Firebird Vitality

Category: Mental Health

  • The Weight of Mental Wellness: Exploring the Intertwined Relationship Between Obesity and Mental Health

    The Weight of Mental Wellness: Exploring the Intertwined Relationship Between Obesity and Mental Health

    By Andrew Hewitt, PMHNP

    Introduction

    Obesity, defined as a body mass index (BMI) of 30 or higher, is a complex and chronic disease affecting millions worldwide. While the physical health consequences of obesity, such as cardiovascular disease, diabetes, and certain cancers, are well-documented, the profound impact on mental well-being is often overlooked. As a Psychiatric Mental Health Nurse Practitioner-Board Certified (PMHNP-BC), I frequently observe the intricate connection between obesity and mental health disorders in my clinical practice. This blog post aims to delve into the bidirectional relationship between these conditions, exploring the psychological mechanisms involved and highlighting the importance of integrated care for individuals struggling with both obesity and mental health challenges.

    The Bidirectional Relationship: A Cycle of Distress

    The relationship between obesity and mental health is not simply a matter of one causing the other; rather, it is a complex, bidirectional interplay. Obesity can contribute to the development or exacerbation of mental health disorders, and conversely, mental health conditions can increase the risk of obesity.

    1. Mental Health Disorders Contributing to Obesity:

    • Depression: Depressive symptoms, such as low energy, reduced motivation, and changes in appetite, can lead to decreased physical activity and increased consumption of calorie-dense, comfort foods. Furthermore, certain antidepressant medications may contribute to weight gain (McIntyre et al., 2022).
    • Anxiety Disorders: Individuals with anxiety disorders may use food as a coping mechanism to manage stress and emotional distress. This can lead to overeating and weight gain. Additionally, avoidance behaviors associated with anxiety can limit engagement in physical activity.
    • Bipolar Disorder: Mood stabilizers and antipsychotic medications commonly used in the treatment of bipolar disorder can contribute to weight gain. Moreover, impulsive behaviors during manic episodes may lead to unhealthy eating patterns (Vieta et al., 2023).
    • Post-traumatic Stress Disorder (PTSD): Trauma survivors may experience emotional dysregulation and use food as a means of self-soothing. Hyperarousal and sleep disturbances associated with PTSD can also disrupt healthy eating and activity patterns.
    • Eating Disorders: While seemingly contradictory, some eating disorders, such as binge eating disorder (BED), are characterized by recurrent episodes of consuming large amounts of food in a short period, leading to weight gain and obesity.
    • Schizophrenia: Individuals with schizophrenia are at increased risk for obesity due to factors such as medication side effects, sedentary lifestyles, and limited access to healthy food options (Correll et al., 2022).

    2. Obesity Contributing to Mental Health Disorders:

    • Body Image Dissatisfaction and Low Self-Esteem: Societal stigma surrounding obesity can lead to feelings of shame, guilt, and body dissatisfaction. These negative emotions can contribute to low self-esteem and depression.
    • Social Isolation and Discrimination: Individuals with obesity may experience social isolation, discrimination, and stigmatization, which can lead to feelings of loneliness, rejection, and social anxiety.
    • Physiological Changes: Obesity can lead to physiological changes, such as chronic inflammation and hormonal imbalances, which have been linked to an increased risk of depression and anxiety.
    • Sleep Disturbances: Obesity is associated with sleep apnea and other sleep disorders, which can contribute to mood disturbances, fatigue, and cognitive impairment.
    • Reduced Quality of Life: The physical limitations and health complications associated with obesity can significantly impact quality of life, leading to feelings of frustration, helplessness, and depression.

    Psychological Mechanisms Involved

    Several psychological mechanisms contribute to the intertwined relationship between obesity and mental health:

    • Emotional Regulation: Food can serve as a powerful tool for emotional regulation. Individuals may turn to food to cope with stress, anxiety, sadness, or boredom.
    • Reward Pathways: Overconsumption of highly palatable foods can activate the brain’s reward pathways, leading to addictive-like behaviors and difficulty controlling food intake.
    • Cognitive Distortions: Negative self-talk, distorted body image, and perfectionistic thinking can contribute to unhealthy eating patterns and low self-esteem.
    • Learned Behaviors: Childhood experiences, cultural influences, and family dynamics can shape eating habits and attitudes towards food and body weight.
    • Stress Response: Chronic stress can lead to increased cortisol levels, which can promote abdominal fat storage and contribute to unhealthy eating behaviors.

    The Importance of Integrated Care

    Addressing the complex interplay between obesity and mental health requires a comprehensive, integrated approach that considers both physical and psychological factors.

    • Collaborative Care: Collaboration between primary care physicians, mental health professionals, dietitians, and exercise specialists is essential for providing holistic care.
    • Mental Health Assessment and Treatment: Individuals with obesity should be screened for mental health disorders, and appropriate treatment, such as psychotherapy and medication management, should be provided.
    • Lifestyle Interventions: Lifestyle interventions, including dietary changes, increased physical activity, and behavioral therapy, can help individuals achieve and maintain a healthy weight.
    • Cognitive Behavioral Therapy (CBT): CBT can help individuals identify and modify negative thought patterns and behaviors that contribute to unhealthy eating habits and low self-esteem.
    • Mindfulness-Based Interventions: Mindfulness-based interventions can help individuals develop greater awareness of their eating habits and emotional triggers, promoting healthier coping mechanisms.
    • Motivational Interviewing: Motivational interviewing can help individuals explore their ambivalence about weight loss and develop intrinsic motivation for change.
    • Pharmacological Interventions: In some cases, medication may be used to treat both obesity and mental health disorders. It is important to carefully consider the potential benefits and risks of medication, as well as the potential for drug interactions.
    • Addressing Stigma: Healthcare providers should be aware of and address the stigma surrounding obesity and mental health disorders. Creating a safe and supportive environment can encourage individuals to seek help and engage in treatment.
    • Focus on Health at Every Size (HAES): The HAES approach emphasizes health and well-being regardless of body size. It promotes healthy behaviors, such as nutritious eating and regular physical activity, without focusing on weight loss as the primary goal.

    Conclusion

    The relationship between obesity and mental health is complex and multifaceted. Recognizing the bidirectional nature of this relationship is crucial for providing effective and compassionate care. As a PMHNP-BC, I am committed to advocating for integrated care that addresses both the physical and mental health needs of individuals struggling with obesity. By promoting healthy lifestyles, addressing mental health disorders, and challenging societal stigma, we can empower individuals to achieve optimal well-being.

    Bibliography

    Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., … & Fornaro, M. (2022). Prevalence of overweight and obesity in schizophrenia, bipolar disorder, and major depressive disorder: a systematic review and meta-analysis. World Psychiatry, 21(3), 392-413.

    McIntyre, R. S., Jerrell, J., Kennedy, S. H., Patel, K., & Woldeyohannes, H. O. (2022). Weight gain and metabolic disturbance in patients with major depressive disorder: a review of current evidence and clinical implications. Expert Opinion on Drug Safety, 21(1), 121-133.

    Vieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., … & Yatham, L. N. (2023). Bipolar disorders. Nature Reviews Disease Primers, 9(1), 1-24.

  • Moving On Like John Cena: What His Retirement Can Teach Men About Identity, Purpose, and Mental Health

    Moving On Like John Cena: What His Retirement Can Teach Men About Identity, Purpose, and Mental Health

    Andrew J. Hewitt, PMHNP-BC

    Abstract

    High-profile retirements can function as cultural mirrors—inviting everyday people to reflect on identity, purpose, and the psychology of “what’s next.” John Cena’s decision to step away from full-time in-ring competition (and close out a farewell run) offers a useful framework for men navigating transitions: retirement, career changes, divorce, empty nest, injury, aging, or simply a growing sense that an old role no longer fits. This blog uses Cena’s retirement as a real world example of healthy “moving on,” integrating recent (2024–2025) research on athlete career transitions, retirement related meaning, social identity shifts, and the impact of masculinity norms on help-seeking. Practical, evidence-aligned strategies are provided to help men reduce anxiety and depression risk during major life transitions by strengthening identity beyond one role, building purpose, sustaining connection, and seeking support early.

    Introduction: Why a Wrestler’s Retirement Can Hit So Deep

    When John Cena announced he would retire from in-ring competition in 2025, it resonated far beyond wrestling fandom. WWE framed it plainly: after a legendary run, he would step away from that chapter and finish on his own terms. WWE Mainstream sports media similarly highlighted the announcement and the significance of the transition. ESPN.com

    From a psychiatric perspective, it makes sense that this kind of moment lands with men in particular. Many men, whether athletes, veterans, business owners, fathers, or providers… anchor self-worth in a role: “what I do” becomes “who I am.”

    When a role changes (by choice or by force), the mind often scrambles to stabilize identity. That scramble can look like irritability, insomnia, increased drinking, emotional shutdown, risk-taking, or quiet depression; symptoms that can be missed because they don’t always look like sadness.

    Cena’s story provides a healthier model: plan the transition, honor what was, and move toward what’s next with intention. That’s not just inspirational, it’s clinically useful.

    The Psychology of “Retirement” (Even If You’re Not Retiring)

    In research, “retirement” is a major life-course transition tied to changes in routine, identity, social structure, and meaning. A 2025 overview of systematic reviews noted that retirement’s effects on mental health vary widely, influenced by socioeconomic factors, job characteristics, and lifestyle, but the transition itself is a meaningful stressor because it disrupts identity and daily structure. ScienceDirect

    Even if you’re 32 and changing jobs, or 45 and stepping out of a leadership role, the psychology is similar:

    • Loss of structure (days become less defined)
    • Loss of community (coworkers/teammates drift)
    • Loss of status (less recognition, fewer “wins”)
    • Identity destabilization (“If I’m not that guy anymore, who am I?”)

    A 2025 scoping review in The Gerontologist emphasized meaning as a central variable in retirement adjustment, people do better when they can build a coherent “why” for the next chapter. OUP Academic

    Athlete Retirement Research: What It Reveals About Men’s Mental Health

    John Cena is not an “ordinary retiree,” but athlete transition data is valuable because it magnifies identity issues that many men experience more quietly.

    Risk: Anxiety and depression can rise after the spotlight dims

    A 2024 systematic review and meta analysis in BMJ Open Sport & Exercise Medicine concluded that former elite athletes can have roughly twofold increased incidence of anxiety and depression compared with the general population. BMJ Open Seminars While “elite athlete” isn’t the same as “everyday man,” the mechanisms overlap: role loss, identity foreclosure, pain/injury, sleep disruption, and a sudden shift in social reinforcement.

    What protects mental health during transitions?

    A 2025 systematic review on correlates of athlete mental health during career transitions synthesized quantitative evidence across many transition types and outcomes, highlighting the importance of planning, identity breadth, social support, and coping resources. Taylor & Francis Online In plain language: men do better when they don’t let one identity (job, sport, rank, “provider”) crowd out all others.

    A separate 2025 commentary introduced “athletic retirement literacy,” emphasizing competencies like preparation, emotional skills, social support, and meaning, making skills that generalize well to non-athletes facing major change. Taylor & Francis Online

    Cena as a Case Example: The Healthy Mechanics of Moving On

    WWE’s official coverage described Cena’s planned exit from in-ring competition and positioned it as a deliberate close to a major chapter. WWE That matters. Transitions tend to be healthier when they include three ingredients:

    1. Narrative closure (“This chapter mattered.”)
    2. A future-facing identity (“I’m becoming someone, not disappearing.”)
    3. Connection and continuity (support systems remain intact)

    For many men, the painful part of moving on isn’t the change itself—it’s the fear that moving on means the past wasn’t meaningful. In reality, psychological health improves when you can hold both truths: that was real, and I’m not trapped there.

    The Masculinity Factor: Why Men Struggle to Ask for Help

    Transitions are hardest when men are taught they must handle them alone.

    A 2025 systematic review on traditional masculinity norms and mental health help seeking found consistent links between stronger endorsement of certain masculinity norms and reduced willingness to seek psychological support. SAGE Journals Related 2025 work also examined how gender norm conformity influences men’s help-seeking and treatment engagement, reinforcing the pattern that “toughing it out” can become a barrier to care. Taylor & Francis Online

    The American Psychological Association also highlighted that rigid masculinity norms can harm boys’ and men’s mental health, and called for healthier models rooted in connection, authenticity, and resilience. American Psychological Association

    This is where Cena’s public persona is relevant. His brand has long emphasized discipline and grit, but retirement represents another kind of strength: adaptability. The ability to pivot without collapsing is mental fitness.

    How “Moving On” Helps Men’s Mental Health

    When done intentionally, moving on supports mental health in several evidence-consistent ways:

    1) It reduces identity foreclosure

    If your identity is fused to a single role, stress increases when that role is threatened. Expanding identity (partner, dad, coach, artist, learner, community member) reduces psychological fragility. Transition research consistently flags identity breadth as protective. Taylor & Francis Online

    2) It restores meaning and agency

    Meaning buffers stress. The retirement meaning literature emphasizes that a coherent sense of purpose improves adjustment and wellbeing. OUP Academic “I’m choosing my next chapter” is psychologically different from “I’m being replaced.”

    3) It keeps social connection alive

    Retirement and role transitions can increase isolation, which is strongly linked to worse health outcomes. A 2025 study using ELSA data examined the relationship between retirement and loneliness/social isolation, underscoring the importance of social continuity during transitions. SpringerLink

    4) It improves emotional regulation under stress

    A 2024 study (HEARTS, Sweden) examining depressive symptoms across retirement transitions in men and women linked outcomes to factors like work centrality and emotion regulation strategies (e.g., suppression vs. reappraisal). SpringerLink Men who rely heavily on suppression often appear “fine” until they aren’t, then symptoms show up as anger, withdrawal, or substance use.

    Practical Strategies: The “Cena Transition Plan” for Real Life

    You don’t need a retirement tour to transition well. Here’s a clinically grounded framework I use with men in therapy and medication-management settings.

    Step 1: Name the role you’re leaving—and what it gave you

    Write two lists:

    • What the role gave you (status, routine, brotherhood, pride, money, identity)
    • What it cost you (sleep, health, relationships, peace)

    This creates narrative closure rather than emotional avoidance.

    Step 2: Build a “next identity” in three pillars

    Pick three identity anchors that will remain stable even if work changes:

    • Body (training, walking, medical follow-ups)
    • Bond (relationships, men’s group, faith/community)
    • Build (learning, hobby, volunteering, entrepreneurship)

    Athlete-transition research supports preparation and identity breadth as protective. Taylor & Francis Online

    Step 3: Replace structure before you lose it

    Transitions become mentally destabilizing when days lose shape. Schedule:

    • Wake time
    • Movement
    • Social touchpoint
    • One daily “win” task
    • Wind-down routine

    Retirement overview evidence emphasizes routine, activity, and social identity as key factors in mental health around retirement. ScienceDirect

    Step 4: Watch for “quiet depression” and “loud anxiety”

    Men’s depression often shows up as: irritability, numbness, sleep disruption, low motivation, increased substances, or anger. Anxiety can show up as control seeking, rumination, and constant “next problem” scanning.

    If symptoms persist for more than two weeks or impair function, it’s time for support.

    Step 5: Practice help-seeking like a skill (because it is one)

    If masculinity norms make therapy feel uncomfortable, start with “low-barrier” steps:

    • A single telehealth consult
    • A structured assessment (GAD-7/PHQ-9)
    • Skills coaching (sleep, stress response)

    This matters because masculinity norms are empirically linked with reduced help-seeking. SAGE Journals+1

    When Medication Can Help (and When It’s Not the First Answer)

    Some men need medication support during transitions, especially when anxiety, panic, insomnia, or depression become clinically significant. In those cases, a PMHNP can help evaluate:

    • whether symptoms meet criteria for a disorder,
    • whether substance use is complicating mood,
    • sleep patterns and medical contributors, and
    • treatment options (therapy, lifestyle, medication, or a combination).

    Medication isn’t a substitute for meaning, connection, and identity rebuilding, but it can lower symptom intensity enough to do the deeper work.

    Conclusion: Retirement as a Blueprint for Emotional Strength

    John Cena’s retirement is more than a sports story. It’s a culturally visible example of something many men must learn the hard way: moving on is not quitting… it’s evolving.

    Research from the past two years is clear on the underlying themes: transitions challenge identity and meaning, isolation worsens outcomes, rigid masculinity norms inhibit help-seeking, and preparation plus social support improves adjustment. Taylor & Francis Online+3ScienceDirect+3OUP Academic+3

    If you’re in a “Cena season” of life closing a chapter, changing roles, redefining yourself; take it seriously, and take it compassionately. You don’t have to do it alone. And you don’t have to wait until things break to start rebuilding.

    References (APA 7th)

    American Psychological Association. (2025, September 23). Rethinking masculinity to build healthier outcomes. Monitor on Psychology. American Psychological Association

    Gouttebarge, V., Bindra, A., Blauwet, C., et al. (2024). Prevalence of anxiety and depression in former elite athletes: A systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 10(4), e001867. BMJ Open Seminars

    McCluskey, T., Stevens, M., Cruwys, T., Murray, K., & Freeman, H. (2025). Correlates of athlete mental health during career transitions: A systematic review of quantitative research. International Review of Sport and Exercise Psychology. Taylor & Francis Online

    Nilsson, L. G., et al. (2024). Depressive symptoms across the retirement transition in men and women: Associations with emotion regulation strategies, adjustment difficulties, and work centrality. BMC Geriatrics. SpringerLink

    Schinke, R., & colleagues. (2025). A commentary on high-performance athletes’ retirement and mental health: Introducing athletic retirement literacy. Journal of Applied Sport Psychology. Taylor & Francis Online

    Wood, R. E., & Pachana, N. A. (2025). The role of meaning in the retirement transition: A scoping review. The Gerontologist, 65(6), gnaf076. OUP Academic

    Zhang, X., & colleagues. (2025). Impact of retirement transition on health, well-being, and health behaviours: An overview of reviews. Social Science & Medicine. ScienceDirect

    Zhou, Y., & colleagues. (2025). The relationship between retirement, social isolation and loneliness: Evidence from the English Longitudinal Study of Ageing. BMC Public Health. SpringerLink

    World Wrestling Entertainment. (2025). John Cena announces that he will retire in 2025. WWE.com. WWE

    ESPN. (2024). John Cena announces upcoming WWE retirement in 2025. ESPN.com

  • When Men Feel “Off”: Understanding Functional Depression and the Role of Testosterone

    When Men Feel “Off”: Understanding Functional Depression and the Role of Testosterone

    By Andrew J. Hewitt, PMHNP-BC

    What Is “Functional Depression”?

    Have you ever felt like you’re running on empty—but still getting everything done?
    You go to work, take care of your family, and meet your responsibilities, but inside, you feel flat, tired, or disconnected. People might even describe you as “doing fine,” but you know something’s off.

    That experience is often called functional depression—sometimes referred to as high-functioning depression. It’s not an official diagnosis in the DSM-5 (the manual mental health professionals use to classify disorders), but it’s a very real experience for many men.

    Functional depression means that while you’re technically functioning—going through the motions of daily life—you’re not feeling emotionally well. You might describe it as:

    • Waking up exhausted even after a full night’s sleep
    • Feeling little enjoyment in things you used to love
    • Constant irritability or restlessness
    • Trouble concentrating or “brain fog”
    • Feeling emotionally numb, disconnected, or guilty for not being “grateful”

    Many men experiencing these symptoms assume it’s just stress, age, or burnout. But sometimes, there’s something deeper at play—both psychologically and biologically.

    Why Men Often Hide Depression

    Depression in men often looks different than in women. Instead of sadness, men might show:

    • Anger or frustration
    • Withdrawal from relationships
    • Overworking or over-exercising
    • Substance use to “take the edge off”

    Social conditioning plays a big role here. Men are often taught to “tough it out” or “handle it themselves.” This makes it harder for men to talk about depression or to recognize it when it’s happening.

    But bottling things up takes a toll—emotionally, mentally, and even physically.

    The Testosterone Connection

    Here’s something that surprises many people: testosterone, the primary male sex hormone, plays a major role not just in muscle mass or libido—but in mood regulation, motivation, and mental clarity.

    Low testosterone, known as hypogonadism, can produce symptoms that look a lot like depression:

    • Low mood or irritability
    • Fatigue
    • Brain fog or poor concentration
    • Sleep changes
    • Reduced libido or erectile difficulties
    • Loss of confidence

    A growing body of research over the past few years shows that low testosterone levels can contribute to or worsen depressive symptoms in some men (Walther et al., JAMA Psychiatry, 2020).
    It’s not the case for everyone—but for certain men, particularly those with “functional” or milder depression, testosterone replacement therapy (TRT) can make a real difference.

    How Testosterone Affects the Brain

    Testosterone interacts with your brain chemistry in powerful ways. It can:

    • Support dopamine activity (motivation and pleasure)
    • Regulate serotonin, which affects mood and anxiety
    • Reduce inflammation in the brain (linked to depression)
    • Help maintain cognitive sharpness and energy levels

    When testosterone is low, these systems don’t work as smoothly—which may explain why you feel “foggy,” unmotivated, or emotionally flat.

    Can Testosterone Therapy Help with Depression?

    Research over the last few years suggests that TRT may help reduce depressive symptoms—especially in men who already have low testosterone.

    A major review of 27 clinical trials found that men receiving testosterone reported significant improvements in mood and energy, particularly when given moderate-to-high therapeutic doses (Walther et al., JAMA Psychiatry, 2020).
    Another recent review in Frontiers in Endocrinology (2023) found similar results, emphasizing that TRT seems most beneficial when combined with therapy or lifestyle changes—not used alone.

    However, it’s not a universal fix. Some men don’t experience mood benefits from TRT, especially if their testosterone levels were normal to begin with. That’s why proper testing and evaluation are so important.

    When to Ask About Testosterone Testing

    If you’re a man experiencing ongoing symptoms of fatigue, irritability, or emotional flatness—especially if you’ve already tried therapy or antidepressants without much success—it might be worth checking your hormone levels.

    Your clinician can order a morning total and free testosterone test, along with other labs (like thyroid function, vitamin D, and blood count).
    Low testosterone is usually defined as below 300 ng/dL, though symptoms and clinical context matter just as much as numbers.

    If your levels are low—and no medical contraindications exist—your clinician might discuss testosterone replacement therapy (TRT) as part of a broader treatment plan.

    What TRT Looks Like

    TRT can be administered in several ways:

    • Injections (weekly or biweekly)
    • Gels or creams (applied daily to the skin)
    • Patches or pellets (less common)

    The goal is to bring testosterone into a normal physiologic range—not to “supercharge” levels.
    You’ll need regular monitoring (every 3–6 months) to check hormone levels, blood count, prostate health, and cardiovascular risk.

    Important: TRT is not appropriate for everyone. It may not be safe for men with certain heart conditions, untreated sleep apnea, or prostate cancer. Always discuss risks and benefits with your provider.

    TRT Is One Piece of the Puzzle

    While testosterone can help, depression—especially functional depression—is rarely caused by hormones alone.
    Men benefit most from a holistic plan that may include:

    1. Therapy
      • Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT) can help you identify unhelpful thoughts and behaviors and build emotional awareness.
    2. Lifestyle changes
      • Regular exercise, quality sleep, and good nutrition all boost mood and hormone balance.
    3. Social connection
      • Men with strong social support networks experience less depression and faster recovery.
    4. Medication when appropriate
      • If mood symptoms remain, antidepressants or other targeted treatments can complement TRT.

    Think of TRT as part of your mental health toolkit, not a magic cure.

    A Real-World Example

    “Mark,” 48, came to my clinic after months of feeling “off.” He was productive at work and keeping up with family life, but described constant fatigue, low libido, and irritability.
    His bloodwork showed testosterone levels below 250 ng/dL—clinically low.

    We started a holistic plan: moderate-dose TRT, therapy focusing on burnout and perfectionism, and simple lifestyle changes (better sleep hygiene, cutting caffeine late in the day, and light exercise).

    Four months later, Mark reported more energy, clearer focus, and improved mood. He said, “I finally feel like myself again.”

    Every man’s journey is different—but this story shows how intertwined mood, hormones, and identity can be.

    What to Watch Out For

    TRT has potential risks, including:

    • Increased red blood cell count (which can raise clot risk)
    • Prostate enlargement
    • Acne or hair loss
    • Fluid retention or mild blood pressure changes

    This is why regular lab monitoring is essential. Your provider will also track how your mood, energy, and cognition respond over time.

    If there’s no improvement after several months—or if side effects outweigh benefits—your provider may adjust or discontinue treatment.

    Breaking the Stigma

    Functional depression thrives in silence. Men are often expected to be strong, self-sufficient, and stoic—but emotional pain doesn’t make you weak. It makes you human.

    Reaching out for help—whether through therapy, lifestyle change, or medical evaluation—is an act of strength, not surrender.
    For some men, that may include looking at testosterone levels. For others, it might mean tackling perfectionism, stress, or burnout.

    The key is to recognize that “functioning” isn’t the same as thriving.

    The Takeaway

    If you’re:

    • Feeling persistently low or unmotivated
    • Experiencing fatigue, irritability, or brain fog
    • Losing interest in things you used to enjoy
    • Not responding to standard treatments

    …it may be time to take a closer look at your hormonal health along with your mental health.

    Functional depression in men is treatable—and recovery often begins with self-awareness and honest conversation.
    Whether the solution includes testosterone replacement therapy, psychotherapy, or both, the goal is the same: to help you feel like yourself again—fully alive, not just functioning.

    References (Simplified)

    (For readers who want to explore further.)

    • Walther, A., Breidenstein, J., & Miller, R. (2020). Association of testosterone treatment with alleviation of depressive symptoms in men: A systematic review and meta-analysis. JAMA Psychiatry.
    • Hauger, U. G., et al. (2022). The role of testosterone and hypothalamic regulation in depression. Reviews in Endocrine & Metabolic Disorders.
    • Forbes, M. et al. (2025). Testosterone concentration and incident depression in older men: A longitudinal cohort study. The Journals of Gerontology: Series A.
    • Schroder, H. S., et al. (2023). Framing depression as a functional signal, not a disease. Social Science & Medicine.
    • Harvard Health Publishing (2023). Is testosterone therapy safe? Take a breath before you take the plunge.