If you were still in peri when you started on hrt, then it could well be that your own cycle has gone through another shift amd your estrogen has dropped, so you may need to adjust your dose.
Even on the right dose of hrt I still find mornings the worst for anxiety. Estrogen levels dip to their lowest overnight and of course you've got cortisol kicking in early morning. What I've found helps is that as soon as I wake up around 7am, I get out of bed, put my gel on then get back into bed for a bit longer or sometimes go straight downstairs. I eat something immediately, usually just a banana and some nut butter, so I can then also take my anti depressant early too. Within an hour of both of those things I start feeling better and my morning anxiety is over sooner. I have also found that estrogel for me doesn't last the full 24 hours it's meant to, so i save a bit of my dose to put on mid to late morning, and that seems to help too. I'm not sure what you could do re patches except perhaps look to increase overall? Or perhaps ask for some gel to do the extra top up with, then you could control when you use the extra ti best suit?
I also drink a cup of GABA tea every day from meileaf , a tea shop you can look up online, I'm not allowed to share the link. That is super calming and works instantly for me.
I take a valerian supplement some nights which helps me sleep and keeps me dozy if I do wake up.
Have you tried any talking therapy, cbd or suchlike? Many Trusts let you self refer. It may help if you could learn some tools and techniques to help you manage your worries better, challenge of your thinking around them. It is so easy to get caught up in a negative cycle of thinking, overthinking is SO hard to stop doing.
Which antidepressant are you on?
