Withdrawal Syndrome

Dependence and Withdrawal

Difficulty stopping despite harm, with low mood, lost drive and fatigue on withdrawal. Recognised as a genuine dependence syndrome in around a third of long-term users.

Depressed Mood

Low mood, flat drive and anhedonia. Concentrated in the withdrawal window after a cycle, when natural testosterone has not yet restarted.

Insomnia

Difficulty falling or staying asleep, often with night sweats. Its own problem, and an amplifier for every mood effect above it.

Loss of Pleasure

Things that used to be enjoyable stop landing. Distinct from low mood: a person can have normal mood and still get nothing out of food, sex, music or company. Reported most on the progestogenic and prolactin-raising compounds, and it is the effect people most often fail to name because it does not feel like sadness.

Suicidal Thoughts

Thoughts of ending your life, most often reported in the weeks after stopping, when natural testosterone has not restarted and mood has not recovered. It is documented in case series and in withdrawal cohorts. It is listed here because leaving out the most serious outcome in the group would make everything above it read as the full picture.

Drive and Motivation

Willingness to start things and to keep going. Reported separately from mood and separately from libido, and it moves separately: compounds exist that lift mood and flatten drive, and the reverse.