Blue

Monday, January 30, 2012

Question

I have suffered from depression ever since my first year in college. In the eight years since then, I have tried several different anti-depressants, and none of them have given me enough relief to make the side-effects tolerable. Now I am in a relationship with a man who genuinely cares for me. We don't live together, and I don't think we ever will, but I enjoy spending most weekends with him. 

I have insisted that we use condoms. Birth control pills just make my depression worse. A lot worse. Besides, they don't offer any protection from sexually-transmitted diseases. I trust him to be monogamous, but I'd also rather not worry about whether that trust is justified or not.

Like most guys, condoms are not his favorite. Now he has come up with a new reason to stop using them. He claims that he read some research online that indicates women who have unprotected sex are less depressed than women who do. There is something about being exposed to the male partner's testosterone that supposedly breaks up a depression.

My secret fear from the beginning has been that my blues will drive him away. Have you heard of any research on this topic? Is there any reason to think that he may be right about this? I would really like to feel better.

 

Answer

Wow. Your boyfriend gets several points from me for originality. I thought I had heard every excuse in the book to stop using condoms. But this one is so new I am almost afraid to publish your letter, for fear every other condom-hating guy on the planet will try this one out on their wife or girlfriend.

Too bad I have to take all those points away from him for being a self-serving bastard! I've poked around in every dark corner of dubious research that I can find, and this study did not rear its goofy head to leer at me. Hormones influence mood, but it's not a simple case of female hormones causing depression while testosterone gets rid of it. Both men and women need a combination of so-called “male” and “female” hormones for their bodies to work properly. Giving a person too much of a specific hormone may simply result in the body converting it into a different one. In the next ten years, we might see some amazing medical discoveries that will make it possible to diagnose and adjust hormonal imbalances that currently don't make a doctor's radar go “ping!” But this is no excuse for throwing away your condoms.

I have a simple, common-sense question. If testosterone was a cure-all for depression, how come there are all these depressed and suicidal men? Your own intuition is telling you to be safe rather than sorry. You are not 100% sure he's keeping his crayon inside the lines. Why add anxiety to depression?

The fact that you have considered trying this mad experiment is, however, a pretty important warning about just how bad your depression is. How long has it been since you checked out anti-depressants? If it's been longer than four years or so, there may be something new that would work. I recommend finding a psychiatrist you like and trust. Get a new medical evaluation. I also strongly urge you to find a therapist who has experience treating long-standing depression. The combo of medication plus therapy may work better than drugs alone. If you try a new medication and it turns out that it doesn't help, you will have a second treatment modality to support you.

However grateful I am for the existence of anti-depressants, I get concerned because this sometimes leads people to believe that depression is a chemical imbalance beyond their control to alter. My clinical experience is that many depressed people are blue because of stressful circumstances in their lives that are unbearable. Some of those circumstances can usually be changed. A third major cause of depression is trauma. We can't change the past, but we can change how we feel about it. A caring but objective outsider can often point out helpful changes that we are not able to see if we are too close to the situation.