This week I would like to focus on the issue of mental health, a topic always relevant, even more so during the current situation. I have picked three excellent questions sent in by readers, to whom I am very grateful.

Question: I’m a software designer and I’ve been working at home since March. I’m not a high-risk individual but the company made the decision that it was safer for us to work in our own environment. Without trying to sound dramatic, I think I’m losing my mind. I can’t seem to switch off, and I’m on the computer first thing in the morning until late in the evening. I’ve spoken to the company, but they’ve been completely unsympathetic – Andrew, 42

Dr Zak says: It is a very difficult time for those working at home during the pandemic, either through being high risk and having to shield, or because of decisions made by their employer. The benefits of working at home are obviously zero commuting time and perhaps a more comfortable environment. The downside is that by not having that commute home, there is no time in which to forget the working day. Similarly, if you are not used to it, or don’t have a dedicated home office, working from home invades that precious space we call our own, where we relax and unwind with family and friends, away from the challenges and stresses of the job.

It is vitally important that you have structure to your working day, as you would in the office environment. Make sure you take regular screen breaks, as well as having a proper lunch away from the room in which you work. Working at home may also mean you don’t see work colleagues, so make time to catch up via available media, socially as well as professionally if this is what you would normally do. The working day should end when it would if you were at the office. Working even an hour more a day soon adds up and can lead to fatigue and reduced productivity.

Question: How do doctors make the decision to prescribe someone antidepressants? My GP has suggested them, but I’m reluctant for several reasons, not least because I hear that they’re handed out like smarties – Annabelle, 58

Dr Zak says: The decision to offer antidepressant medication is taken seriously, after a full history of the person’s mood complaint including duration, severity of symptoms, their views towards medication, if they have had antidepressants in the past, and if so, the results of such treatment.

Experts would agree that talking therapies, i.e. counselling, should be offered first for those with mild to moderate symptoms of anxiety and/or depression, providing the person is receptive to this form of treatment. For some with severe symptoms, where their day to day functioning is significantly impaired, it may be more suitable to offer antidepressant medication with counselling, or before counselling if the person is in a place where they are not well enough to engage with talking therapies initially. Best results are often achieved with a combination of the two treatments. For those taking antidepressants, they must be made aware that starting medication may initially make them feel worse, that a noticeable improvement in mood can take two to three months, and that a course of treatment may last 12 months or potentially longer. Factors precipitating or maintaining low mood, for example financial difficulties, problems in the workplace, an abusive relationship, must also be addressed.

Question: Is there such a thing as a “manopause”, and would testosterone supplements help? I’m 59 and have notice over the last year or so that my sex drive has reduced and that I’m just not as buoyant as I used to be – Vince, 59

Dr Zak says: The concept of a “manopause” in the same way as women have a menopause, is certainly gaining recognition. As we get older, nature dictates that we aren’t able to do the things we did 10 - 20 years ago, or at least not with the same ease or vigour. Symptoms of low testosterone levels include reduced frequency of needing to shave, the loss of pubic hair and a decreased muscle mass. Don’t forget that we all lose muscle bulk after a certain age, itself a normal phenomenon.

Testosterone levels will need to be checked on more than one occasion as they do vary. Many results will be normal. Borderline low results might not be the cause of your symptoms. Replacement therapy, while improving the numbers, might not alter your symptoms, which may be those of low mood itself.

Your GP will most likely seek advice of a urologist with a specialist interest before commencing any hormone treatment.

l Dr Uddin’s advice is provided in good faith and in line with current guidelines and treatment. However, it cannot be used as a replacement for consulting your own doctor.