My Brief Storyline I have been losing hair since I was 17. Somehow I managed to stay without any bald patches so far. I had extremely dense hair and my regrowth rate was phenomenal for years, probably some sort of immune reaction to the excessive hair loss. I usually have 2 or even 3 layers of hair of different length due to the extreme regrowth rate. Usually, my hair loss pattern is clearly visible under bright light. Although it kinda looks like normal hair anyone could naturally have vs super thick super dense gorilla-level hair. I have been on finasteride for around 10 months, I started when I had a little almost completely bald less than 1sqcm spot above my hairline which was visible when I cut my hair short. Finasteride helped me restore my hair almost 2 years back in time but then I started shedding aggressively. So, I started taking dutasteride which I believe has culled my hair loss to a very natural 20 or fewer hairs per day. About me For personal reasons, I will not share photos of myself on the forum, at least for now. So I will try to describe some useful information for reference. I'm a 24-year-old man with a very hairy slim-ish slightly muscular body and naturally, I have all the signs of high testosterone levels. That's the hairy body, deep voice, super early hair loss to name a few. I'm a bipolar disorder type II patient and I'm on sertraline, potentially for life. Hair loss for me is an existential crisis, during my naturally occurring depression episodes seeing hair on my hands makes me more suicidal than I'm even with anti-depressants. Bipolar already has one of the highest suicide rates of 15% success and 50% attempt. Hair loss is already hard on a very stable person, for me, it's almost a death sentence. I have issues with women during my depressive episodes and the impact on my self-esteem the hair loss has is largely contributing. During my hypomania though, I'm hypersexual. I can't tell for sure if my hair loss aesthetically affects my dating life since it's usually not noticeable especially in dark environments. But I can confirm that the impact on my self-esteem IS very effective in ruining my attempts at flirting. Hypomania just comes with enough grandiose feelings to overshadow any insecurities I have, It's like "I'm a god and I will mate with you, worthless woman" sort of mode that just does the trick most of the time and even if I get rejected it would mean nothing to me it's her loss missing on my highness lol. If you have seen anyone during hypomania or mania before, you'll know what I mean. No offense to women out there but, it's shame on you that you admire arrogance so much. I'm almost sure that my grandiose self is more arrogant than confident, at least by my own standards. Throughout my struggle with hair loss, I tried the following products and I'll tell you what happened with each. Minoxidil Effect: Useless for me, I already had an extreme case of regrowth as I previously stated and minoxidil didn't seem to affect it. If anything, it made my hair thicker. Sides: None that I noticed Status: Loss > Regrowth Topical Liquid Caffeine (Alpecin) Effect: It kicked my regrowth into overdrive for a bit over 2 months (this is when I started seeing 3 layers of hair lengths) then just nothing back to normal. Sides: The caffeine absorbed by my skin is unlikely to stay there is it? I believe the caffeine just got into my bloodstream and, well, did what caffeine does. Status: Regrowth > Loss for 2 months then reverse Finasteride 1mg (Generic) Effect: It's complicated, I went through lots of shedding and stable times but overall I was gaining hair. Sides: Increased libido (could be linked to my bipolar disorder symptoms, quite unpredictable). I had erectile issues for exactly 2 days (soft erection), but I believe someone who is not already on anti-depressants would freak out about that and worsen it. I was sexually active for months on the drug and I only got long stretches of delayed orgasm and short stretches of premature orgasm and I'm talking about the first orgasm because for me the second orgasm is always almost eternal, aka I can't get a second orgasm until my body says f*** it I want that blood back or the girl gets exhausted (To be very specific, out of 11 girls I have been with in total and with attractiveness varying from 6-10 during the 10 months period, 9 delayed, 1 normal-ish, 1 premature, and the premature case happens to be a 10 soooo could just be too hot?). Again, those effects could be attributed to my anti-depressant, not to finasteride, especially that delayed orgasm is a very common effect of sertraline. Naturally and even before taking any drugs for anything at all, I had quite a long orgasm time usually 40 minutes minimum. I started sertraline and finasteride very closely so my case of delayed orgasm is hard to judge. Status: Regrowth > Loss for 10 months then aggressive shedding that took away almost 50% of my gains. I couldn't wait it out as it hit me during a massive depression episode and during that unstable period, a hand full of hair in the shower too often can drive a bullet through my head. Dutasteride 0.5mg (Avodart) Effect: Well, so far so damn good. Hair loss is 20- hairs per day, for someone with my regrowth rate that's negligible. Sides: Slight lower abdominal cramps, not noticeable unless I feel the need to pee. Normal libido; which might actually mean that finasteride was, in fact, responsible for my high libido to some degree. I have no clue how, medically, things are working here. Anyways, I have only been on it for a week as of this post so it's difficult to judge. Status: Most impressive halt in loss so far. Hard to judge regrowth yet but looks like it's gonna be the same rate as finasteride. Significant Impact As I already mentioned, hair loss psychological impact for me is on steroids during depressive episodes, and devastating during mixed ones. My self-esteem plummets. I try to avoid social interactions unless I wear a hat or something, even if it was a night-time event (I once wore an ICE CAP to a NIGHT CLUB damn it! No one would spot my damn hair loss at a night club!). Things went as far as skipping a master's scholarship, just because "I didn't want more college life with hair loss". In reality, my hair loss was not noticeable by most of my colleagues in college. I just had a depressive episode + hair loss and that was the result. I once came close to attempting suicide. I stood in my balcony during a rage/crying/laughing whatever breakdown. Yeah, that happens sometimes when you have a chronic mental illness, especially bipolar so to speak. They have a name for them, they are the "mixed episodes" and they are when you are most prone to hurting yourself. Oh, I also once planned to inject my self with a potassium chloride solution. Lovely memories. Before I started getting the hypomanic episodes those started for me at 21, it was difficult for me to date once I noticed my hair loss. EVEN BEFORE VISIBLE HAIR LOSS! I was still approached by women and befriended and flirted with but I just had such destroyed self-esteem that I couldn't just go for anyone, I couldn't make a move! Even when I started making reluctant moves cuz of my hormones telling me WTF YOU NEED TO DO THE THING, I get rejected. Rant: Girls are absolute b****s when you are desperate. I currently have a girlfriend who I love adore and respect but still that's a fact. If I didn't meet any girl who ever fell in love with me while on hypomania, she'd have probably given me the cold shoulder. Yep, that's me the same person she considers her "dream man" and will be brutally heart-broken if he leaves. End of rant. I don't mean to be stereotypical about it's confidence that matters bla bla bla, but confidence does matter. Or rather, lack of confidence fucks you up. When it comes to whether or not women like men who are visibly and undoubtedly bald, I have no solid evidence but most women are shallow (fact, I'm in-your-face type of person sorry). Anyways, I never cared about that because I'd probably commit suicide before I have to worry about it. If I had miss world as my girlfriend then I started becoming visibly bald, I'll only have slightly reduced suicidal potential cuz she's gonna be a "trophy" of sorts to lift my spirits. On the other hand, if I had an average looking yet supportive girlfriend it would be more useful tbh (both is better obviously, but attractive AND considerate??? I'll be damned if I see one girl who has both, it's like the lottery). So long story short, my biggest issue with hair loss is that it largely contributes to my already existing and chronic suicidal ideation caused by BD. It gets to me through any amount of anti-depressants. If I was given the choice between a life-threatening disease or hair loss I'd probably go for the former. At least it means survive or not survive, not survive or suffer and eventually commit suicide. I'm a quality of life over survival type of person, plus I might already have children I don't know of somewhere around the world (yep, you are not so fond of protection when you are manic really and I travel a lot) so I have done my part recreating with at least 1 confirmed child out there.