Are Guys Hormonal Too? Deep Dive Into Male Emotional Development and Andropause with WakeMed Therapist, Tyrone David, LCSW-A

Guys — They're known for being happy-go-lucky, fun-loving and all-around NOT hormonal. The reality is that teen boys and men go through the phases and stages of hormonal changes just like teen girls and women. From fluctuations in hormones during the teen years; and depression after the birth of a child, similar to postpartum depression; to hormonal declines later in life, known as andropause — guys have their fair share of challenges too. 

This Men's Health Month, let's do a deep dive into the natural hormonal influences that teenage boys and men face as well as steps to adapt, overcome and address these issues — with care.  

Emotional Development in Teen Boys

In adolescence, teen boys transition from childhood to early adulthood, forming their identity, autonomy and emotional maturity. This transition is a period that involves physical, hormonal and emotional changes filled with highs and lows, erratic mood swings, heightened sensitivity and anxiety. Hormones, such as estrogen, progesterone and testosterone are primarily responsible for physical development and play a n important role in mood regulation.

Emotional health during this transition can significantly impact a teen's life trajectory, including self-esteem, social relationships and academic performance.  

Hormones can cause the following:

• Mood swings
• Emotional lability
• Fluctuations in energy levels 
• Changes in sleep patterns

These can potentially contribute to feelings of anxiety and depression in teen boys. 

Mood Fluctuations in Teen Boys

When it comes to mood changes, teen girls often get the attention, but puberty causes changes in the brain, that affect mood in boys and girls alike. The uneven changes in testosterone levels in boys may showcase as these behaviors:

• Excessive anger
• Aggressiveness
• Shutting down

Biological and emotional changes cause many of the unusual behaviors found in teen boys during adolescence. Moodiness is typically identified as an attribute of teenage girls, but when teenage boys are moody, others and the boys themselves, may think something is wrong, and that this is not normal.

These physical and emotional changes may cause teenage boys to isolate and refuse to discuss them with anyone. These changes can be related to their sexual desire, confusion around their emotions and fear that something is wrong.

Amongst boys, changes in their mood (bulleted above) can begin as early as early as nine or 10 years old. This is due to testosterone, which circulates in young boys’ bodies a year or two before signs of maturation appear.

Healthy and Safe Coping Mechanisms

Anxious/fearful

• Initially, teens should work to identify the source of anxiety. They should determine if they are safe or in a dangerous situation.
  • If in a dangerous situation, they should seek safety immediately. If not, and still feeling anxious, they should take the following steps:
    • Choose to do something enjoyable despite current feeling of anxiousness (e.g., watching a funny show, talking to a good friend, taking a walk or exercising).
    • Try a self-soothing activity (e.g., listening to a meditation app; listening to music; taking a long, hot bath or shower; spending time with a pet; capturing and viewing pleasant photos; meditating).
    • Ask for support from a trusted friend or adult.

Sad/Depressed

• They must identify the source of sadness. Do the sad feelings make sense? For example, was there a recent breakup or a disappointment at school/work? If so, teens should be reminded that it is okay and perfectly natural to feel sad or down. Then take action:
  • They may consider talking to someone about the feelings or even crying.
  • Many people find it helpful to journal about how they are feeling.
  • Teen boys could do an enjoyable activity (even if not in the mood), such as completing an art project, playing a game, watching a funny movie/show or going outside for fresh air.
  • Teens may try making a list of what is going well or things to be grateful for.
  • Teen boys must avoid isolating or withdrawing from friends and family, as this often leads to worsening feelings.
  • They must be reminded that no feeling lasts forever, and this will pass.

Angry / Irritated / Frustrated

• Everyone feels angry sometimes, so an awareness of anger cues is paramount: 
  • Racing heartbeat
  • Feeling hot
  • Clenching jaw or fists

It’s natural to have an urge to act or lash out, but it is important to remember that the urge to act and taking action are two different things.

Teen boys must recognize the source of anger. 

• If in a situation where it’s appropriate to take a break, then take a moment to walk away from the situation and cool down. 
  • Take a few deep breaths, count to 100 or take a walk around the block before returning to the situation.
    • For example, if a teen boy is becoming frustrated with math homework, it may be useful to take a brief break and return when calmer. It is important to return to the activity and not avoid it completely.
• If in a situation where it is not appropriate to walk away or take a break (e.g., in a classroom, when parents are talking or at work), then take a mental break.
  • Take a few deep, controlled breaths; visualize a calming image (e.g., waves crashing on the beach, wind blowing through a meadow, reliving a fun memory). Teen boys can calm their emotions by activating the thinking brain. 
    • For example, he can count backward from 100 by threes or say the alphabet backward. When able, he can then bring his attention back to the person or situation.
• If the source of anger is another person, then teen boys must to remember to respond effectively even when angry, so they do not cause more problems later. 
  • For example, rather than yelling or storming out of the room, he should ask to take a break from the conversation, or just listen and say, “Okay,” and then ask to continue the conversation later when calmer, having had more time to think about what to communicate.
     

From the Teen Years to Adulthood

A number of environmental and natural factors impact a man. Environmental factors increase unhealthy cortisol levels. Environmental factors include:

• Socioeconomic status
• Educational level
• Environmental circumstances
• Health
• Cultural customs and norms
• Gender
• Ethnicity

Men with negative environmental influences are at greater risk for lifelong challenges. 

Testosterone is responsible for the following: 

• Sex drive
• Sperm production
• Bone density
• Fat distribution

Testosterone decreases at a rate of about one percent per year after the age of 30, while growth hormone decreases at a rate of about two to five percent every five years after its peak in the early 20s. 

Sex hormones, including testosterone, affect brain development and organization during puberty as explained earlier. The decrease in testosterone is a normal function of life. 

With a decrease in testosterone comes changes in these areas:

• Sleep quality
• Physical composition 
• Mood regulation that could result in depression, sadness and low self-confidence/motivation 

Sadness and depression may be a result of a low sex drive, fatigue and irritability. These come with low testosterone. Yet, there is treatment around increasing testosterone in men. A urologist can support a man in determining if he has low testosterone and appropriate medical management to address it, if so.

Clinically, low testosterone is called “male hypogonadism,” and the side effects are changes in mood, anxiety, depression and hypomania (elevated mood and energy that is not context behavior). 

Changes in the mood amongst men is called “andropause,” the opposite of menopause, found in women. 

Methods to Cope with Environmental and Hormonal Impacts

Exercise

Movement activates brain endorphins, the brain’s feel-good neurotransmitters — it also acts as meditation in motion, helping with clarity amidst the chaos of life.

Eat Well

Men should eat a balanced diet, limiting sugar and caffeine intake. Consider teas (green, eucalyptus, Chai) as alternatives to caffeinated drinks.

Maintain Quality Relationships

Making connections with family and friends and having a good laugh or discussion can relieve life stressors. Therapy is also an option. A primary care doctor can be instrumental in connecting a patient with a mental health therapist.

Be Mindful (Mindfulness)

Men should practice deep breathing, meditate regularly or even enjoy a favorite piece of candy/chocolate.

Make Lifestyle Changes

It is important to reduce social media use and screen time.

Practice saying “NO." This will increase emotional intelligence around responding to messages, calls or demands on time. It can also reduce procrastination and improve time-management skills.

A Possible Impact of Fatherhood

Fatherhood brings abrupt and radical changes in the life of a man. Changes include loss of sleep, challenges on the job and financial stability. Men can experience challenges after childbirth similar to post-partum depression, formally called “paternal postpartum depression (PPD).

According to the National Institutes of Health, roughly 10.4% of fathers are impacted by PPD. PPD is prevalent in first-time fathers and can present as early as the first trimester of pregnancy, peaking during the three- to six-month period of pregnancy.

Symptoms of PPD:

• Anger, sudden outbursts or violent behavior
• Increase in impulsive or risk-taking behavior, including turning to substances, such as alcohol or prescription drugs
• Physical symptoms, such as headaches, muscle aches, stomach or digestion issues
• Suicidal thoughts
• Irritability
• Isolation
• Fatigue

Concerns for Men after Fatherhood 

Some men may be accustomed to having their mates’ undivided attention. Once the baby comes, they can feel they are no longer the focal point. 

New moms are known to bond with the new baby swiftly. On the other hand, men may take a while to bond with the new baby. This in turn can make the man feel like a tag-a-long in the mother-child relationship.

Other challenges also abound.

Provider Pressure

Being the other parent means sharing 50 percent of the load. This load can be new to many men who have never been in the role of a provider.

Guilt Trips

New dads want to get it right the first time and be the "savior." In the event they are not able to solve all problems or be dependable, this may lead to excessive guilt.

Lack of Understanding

Childbirth means less sleep, fewer sexual interactions and less quality time with the wife/partner. These can impact male mood, especially when he is not understanding the timeframe for these changes or if he goes into this new phase of life not expecting or considering what will change.  

Andropause and the Mid-Life Crisis

Scientifically speaking, the mid-life crisis can be attributed to what psychologist Erik Erikson coined as “Stagnation versus Generativity,” which is one of the eight stages of psychosocial development.

Stagnation versus Generativity begins around 40 and lasts to the age of 65. During this stage, individuals face two stages in which they will likely function. 

• “Generativity” refers to the sense of contribution to society, productivity and the impact one has made, by way of being involved in the community and making a difference. 
• "Stagnation" refers to the feeling that one is not productive, stuck in a rut and void of purpose. Individuals who experience stagnation may experience feelings of emptiness, stunted growth and limitations around reaching goals in life. These individuals can also have challenges finding a purpose in life.

Commonly speaking, the thought of aging and not having enough time is rarely a thought for men. There’s always time, until men reach around the age of 40. Then thoughts about life and how the clock is ticking become ever so obvious. 

A mid-life crisis is the realization that there will never be a right time. So, why not now? Many men put off the things they desire due to an inability to acquire them (financial challenges) or a focus on providing for others (family). 

Once some men have ensured their responsibilities have been taken care of, they often seek out the things they always wanted (sports car, new look, the right partner). Often, these choices don’t align with societal norms, and men are viewed as experiencing a crisis. On the other hand, some men may be dissatisfied with life and their success. This dissatisfaction thrusts them on a mission to right the wrongs and level the ground.

Mid-Life Crisis Management

• Once a man realizes he is dissatisfied with his life, he must decide to no longer remain in the state he is in. He should stop the search for happiness and start taking actionable steps toward creating the life he wants. 
• A man should consider trying meditation and mindfulness as they reduce symptoms related to depression and anxiety. They can also improve concentration, focus and self-awareness as well as lead to better physical health. A better life in the younger years can thwart the mid-life crisis for many men. 
• Men should practice gratitude. This can start with ending each day speaking or writing down five positives in life. These can include a completed project, a nice sunset, a favorite song or a new skill.  
• Passionate pursuits are important. Men can enjoy the activities they've always wanted to do, that are within their means.
• Exercise is one of the more beneficial ways to do away with negative feelings and gain a positive perspective on life. This does not have to be done in the gym and can be achieved by cutting grass, de-cluttering the garage, tending to the garden or taking a walk for 30 minutes per day at least four times a week.
• Goals are critical. A man should create a list of the things he'd like to accomplish over the coming years. Speaking with a therapist, mentor or life coach can make it possible for him to take action with Specific, Measurable, Achievable, Relevant and Time-bound (SMART) goals.
• Social media has been found to contribute to anxiety, envy, feelings of hopelessness and worthlessness as well as an array of other social and mental health challenges. This is not to mention the time that is wasted browsing social media. That’s time that could be spent bettering oneself. A good step away from a mid-life crisis is to step away from social media.
• "Laughter is the best medicine." Laughter activates the neurotransmitter — serotonin, relieves physical tension and releases endorphins. Men should make a valiant effort to include laughter in their daily routine.  
• Sometimes people fail to appreciate what it means to be alive and amongst the living. This may lead one to give in to fears, put a pause on dreams and accept the intolerable. Bad jobs, bad relationships and bad situations can mean allowing bad treatment. It is paramount to think of life as a party and remember life is meant to be enjoyed, not endured.
• Remember, it's never too late to achieve one's life desires!

Indicators of a Mid-Life Crisis 

The best way to navigate a mid-life crisis is to recognize it. There are identified stages to a mid-life crisis.

 They are the Trigger, Crisis and Resolution. 

The Trigger

This is a situation in life that reminds men that their lives are vastly different now than years ago. Triggers can be the loss of a job, medical illness, fear of dying or the loss of a loved one. 

The Crisis

This is the time when men spend time wondering how and if life has changed. All things that they've done up until this point (relationships, achievements, goals), will be assessed to identify if they were “good enough.” 

The Resolution

Following the crisis, there will be a time when men will get accustomed to the realities of life and accept the person they are. This will be a result of the crisis phase and will determine how they move forward in life: Stagnation vs Generativity.

There is Hope

There is hope for men at every phase and stage of life. Support from a urologist, primary doctor and therapist could make a huge impact. 

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About Tyrone David, LCSW-A

Tyrone David is a social worker. He holds an associates of science in computer technology from Denmark Technical College in Denmark, SC and a bachelor and master of social work from North Carolina Central University in Durham, NC.

In his therapeutic practice, he specializes in pediatrics and behavioral health, serving as a therapist in the Internal Medicine Clinic and Hospital Outpatient Department. The clinic is located at WakeMed Raleigh Campus and aids individuals who lack insurance or a regular medical provider. The services offered include medical and behavioral treatment. Patients complete treatment measures to identify challenges and stressors, suicidal ideations and homicidal Ideations as well as audio-visual hallucinations. If any are identified, these patients receive services from David. David offers six to eight sessions consisting of solution-focused therapy for depression, anxiety and other general mental health challenges. 

Following these sessions, David may refer patients for additional services, if needed.