I was depressed for twenty years. It turned out to be my hormones

Nathan Chadwick · August 16, 2026 · 8 min read

TLDRRead the short version

Depressed from 11 into my thirties. Assessed, listened to, prescribed for. Nobody took my blood in twenty years.
When someone finally did, my testosterone was on the floor. The NHS still called it normal, because lab ranges describe the average population, not men with symptoms.
Paid a private clinic for proper bloods, couldn't afford private TRT forever, so I sort it myself now and run my own bloods twice a year. Not advice, and there are real downsides.
The research is genuinely mixed and the arrow points both ways, because depression lowers testosterone too.
Not anti-SSRI. Anti-shortcut. Depression is a description, not an explanation.

Twenty years#

I was 11 the first time I felt it. Not sad about anything in particular. Flat. Heavy. Wrong in a way I couldn't explain to a teacher, or to my mum, or to myself.

It never really left. On and off through my teens, then mostly on, through my twenties and into my thirties.

I was assessed. Listened to. Sympathised with. Prescribed for. In twenty years nobody took my blood.

When someone finally did, my testosterone was on the floor.

I'm not claiming an 11 year old's depression comes down to a hormone. I'm claiming something duller: there was a physical, measurable, treatable thing happening in my body for most of my life, and nobody went looking for it, because everyone had already decided what sort of problem I was.

That's what this is about. Not the hormone. The not looking.

None of it is medical advice. I'm not a doctor. I'm someone who got let down by a process and then went and read the papers.

The prescription is easy. The blood test isn't.#

England got through 96 million antidepressant items last year, for around 9.1 million people. Up again on the year before, as it has been for a decade.

That isn't doctors being lazy. A GP has ten minutes, a therapy waiting list measured in months, and someone in front of them who is clearly struggling. An SSRI is the one thing they can start today. That's triage, and triage is fair enough.

The problem is triage quietly becoming the diagnosis, and nobody going back to it. Mine got repeated for years. Not once did anyone reopen the question of why this was happening in this particular body.

The asymmetry is what gets me. Altering my brain chemistry took one appointment. A hormone panel took two decades and, in the end, my own money.

It doesn't pay off as often as people assume, either. In STAR*D, the largest real world trial of this, about a third of people got well on the first antidepressant. The other two thirds usually get offered a different one. Some of them need a different question.

What the research actually says#

Careful here, because this corner of the internet is full of people selling something.

There is a real signal. Depressive symptoms show up in 35 to 50% of men with hypogonadism. One study of men over 45 found depression diagnosed in 21.7% of the low testosterone group against 7.1% of everyone else, around four times the risk after adjusting for the obvious confounders. A meta-analysis of 27 trials and 1,890 men found testosterone beat placebo on depressive symptoms, more so at higher doses.

There's plenty pointing the other way too, which the supplement crowd never mentions. Lots of cohorts find nothing at all. Trials giving testosterone to men with full major depression mostly don't work. The effect in that meta-analysis was modest, and the journal ran an editorial beside it titled "Too Much Smoke, Not Enough High-Quality Evidence".

The arrow also points both ways. Being depressed suppresses the hormonal axis by itself: broken sleep, more drink, no training, weight creeping on. A low reading can be the consequence rather than the cause. That's the bit that stopped me feeling smug about my own story.

So for some men it's one real, measurable, fixable part of the picture. Not the cause of depression. Not a myth either. Exactly the sort of thing ten minutes can't sort out.

"Normal"#

Here's the part I suspect a lot of men will recognise.

When the NHS eventually measured me, I wasn't considered low. The number landed inside the lab's reference range, and that was the end of it. No repeat test, no referral. On paper, fine.

For a long time I took that to mean I'd got the whole theory wrong. What I didn't know is that the specialists had already flagged this exact trap. The BSSM guidelines say it plainly: lab reference ranges describe the normal population, while their treatment thresholds are meant for men with symptoms. They go as far as warning that variation between UK labs means some men with real deficiency get missed.

Their numbers: below 8 nmol/L, treat. Above 12, don't. Between 8 and 12 with symptoms, that's a case for a six month trial.

That middle band is where a lot of us sit, and it's precisely what a reference range waves through. There's no NICE guideline on male hormone deficiency at all, and GPs largely don't manage it because they aren't confident prescribing for it. No pathway, no guideline, and a lab range that gives everyone permission to stop looking.

So I paid a private clinic to do it properly. That was the first time the numbers matched the twenty years of symptoms sat in front of them.

Then came the thing that actually decides this for most people. Money. Private TRT means consultations, prescriptions and follow ups, indefinitely, because this doesn't end. I could afford to find the answer. I couldn't afford to rent it for the rest of my life.

So I handle it myself now. I buy test E and run my own bloods twice a year.

I'm not telling anyone else to do that, and there's no dosing or sourcing here. But if I'm being honest about doing it, I should be honest about the rest. Testosterone is Class C in the UK: possessing it for personal use isn't an offence, though having it posted to you isn't covered, and whoever sells it to you is committing a serious one. Nothing about an unregulated vial is guaranteed, not the strength, not the sterility, not even what's in it. And twice a year is thinner than the monitoring the guidelines ask for, which is three checks in the first year and then annually, watching haematocrit and PSA.

The bigger loss is the second opinion. A good doctor isn't there to write the script. They're there to tell you when you're wrong about your dose, or your symptoms, or your reasoning. Doing it alone means the least objective person in the room makes every call.

If you can get seen properly, get seen properly. Ask for a GP with an interest in men's health, or an endocrinology referral, and take those thresholds with you. "I'm symptomatic and sitting at 9" is much harder to wave away than "I feel rubbish".

What it costs#

Worth saying, because the marketing won't.

It shuts your own production down. LH and FSH collapse and most men hit severely reduced or zero sperm within three to six months. It usually returns after stopping, somewhere between six months and two years, but for 10 to 20% it never fully does. If you want children, there's a clock on the decision.

It's effectively for life. Once you're suppressed and running on replacement, stopping means going back to how you felt before, plus a rough stretch while your own system restarts.

And it's safer than the scare stories without being clean. TRAVERSE, 5,246 men, found no increase in major cardiac events. The same trial found more atrial fibrillation, more kidney injury and more pulmonary embolism.

On antidepressants#

I'm not anti-SSRI and I don't want this read that way. They keep people alive. If yours is working, this is not an argument to stop.

Two things I'd still say. The sexual side effects get glossed over, and since 2019 UK and European labels have carried a warning that they can persist after you stop. For a man that creates a proper mess, because low libido reads as low testosterone, or as "the depression", and nobody can tell you which.

Coming off is also harder than we were told. NICE rewrote its guidance in 2022 to accept withdrawal can be severe and last months, and now advises cutting by a proportion of your current dose so the steps get smaller the lower you go. Don't stop suddenly, and don't stop because a blog post annoyed you. That's a conversation with your prescriber, probably over months.

If any of this sounds like you#

Ask for bloods. Full blood count, ferritin, thyroid, B12, folate, vitamin D, HbA1c, liver and kidney, coeliac screen. If you're a man carrying the fatigue and the flatness and no libido, ask for total testosterone twice, both in the morning, both fasted, with LH, FSH and SHBG alongside. Ask what the actual number was, not just whether it was "fine". Get your sleep looked at, especially if you snore and still wake up shattered. Be honest about what you drink.

Then put a time limit on whatever you're already doing. If a drug hasn't worked after a fair go at a proper dose, that's information. It should make someone re-examine the diagnosis, not just reach for the next one on the list.

I lost a long time to a question nobody asked. Depression is a description, not an explanation. Sometimes it really is grief, or trauma, or the plain unfairness of someone's life. Sometimes it's a thyroid, an airway, a vitamin or a hormone. Often it's several at once. You're allowed to find out which.

If you're struggling right now: Samaritans on 116 123, any time, free. NHS 111 and pick the mental health option. CALM on 0800 58 58 58. If you're in danger, 999.