Expert: Libby Bonner - 7/11/2006

Question
My husband has struggled with depression and periodic highs for as long as I have known him.  In the past couple of years, he has been found to have low testosterone levels.  The dr started him on shots for it.  With the shots he would spike in his moods and then drop toward the end when he was due for another shot.  If his levels got too high he had the same symptoms as too low...depression, sleeplessness, irritability etc. Recently he has switched to testosterone gel and he seems to be more evened out, but struggles with sleep, depression etc.  He is seeing a psychiatrist and is on several drugs...mood stabilizier, anti-depressant, anti-anxiety etc.
My question is this:  Can fluctuating testosterone levels mimic the symptoms of bipolar? He is seeing a doctor right now that specializes in bioidentical hormone treatment.  We are wondering if she were to get his testosterone levels under control if maybe the bipolar problems would either dramatically improve or maybe even go away?

Answer
I doubt that you husband's bipolar illness will disappear w/ stable testosterone levels.

It is not clear to me how many doctor's are involved here.  Who began the T shots, and that is a different doc from the one who is going to do the bioidentical hormone treatments?

My larger question is:  does his psychiatrist know of the hormone treatments - past, present, or future - and what is his/her opinion of them?

If s/he does NOT know, your husband needs to make the psychiatrist aware of the hormone 'problem' and the treatments undertaken for it.  It could, apparently does, interfere w/ other therapies.....your psychiatrist needs to know why proven treatments are not working for your husband - if that is the case.  Needs to know, PERIOD.

Good luck and thank you for writing.