While women may be more predisposed to depression in the earlier years of life, the difference between the sexes disappears as people age, and doctors are finding that increasing numbers of men are seeking assistance for the mood disorder in their later years. They attribute this to lowering levels of testosterone, which goes into decline once men reach middle age.
A study that was carried out in Australia revealed that men who had categorically low levels of the sex hormone were 271% (almost three times) more likely to experience serious clinical depression than men with high testosterone levels. Rather than heading for the antidepressant arsenal, doctors are starting to argue that testosterone replacement therapy might be the answer, especially for older men. It also explains why so many older men do not respond favorably to treatment with antidepressants.
Laboratory tests indicate that testosterone increases the bioavailability of noradrenaline and serotonin in the brain, neurotransmitters which affect brain chemistry and determine the mood. Low levels of these chemicals indicate depression, although it is not understood exactly why they have such an influence.
The jury is out on what constitutes "low" though, as men's bodies are all different, and everyone needs different levels to regulate different bodily processes. Some men can get by on the lower end of the "average" scale, which ranges between 300 and 1200 ng /DL, while a little drop for a man whose levels feature higher up may cause some serious discomfort.
While testosterone fulfills a primary role in regulating the male reproductive system, it has an impact on all the processes in the male body. Maintaining some level of normality is really important for a man's body to function optimally, and side effects range from physical, emotional and behavioral if there is an imbalance.
While it is normal for the body clock to slow down once in the middle years of life, the natural process is only responsible for a drop of 1 to 2% per annum, which most men should be able to cope with comfortably. Some men are more sensitive than others, and especially for the older age groups, may have other conditions which can exacerbate the symptoms.
Obesity, something that can affect everyone as they get older, can have a decreasing effect on testosterone, as too many fat cells convert testosterone to estrogen, causing levels to drop further. Alcohol, smoking and drug abuse can also cause levels to ebb lower than they would under normal circumstances. Men who have had treatment for cancer, like radiation and chemotherapy, are likely to experience low testosterone levels as a result of treatment.
While one study revealed that testosterone would need to decline by 20% for it to affect a healthy young man's mood, that 20% could be easily made up by a combination of aging and one or more lifestyle factors in an older man.
It's not all bad news though, as testosterone replacement options are vast and varied, and modern technology has a convenient solution for everyone. It's also refreshing that there may be another alternative to prescribing antidepressants to treat depression among older men.