Mental health in the toilet 🚽

[Diamondlamp]

Just wanted to 'dump' this here and see if anyone else is going through similar.
I have a history of anxiety and depression. I've been having perimenopause symptoms the past few years, including short, irregular cycles, a background tense feeling, constant irritability, lack of motivation, libido, energy, weight gain around middle, etc.
Went private for HRT as GP wouldn't prescribe - thought I was too young (was 40 at the time and had low ovarian reserve when ttc in my early 30s which private doc says can mean earlier peri).
Tried Zoely (bio identical estrogen contraceptive pill) at first felt pretty good, confidence up a bit. But now having a very weird two weeks and counting period of anxiety and extreme ongoing PMS type stuff. I feel overwhelmed, touchy, sad, jumpy, irritable and negative nearly constantly. I'm not sleeping well, which isn't helping. Then I feel ashamed for feeling like this, for letting the tiniest negative comment escape me. I'm in an amateur orchestra, last night we sight read a piece with some extremely hard passages way above my ability level. I whispered to the person next to me, 'I'm never going to get this' in a conspiratorial sort of way as we often do, but really meant it. Then the conductor announced sternly that if we weren't prepared to practice, we didn't belong in the orchestra. It might not even have been directed at me but I started spiralling into guilt, shame and anger. I do practice but I'd never be able to get those particular bits right without a long period of intense private tuition and way more discipline than I possess. I'm already stressed and busy, and it's supposed to be a fun activity, a release from my mundane week of working from home, clearing up stray cat wees and school pickups. I cried in the car on the way home.
I'm not okay and I feel guilty about that. Doctor is prescribing me patches at a higher strength instead and I've asked gp to be put on the waiting list for a mirena coil so I'll be able to stop the progesterone pills. I'm worried all this won't work either and I'll be stuck feeling like crap forever 😭

Edited to add: I've been tapering off citalopram as felt I should be able to cope without it. Doctor rightly said to go back on it as I need it, some people just do.

Best thing I got from the GP - sertraline

Its an anti depressent , but dished out for anxiety

I realised I wasnt depressed, more fearful , scared, anxious , been on these and Im back living a good life

I'm not clear if you are still seeing a private consultant or your GP?

If it's a private consultant they should be on your case and offering options.
Can you go back if you are no longer seeing them for reviews?

Why not try estrogen gel rather than patches?
You can adjust the dose yourself without having to go back for a new prescription.

You can also use micronised progesterone either vaginally, to avoid mood swings, or if under a specialist you can use it less often (like every other month.) These variations exist for women who are intolerant to it.

If you really want the coil, you can have it fitted privately with no wait at all- see the private consultant you saw initially?

It's NICE guidance to tweak HRT before offering anything like antidepressants which don't work for hormone driven anxiety, and come with side effects too,

Thanks for your replies 🙂
Testosterone is definitely worth pursuing. I tested a few months ago and it was very very low. I'll mention it to my private doc next time.
I'll ask gp about something for sleep. And I am back on the citalopram. 🤞

You probably need to increase your estrogen to help with your sleep.
What dose patch are you on now? You can go up to 100mgs or 4 pumps of gel.

I only started HRT to help sleep (and flushes) and the minute I try reducing my dose the sleep issues start again.

TBH specialist drs like Dr Louise Newson would never have put you on ADs for your symptoms. There is a lot of evidence that they don't help and that HRT should have been used earlier and at the right dose.

It's also very hard to get your estrogen dose right if you are also using ADs as they can mask things.

Your GP can't offer anything for sleep. Sleep-inducing drugs are for short term emergency use only ( like 3 days.) They are addictive. The older anti histamines which can induce sleep are now being linked to other issues such as dementia.

https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-to-increased-dementia-risk-20150128812

Sometimes people don't like it when anti-depressants or anti-anxiety drugs are suggested instead of HRT - and I fully understand why - but I will be honest and say that sertraline gave me my life back during my most menopausal low period.

It's only looking back that I can see how anxious I had become. It has been a game changer for me personally.

I had crippling anxiety until my I found my good oestrogen dose. And I’m not anti sertraline by a long way.

Thanks for the replies. The patches I'm starting on are 75mcg, so higher than the zoely which I think is 50.
Thanks for the info about sleep, hopefully the increase in estrogen will help.
It's so confusing and complicated all this hormone stuff, really hard to tell what's causing what!

You can't compare tablets and patches /gel.

Tablets are metabolised via the liver etc and a lot of the estrogen is lost.
Transdermal estrogen gets straight into the blood stream not through your stomach.

Fingers xd you feel better soon.