Sixty-three-year-old Leslie "Lester" Smith is accused if shooting 48-year-old Jaquelyn Larue Gore in his Wake Forest home July 26, 2009.
Smith's attorney has argued an unusual 'suicide by boyfriend' defense - telling jurors Gore actually wanted Smith to shoot her.
Psychiatrist James Bellard said from the stand Monday that he examined Smith several times after the shooting.
The doctor testified he believes Smith was legally sane, but he was suffering from mental issues from a string of stressful events leading up to the shooting.
"The depression, from prostate cancer possibility, mother's death, financial problems, losing his job - most would have cognitive problems," Bellard said.
Bellard also testified he believes Smith was also suffering from delirium after not taking his medicine for diabetes and a shoulder injury.
Smith's attorneys claim Gore had a history of alcoholism and suicide attempts. They say she committed suicide by boyfriend by taunting smith to kill her.
Dr. Bellard described what Smith told him happened moments before the shooting.
""She said what are you going to do shoot me?' He said, 'I could.' She said 'You ain't got balls enough.' She then hit the gun with her chest and it went off," said Bellard.
But prosecutors are trying to prove the shooting was premeditated. They questioned Smith's impaired logic and reasoning before the shooting.
The jury could get the case as soon as Tuesday.