Depression around ovulation time

[ArwenUndomniel]

I wasn't sure if this is the right place for this thread, but I have a history of depression and anxiety since my late teens, with eating disorders thrown into the mix too. I've had antidepressants on and off over the years but generally haven't found them helpful and have "managed" without most of the time.

I'm 46 now and suffering from a relapse of anorexia, but I'm still getting periods and I'm increasingly finding that I get horribly low in the days leading up to and just after ovulation. I start spiralling about all my life choices, and have to sit on my hands to stop myself from making rash decisions. I feel unhappy in my job and one of the things I have to restrain myself from doing is handing in my notice without having anything else to go to. I know it would be a disaster but part of me wants to throw a grenade into my life just to make something different happen.

I'm having a coil fitted next week because of fibroids but as I understand it, this won't stop me from ovulating. I'm reluctant to go to the GP about depression that's attributable to my hormones or seek out counselling when the feeling passes after a few days. But I dread this every four weeks and I already feel shit enough about myself with the ED. WWYD in my place?

Sounds like PMDD x

I get mood drops around ovulation and the day I come on, worse when I hit 45. Is it the copper IUD or hormonal coil?

Its worth speaking to GP about all options. In the end I settled on 10mg of escitalopram AD, it's just taken the edge off. I'm still very pissed off it's January and my period is due on Tues, but there's less of a crushing feeling with it, more 'this too shall pass'.

It's a Mirena. The feeling has started to pass but it's exhausting having it to "look forward to" every four weeks!

Try the coil and see. Also is HRT a conversation to explore? Maybe keeping a diary for 2 - 3 months as well.

I found with mood drops that once I sort of accepted that this is another transition phase through having periods / menopause, it got a bit easier and settled over the next few months. Helped me adjust rather than fighting change (as for me anyway sometimes I make the feeling worse by having a negative thought about the feeling IYSWIM).

Then there's creature comforts - anything I can do to adjust my environment or adapt my work when I know I'm going to be potentially very grumpy. Even just watching a TV show or bath before bed.

Sleep also helps. And I know you mentioned anorexia so hope you are getting some help with this.

When you are in a better phase in the month, maybe looking objectively at some of the thoughts and either thinking of some counterphrases, or something you can do next time they come up or small actions to take if there's anything that needs addressing.

I always think daily journalling would be good but never quite get round to it.

I'm seeing my GP this week so I'll mention everything from my OP and see how it goes. I feel like an AD that helps with sleep would be my preferred option but maybe I need to see if the coil helps at all first.

And I know what you mean about journalling. I like the idea of it but I always feel oddly self-conscious about trying it, even though I live alone and nobody would see. I suppose it feels almost self-indulgent somehow!

Hi @ArwenUndomniel How did you get on with your GP. This has been something I've increasingly had trouble with and whilst it isn't dead common, there are a few of us out there. I must have tried everything to help with it, really good self care, dropped alcohol (body couldn't handle it anymore), try my best to incorporate some exercise or walks in my life, AD, counselling, not using my phone, but yet it still happens.
The anxiety has been a living nightmare. Unable to function. Shell of my usual self. Having to take days off work. And it's so different to how I usually am. Always on the run up to ovulation and then it passes and I can function again.
Anyway, as a bit of a last resort my GP finally agreed for me to try HRT. They were reluctant at first because I have kind of regular periods and am too young for menopause in their eyes (mid 40s) but as nothing else was helping... I gave it a go. I'm on my 3rd month and it is helping. First month was a bit wobbly but it seemed a little better. Second the improvement was still there. And third month I've had two wobbly slightly more tricky days on the run up to ovulation, but I think I have to start being brave enough to admit it's helping. I'm much better and starting to feel more confident in being a more reliable person that doesn't have to worry about making commitments around the time I am due to ovulate.

I know it's not for everyone, but I am glad I was brave enough to give it ago and I'm starting to feel more like me. A new version of me that has masses of sympathy for anyone who experiences anxiety.

I had two separate appointments last week, one for the depression and one to have the coil fitted. The latter didn't go according to plan at all! The doctor couldn't even get the speculum in and we ended up abandoning the attempt. I was bleeding by this point and couldn't face the thought of trying again another day so I was put on the pill instead. I've only just started it, so too early to tell what effect it will have, but it will stop me from ovulating so I'm tentatively hopeful.

At the other appointment I was prescribed mirtazapine, which I have also just started. I was warned it would probably increase my anxiety in the first couple of weeks but so far I haven't noticed a lot of difference in my mood, so we'll see. I was also referred to a mental health nurse who I'm seeing next week.

My biggest worry atm is that mirtazapine can increase your appetite. I'm terrified of not being able to control my food intake tbh, and of gaining weight. I'll talk to the nurse about that but if I start getting uncontrollable urges to eat loads I can't guarantee I won't stop the drug.

I can't fault the GP and what they've done for me so far. They took me seriously and listened to what I wanted. I just need to engage properly with it all now, and that's always the hard bit.

I had that problem with the coil fitting too. Waiting to go to the hospital.

I tried the progesterone pill and it made me really calm, only reason I stopped was I'm on an immune suppressant which makes my skin dry, and I felt the pill was also making my skin dry, the two together were too much. So my logic was to try the Jaydess coil which is a lower level of progesterone. Except they couldn't get it in. To be fair I came down with flu later in the day, so maybe that was part of it.

I was going to mention mirtazapine as it's beautiful for sleep. I didn't find it increased my appetite in itself but it was more of a constant gnawing feeling in my stomach (even if I ate), I'm sure if I had given it a bit longer I would get used to it. I think with ADs, always go up slowly in dose, expect a wobble at about 2-3 weeks, and wait for about 6 weeks if possible as it generally levels out then. Nothing is 100% side effect free, just which side effects you can live with.

I've been on escitalopram about 3 months now and would say its probably only about now that my appetite regulation is evening out. Initially I lost my appetite, but found myself in the position of still needing to eat but not feeling like anything, so reverted to unhealthy choices to entice myself. I still feel a bit disconnected from my appetite now but am able to make more healthy choices, so gradually hope it gets fully back to normal.

Well done for reaching out, keep going. 👏

The merina coil can suppress ovulation. I have always suffered from Pmdd, I have found that on my 4th month of having the coil it suppresses ovulation and it has really helped.

I feel relatively comfortable on the pill and I'm not planning to try again with the coil. It was for regulation of fibroid-related bleeding rather than anything else, but if it also has the effect of stopping ovulation and helping my mood, then that'll be great too.

The mirtazapine hasn't really done anything yet, including helping with sleep - as you say, I need to give it longer to work. The gnawing hunger feeling is normal for me anyway at the moment, what with the ED. I haven't noticed it getting worse and I can ignore it (not that that's a good thing, but I'm not ready to address that yet - one step at a time).

Just a quick update if anyone's interested. I think the pill has helped stabilise my mood a bit and I've felt calmer and more able to cope with the small things.

The mirtazapine, however, has been a nightmare and I'm going to tell the GP I want to stop it. It still hasn't done anything for my sleep other than give me really bad dreams when I do drop off. And on top of that it's triggered a horrible week of restriction/binge/purge stuff because of the increase in appetite, which kicked in at the weekend. I eat until I feel ill, then panic and try to get rid of it, then try to not eat the next day, and rinse and repeat. For me, any benefits I might get out of this are not worth it. I'm absolutely terrified of gaining weight.

I think I will just ask for a short-term sedative to help me sleep better for a while and see if the pill levels out my mood enough to function properly. I spoke to the mental health nurse this week too and she said she thought that sounded like a good plan.

@ArwenUndomniel good news on the pill front then after the failed efforts to have a coil fitted. But I am sorry to hear mirtazapine hasn't helped. I'm glad you have a plan. Does all seem hormone related so 🤞🤞