This piece was originally featured on VICE US.
At 19, I was diagnosed with major depression. I spent the next 14 years searching for the holy grail of antidepressants. In that time, I've been on more than two dozen psychiatric medications. I've tried all the well-known SSRIs (selective serotonin re-uptake inhibitors), like Prozac and Zoloft, as well as NDRIs (norepinephrine–dopamine reuptake inhibitors) like Wellbutrin. I've been on antipsychotics and atypical antipsychotics like Abilify, a drug I was on for only two weeks because it made me so tired that I slept through my alarm every morning.
I've been on mood stabilizers, anti-anxiety drugs like Xanax and Ativan, ADHD meds like Adderall, and more than a few treatments not approved for depression by the FDA. Every single drug I took ended up not working, only working for a short time, or producing unbearable side effects, like when the antidepressant Remeron made me puke for three days straight.
I'm 33 today, and my mental health deteriorated earlier this year in ways it never had before. Despite the three drugs I had been on (Paxil, Wellbutrin, and Lamictal), I became so depressed that staying awake for more than ten hours became nearly impossible. I lost interest in sex. (I'm in an open triad relationship, and my boyfriend Jeff, who writes for VICE, can confirm this had never been a problem before.) I started wishing that I was dead. Work became a nightmare. It was the most intense period of depression I'd experienced in my life.
It was around this time that I decided to take matters into my own hands and start illegally purchasing and injecting myself with testosterone.
I was 25 when a doctor first suggested I get tested for low testosterone, explaining that men with "low T" mimic depression symptoms: lethargy, low mood, general loss of interest, and low sex drive. My test results revealed that my testosterone level was 225 ng/dl. Low testosterone is medically defined as occurring in men who test below 200 ng/dl. Although I was borderline, because I didn't fall into the official low T range, my doctor wasn't comfortable prescribing me testosterone.
This February, after being let down by yet another cocktail of medications, I started thinking about testosterone again. Over the past decade, low T has become an extremely controversial diagnosis. Drug manufacturers stand to make a fortune from drugs that can treat it, but modern studies have had mixed results when it comes to its efficacy for treating depression, my problem. A study of testosterone's effects in men over the age of 65 found that "testosterone was associated with small but significant benefits with respect to mood and depressive symptoms"—but that's for older guys, not 33-year-olds like me.
The risks of testosterone therapy are great enough to make physicians wary of prescribing it. Testosterone injections have been shown to cause heart attacks, infertility, liver problems, polycythemia (thickened blood, which increases one's risk of blood clots, stroke and heart attack), to aggravate sleep apnea, cause skin reactions (depending on how you take it), and other risks that should give anyone pause.
"We need to more completely understand the significance of the consequences of low testosterone, and to what extent testosterone therapy is effective in mitigating those consequences," said Dr. Christian Pike, a professor at USC's Leonard Davis School of Gerontology, when I asked him about the effectiveness of testosterone replacement therapy. He thinks that more research needs to be done before it's available as a treatment option for the general population. Though he did tell me that low T is "a real issue that pharmaceutical companies are aggressively targeting" and that "there is evidence from research in my lab and others suggesting that low testosterone increases the risks for Alzheimer's disease, metabolic syndrome, type 2 diabetes, and several other age-related conditions."
Earlier this year, I went to four LA-area doctors, looking for one who would agree to at least test my testosterone level again. One told me he didn't know enough about the science behind it, while the other three told me my insurance wouldn't cover it because I had been tested less than ten years ago.
Deep in my depression with no relief insight, I started to feel desperate for anything that could offer some relief. So this March I decided to circumvent medical professionals and take my mental health into my own hands. I did this at great personal risk. It's a choice that I would never recommend to anyone else.
The common dose of testosterone prescribed to treat low T is 200 mg a week. Synthetic testosterone is an anabolic steroid, the same drug bodybuilders and athletes inject to build muscle mass, just at a lower dosage. Anything over 400 mg every two weeks lifts the drug into steroid territory.
I've dated bodybuilders and had athlete friends who were well-acquainted with that side of the drug. I didn't want to be like the muscle queens on the LA gay scene. My goal wasn't about vanity. I just wanted to feel normal again.
This might come as a shock, but finding black market testosterone in LA is a breeze. I bought my first vial from a guy I met through a mutual friend. He calls himself a "health consultant" and only deals steroids, no other drugs.
Getting over my fear of needles was the real struggle. It took weeks of staring at a syringe before I could even hold one. I also had a considerable amount of anxiety due to the fact that I was using black market drugs, which can be lethal.
"You could be injecting bacteria-infected material. You have no way of knowing what you're really injecting. It's a whole host of issues," Dr. Larry Lipshultz, a Houston-based urologist who specializes in men's health issues like infertility and low testosterone, told me.
But any anxiety I had melted away after my first injection. Within 24 hours, I had more energy than I'd had in a decade. I felt sexual again. And I began to have hope that my life could get better.
While writing this, I asked Dr. Lipshultz and Dr. Pike about my elevated mood, improved sex drive, and increase in energy since I began injecting and why I might be seeing those results. However, they refused to comment without seeing my labs and knowing my complete medical history. Another doctor I interviewed refused to comment on my results, citing legal concerns. And though no physician would lend their expert opinion on why I'm experiencing relief, I'm aware that what's happening to me might not be due to the synthetic testosterone at all and will probably not produce similar results for anyone else.
Testosterone enanthate, the synthetic version I chose to start taking, certainly hasn't been a magical cure. I still have trouble getting out of bed some days. But it has alleviated the physical symptoms of my depression and allowed me to focus on the mental aspects of my disease.
Of course, I'm not a doctor. If you're suffering from depression, you should always heed the advice of licensed medical practitioners, who are there to ensure that the drugs you take won't end up causing you more harm than good. Off-book treatments like what I am doing are incredibly dangerous. The only reason I started doing this was because I felt as though I had no other choice.
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