirectly) they should be strong and show no fear, and that any admission of being afraid or they are struggling makes them appear weak. Unfortunately, mental health doesn’t hold a sexual bias.
According to the American Foundation for Suicide Prevention, men die from suicide at a rate of 3.5% higher than women. That’s not all. I mentioned that more than 6 million men are diagnosed with depression each year, which makes them more prone to alcohol and drug abuse. In fact, the National Institute on Alcohol Abuse says that 62,000 men die from alcohol-related causes compared to 26,000 women, and are 3 times more likely to use drugs.2
Suicide is the second leading cause of death among men under the age of 45. Yet, men are far less likely to seek mental health treatment than women.3 It doesn’t have to be this way.
The truth is that there is one common factor to men’s mental health issues that conventional medicine often overlooks – low testosterone. Conventional medicine focuses on naming a disease and giving a pill for that disease. This practice is becoming increasingly true as conventional medicine becomes more specialized and more fractured, viewing symptoms and diseases as separate entities within the body.
As a functional medicine doctor, I know that to reverse your symptoms, you have to look at the body as a whole and get to the root cause of them. Let’s talk about at the five common mental health disorders affecting men.
Common Mental Health Disorders Affecting Men
As I’ve mentioned, men do not talk about their low self-esteem, depression, anxiety, or fear openly. They hide when they are feeling sad, hopeless, or worthless. Social norms teach young men to not be vulnerable and show emotion.
This social stereotype leads to men downplaying and ignoring mental health symptoms and not seeking help. Instead, these symptoms are shown through aggression, substance abuse, gut health issues, weight changes, brain fog, fatigue, and obsessive thinking.4 Unfortunately, mental health issues go undiagnosed, which could mean that the statistics I mention here could be far lower than reported.
Here are the most common mental health disorders that affect men:
The Centers for Disease Control and Prevention reports that 5.5% of young adult men struggle with depression.5 That number is half of what is reported by women of the same age. As a physician, I believe the number of men suffering from depression is much higher.
Depression is more than just feeling sadness every now and then. It’s a persistent feeling of sadness and loss of interest in activities you once found enjoyable. It affects how you feel, think and behave and can lead to a variety of emotional and physical problems.6
Symptoms of Depression
Feeling sad or hopeless are common signs of depression, however that’s just the tip of the iceberg. Here are signs of depression.
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability, or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
Depression in men is often misdiagnosed or not diagnosed at all because conventional medicine often brushes aside symptoms of depression. Also, remember that men are far less likely to tell someone they are feeling sad or depressed. In a survey conducted by the Today Show, 49% of the 1,000 men surveyed said they feel more depressed than they are willing to admit to the people around them.
Acute anxiety happens over a short period and our bodies quickly recover. For some of us, anxiety is the bit of stress we experience when we’re about to miss a deadline, have to give a speech, or face an unexpected expense.
For others, it’s a chronic condition that can cause panic attacks in social situations, paralyzing fear of open spaces, or a racing heart and feelings of doom. Anxiety disorders can develop from continuous pressure to perform in a challenging job or maintaining a difficult personal relationship, or a traumatic life event such as death or abuse.
Anxiety disorders are a category of one of the most common male mental health disorders. These include panic disorder, obsessive-compulsive disorder (OCD), social anxiety, phobias, a generalized anxiety disorder.
Persistent anxiety may also be a symptom of an underlying health issue. In fact, anxiety is often the very first symptom of thyroid dysfunction, heart disease, diabetes, or chronic obstructive pulmonary disease (COPD). What’s more, anxiety disorders in men increase their risk of developing ADHD or substance abuse.
Bipolar disorder affects 2.8% of the adult population and does not discriminate based on sex.7 Symptoms typically begin between the ages of 15 and 24. Formerly known as manic depression, bipolar disorder is characterized by mood imbalances and ups and downs in activity levels.
Bipolar disorder is more difficult to spot in men because the most common symptoms are viewed as common masculine characteristics. These symptoms include extreme confidence, sudden and inexplicable euphoria, hyperactivity, and risk-taking.
Substance Use Disorder
A survey by Monitoring the Future showed that men are more likely than women to abuse drugs, including prescription medications. Men are also more likely to binge drink. This is another social norm that is viewed as normal behavior and even considered masculine. How many videos have you seen of young men chugging beer on social media with their friends cheering them on? Unfortunately, it’s less frequently viewed as a sign of a men’s mental health problem.
Post-Traumatic Stress Disorder (PTSD)
Consider that there are 93,270 members of the U.S. Army, and of those 82% are men. Of those, nearly 60% of men that have witnessed combat will suffer from PTSD. It is one of the most common mental health issues men face. Yet, it’s not just exclusive to military veterans. Nearly two-thirds of men will experience some trauma in their lifetime, whether that’s from accidents, assault, or witnessing a death or an injury. Despite the statistics saying otherwise, PTSD is more likely to be diagnosed in women than in men. Many believe that symptoms are mistaken for another mental health disorder or that men suffer in silence because that’s what they are conditioned to do.
So what’s behind this? We in functional medicine know that changes in hormone production can lead to depression. It happens with women as they get older or go through menopause. A similar type of hormonal change in men affects them the same way. Let’s talk about that.
Low Testosterone and Mental Health: Is There a Connection?
When your hormones are balanced, you will feel less stressed and anxious, have higher energy levels, a healthy sex drive, better brain function, a happier mood and enjoy deep restorative sleep every night. However, sometimes our hormones get out of balance. This happens in men just as it does in women.
Imbalances are often a result of natural changes that occur with age, such as puberty. When you were growing up, hormones triggered bone and muscle growth. They also set in motion the reproductive changes that led to fertility in young women and sexual maturity in young men. This surge of hormones is the cause of acne, mood swings, and other issues that affect most adolescents as they mature.
Remember, men begin to produce less testosterone after the age of 30. A man’s sexual peak is between the ages of 18 and 30, while a woman’s sexual peak begins in her late 20s and continues into her mid-30s. This is typically when sex hormones – testosterone in men and estrogen in women – are at their highest levels.
While everyone produces testosterone, it is the most dominant hormone in men. When your body stops producing it or produce less of it, it can cause a lot of unwanted symptoms such as weight gain and erectile dysfunction. However, low testosterone also affects your mood.
Testosterone is a hormone that affects how your nervous system functions and can boost the production of serotonin, the happy hormone.8 If you have low testosterone levels, it can affect your body’s ability to make serotonin. Let’s discuss the signs of low testosterone.
Signs of Low Testosterone in Men
Many common signs of low testosterone in men are considered to be normal signs of aging. However, that doesn’t have to be the case. By supporting testosterone levels through diet and activity, you can balance your hormones. Don’t worry, I will tell you how you can do that in just a minute. First, here are the signs of low testosterone in men:9
Ask your functional medicine doctor to check your male hormone levels to find out whether your hormones are balanced. This is done through a simple blood or urine test.
If you want to test your hormone levels at home, I recommend using the home male hormone tests from LetsGetChecked. You can get a basic testosterone test or more complete tests that will test your androgen and cortisol levels. The best part is you can do the test in the privacy of your own home, get the results online, and discuss them with your doctor.
Support Testosterone Levels and Mental Health
There is a connection between low testosterone and mental health. The good news is that just because you get older, doesn’t mean you have to just live with low testosterone levels. Here are great ways to support healthy testosterone levels and take care of your mental health.
Talk to Someone
One of the more promising statistics is that more men are talking about their mental health, however, the social stigma is still a big factor why many men still does not talk about their mental health. There are so many places to get help online and more counselors are offering online sessions through video calls, which makes them more convenient and more private. Talking to someone is the first step in addressing mental health problems.
Eat A Whole-Food Diet
One of the easiest ways to support your testosterone levels is to eat nutrient-dense foods. Omega-3 fatty acids, healthy protein, and micronutrients found in dark leafy greens and purple-colored fruits provide a plethora of nutrients for healthy testosterone production and regulation. There are a few foods, in particular, I recommend for their superstar ability to regulate these hormones including wild-caught salmon, leafy greens, grass-fed beef, and maca root.
Exercise increases the production of testosterone. Declining levels of testosterone lead to loss of muscle mass and reduced libido, so finding an exercise routine can help you slow the natural effects of aging, including low testosterone. Don’t stress about doing the “right” exercise. Find an activity you enjoy doing and will keep doing – consistency is key. I love swimming and my daughter, Elle, has also picked up my love of swimming. We often spend a lot of mommy-daughter time together in our pool. Swimming does not just allow us to move our bodies. We tend to laugh and smile a lot which is a huge boost to our mental health.
Get the Sleep You Need
Maximize quality sleep by eating foods rich in tryptophan, magnesium, and melatonin; eliminating alcohol, caffeine, over-the-counter medicines, fatty foods, and chocolate; and getting on a regular sleep schedule and creating a bedtime routine. Rest and Restore Max™ is my number one tool to support a healthy sleep pattern. I formulated it to include essential amino acids and minerals designed to support falling asleep fast and promote deep and restful sleep.
Ditch the Plastic
Continuous, low-level exposure to these chemicals through the use of plastic water bottles, heating your food in plastic containers, or drinking unfiltered water can lead to hormone imbalance.
I recommend avoiding plastic water bottles in order to reduce plastic waste but also to avoid toxins like Bisphenol A (BPA), which imitates hormones in the body. You can typically find BPA-free containers, however, I still prefer to drink out of glass and stainless steel. I also use glass food storage containers instead of plastic ones.
In conjunction with these lifestyle strategies and talking with someone, it’s also important to make sure you have the right nutrients for healthy testosterone productionl. Vitamin D, zinc, and adaptogens are essential nutrients and herbs that promote healthy testosterone levels. My go-to supplements for hormone balance are:
- Vitamin D3/K2: Vitamin D is needed at every level for whole-body health. Studies show that low levels of vitamin D have been linked to decreased testosterone in men.10
- The Myers Way® Multivitamin: I formulated this vitamin to include the most bioavailable form of key nutrients for better absorption. It includes optimal levels of zinc and other vitamins and minerals for general health.
- Adrenal Support: Adaptogens support balanced cortisol production and a normal stress response to promote whole-body health, including healthy testosterone levels.
Low testosterone doesn’t have to be a part of life, and neither do men’s mental health disorders. There is a connection between low testosterone and mental health. Getting to the root cause and addressing low testosterone with the tools I gave you can slow the effects of this natural process and get you on the path toward optimal health.
- Low Testosterone: How Do You Know When Levels Are Too Low?. Matt McMillen. WebMD. 2016.
- Sex and Gender Differences in Substance Use. National Institute on Drug Abuse. 2022.
- 10 Top Health Risks for Men. Elizabeth Santeramo. Healthline. 2018.
- The 5 Most Common Male Mental Health Disorders. Newport Institute. 2021.
- Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016. Debra J Brody, MPH, et al. Centers for Disease Control and Prevention. 2018.
- Depression (major depressive disorder). May Clinic. 2021.
- Bipolar Disorder. National Institute of Mental Health. 2021.
- Low Testosterone May Affect Your Mental Health. Low T Center. 2021.
- Low Testosterone (Male Hypogonadism). Cleveland Clinic. 2018.
- Causal Link Between Vitamin D and Total Testosterone in Men: A Mendelian Randomization Analysis. Chi Chen, et al. Journal of Clinical Endocrine Metabolism. 2019.
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