How Can You Differentiate between Fatigue and Depression, and What Role Does Testosterone Play?

Reviewed by Garrett Kneese, MD, MPH

Family Medicine

Fatigue is a tired feeling that can occur with many conditions, while depression is a mood disorder that not only brings tiredness but also sadness and loss of interest. Testosterone, a hormone found in higher levels in men, can affect mood, and low levels are sometimes linked with signs of depression rather than just simple fatigue.

Explanation

When looking at fatigue versus depression, think of fatigue as a state of weariness that may occur after physical exertion or long work, while depression includes a deep sadness, lack of interest in activities, and feelings of worthlessness or hopelessness. In depression, people might feel tired but also experience a heavy burden on their feelings and thoughts. Research from the studies shows that testosterone has a role in mood and well-being. For example, some men with low testosterone may feel more depressed and less energetic. However, not everyone with low testosterone will have depression, and not everyone who feels fatigued is depressed. Doctors look at other signs, like changes in sleep, appetite, and everyday enjoyment. They ask detailed questions about mood and energy levels to tell the difference. Overall, while testosterone levels can influence mood, they are just one part of the larger picture of mental and physical health.

(References)

Määttänen I, Gluschkoff K, Komulainen K, Airaksinen J, Savelieva K, García-Velázquez R, Jokela M. Testosterone and specific symptoms of depression: Evidence from NHANES 2011-2016. Compr Psychoneuroendocrinol. 2021 Mar 10;6:100044. doi: 10.1016/j.cpnec.2021.100044. PMID: 35757365; PMCID: PMC9216439.
Spitzer M, Basaria S, Travison TG, Davda MN, DeRogatis L, Bhasin S. The effect of testosterone on mood and well-being in men with erectile dysfunction in a randomized, placebo-controlled trial. Andrology. 2013 May;1(3):475-82. doi: 10.1111/j.2047-2927.2013.00075.x. Epub 2013 Mar 15. PMID: 23494931; PMCID: PMC3630276.
Kheirkhah F, Hosseini SR, Hosseini SF, Ghasemi N, Bijani A, G Cumming R. Relationship between testosterone levels and depressive symptoms in older men in Amirkola, Iran. Caspian J Intern Med. 2014 Spring;5(2):65-70. PMID: 24778779; PMCID: PMC3992230.

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