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Author Topic: GP booked today - low mood/depression? Post-menopausal  (Read 1345 times)

ScandieBirdie

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GP booked today - low mood/depression? Post-menopausal
« on: August 06, 2024, 08:13:22 AM »

Advice please.
I'm a do'er, an achiever, the organized one with 6 millions things on the go all the time. Love my job and work hard, loving & supportive partner, functional and communicative teen. But I'm low. I cry. I lose my shit. I feel overwhelmed every morning at the thought of having to shower, brush teeth and "put Humpty Dumpty together again". Everything feels uphill and like groundhog day. I rally, but then i dip. It's not like me.

So... I have booked my GP today - facing the lows and Humpty Dumpties. What do I say? What do I ask for?

Am almost 2 years since my last period - shouldn't this be over? Is this my new personality??

Had HRT some years ago for 5 months for night sweats, but just got the rage when the progesteron started. Try again? Patches? Sertraline? Other Antidepressant? Can they even help me?

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CLKD

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #1 on: August 06, 2024, 08:28:38 AM »

Morning.   Some GPs may well push anti-depressant medication when HRT may help.

U need to decide whether you are depressed or whether these symptoms are caused by a dip in hormone levels in the last couple of years.  Make a list to take with you and jot down the options.

Many have problems with the progesterone part of a regime  :-\.  Which symptom would you like to ease first?

Some find that keeping a mood/food/symptom diary of use.  Let us know how you get on.
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ScandieBirdie

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #2 on: August 06, 2024, 08:39:35 AM »

Thank you!
I *think* it's hormone related as depression has not been an issue for me in the past.
Last year, I lost 14 kilos, changed my diet and exercised more -- unsurprisingly, I felt really good doing that and achieving that. Now, I'm just stagnated, tired, giving up'y, low, low, low and with mood swings. And the diet changes etc. don't seem to cut it. I don't drink (except having an occassional drink socially), so feel like lifestyle-wise, I'm "doing all the right things", but just not feeling any better.
They booked me a female GP - I don't mind either way, TBH, but appreciate that they heard "hormones" and "Menopause" and directed me to a woman. I did have a really great GP a year back, when dryness (TMI - sorry) was an issue and she was very clued in and proactive. Hoping it's the same one today, but honestly just relieved to have called and gotten an "emergency" appointment today already.
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ScandieBirdie

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #3 on: August 06, 2024, 08:41:56 AM »

Sorry - forgot:
...as for symptoms, I want my mood to be adressed as the main issue. The rest (hot flush, bad sleep etc.) are minor in comparison.
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Sb1974

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #4 on: August 06, 2024, 09:02:27 AM »

I just wanted to say good luck with the Doctor today. I too am suffering with low mood an inability to get stuff done - 2 years ago before this all started I was coping really well - single mum working full time etc. But now as you say having shower seems like hard work - I am on HRT and AD which are helping somewhat - just wanted you to know you are not alone.
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ScandieBirdie

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #5 on: August 06, 2024, 09:31:00 AM »

Thank you!!! I hope things continue to improve for you as well.
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CLKD

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #6 on: August 06, 2024, 10:24:17 AM »

Nothing on here is too much information, silly or stupid.  We are a Mine of ......... many having experienced various symptoms during The Change. 

Let us know how you get on?

The stagnation mayB hormone related rather than altering your diet.  Stick with the latter!  Since cutting out ultra processed foods I have felt a lot better in that slow bowel transit has become less of a problem.  What I was able to eat during my 20s, 30s, 40s is no longer an option and to be honest, I don't miss croissants etc..

MayB ask for a full blood count to include VitD and thyroid function tests as both the latter can cause extreme tiredness.  R the mood swings cyclical?
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ScandieBirdie

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #7 on: August 06, 2024, 12:14:12 PM »

CBT and Setraline prescribed. Review in 28 days and booked in for that, so that’s a start.
HRT not currently indicated as my other physical symptoms aren’t really there anymore/have gotten a lot better.
But we’ll see. If this doesn't make a difference or help, I’ll try again?
Not an easy visit to sit there & say how you “cannot cope” when coping is what I “do” as a default
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CLKD

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #8 on: August 06, 2024, 12:17:59 PM »

Tnx 4 the update.  Do U feel supported and listened to?  Trying Setraline for 4-6 months may well allow U to see the wood for the trees.  How long do U need to wait for CBT? 

Certainly my friend did well on Setraline after a bereavement which she weaned off eventually. 

Currently U R not coping, be kind to yourself.  Do U have hobbies?  We have threads about that here too  ::).  Getting more 'me' time 20 mins twice a day can help too: a walk, swim, sitting in the sunshine with a cuppa, delegating is probably important too.

Little steps ........
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ScandieBirdie

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #9 on: August 06, 2024, 01:29:54 PM »

Thank you - really!
It has been a relief to come on here and find such support.
I am glad I went and started the process. The GP was female but young, and very "undramatic" about it all (which I suppose is good :)). I do feel she listened, but obviously there is no magic "fix" so throwing 2 out of 3 options (AD and CBT) at it counts as a result. For now.

Hobbies... I make sure I walk and aim for 11000 steps a day (I have a desk-based job, so I need the air and activity - having a dog helps with ensuring I go out. Friends too - I may not feel like it, but if we're meeting up for a coffee or cocktail (mocktail for me for now -- not that I drink normally. Covid sent me teetotal and I quite liked it), I make sure I go and that we say yes to "outings". Sitting at home "angsting" certainly doesn't help - going out may, but it won't make it worse.

I swim -- or try to. Finding it hard currently to go as the thought of getting there (10 mins away so not hard!), changing, doing it and changing again feels like a lot these days. As do general showering/getting up and routines. But I'm working on it and making myself do what I have to do. Swimming will come at some point again.

I have started delegating. Which helps! Teen doing her own laundry during summer hols. having my partner around ditto (He normally works away from home 4 days a week, so I've been juggling dog, house, shopping, cooking, steering teen thru GCSEs and my own work pretty much on my own for most of the time. Which didn't - apparently - go as well as I thought as I have now stumbled and lost my mojo a bit.

Thyroid is in control (I don't have one so am being monitored regularly to ensure my thyroxine meds are correct and all is steady on that front. Which it is).
I am hopeful this will get better incrementally over the coming weeks and months. Signing up for the CBT now and hoping for a short wait list.
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CLKD

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #10 on: August 06, 2024, 02:32:00 PM »

We have a dog breed thread too ;-)

When severely depressed I found that walking the dog and meeting people helped lift the mood.  Going into R village shop when I was able to do so also.
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bombsh3ll

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #11 on: August 06, 2024, 03:42:25 PM »

What were you hoping for as the outcome?

If you were hoping for an SSRI that's fine.

However if you were really hoping to have the hormones addressed and then see if this was a genuine case of depression, then I think you deserve to get that - after all even NICE guidelines recommend hormone therapy as first line treatment for the low mood associated with menopause, rather than antidepressants.

https://www.nice.org.uk/guidance/ng23/chapter/recommendations
Psychological symptoms
1.4.5Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression.

Antidepressants only marginally outperformed placebo in clinical trials of patients with an actual diagnosis of depression and do not provide any of the health benefits of estrogen - for example they actually increase the risk of fractures
https://www.gov.uk/drug-safety-update/antidepressants-risk-of-fractures#

SSRIs are massively overprescribed, particularly to women, and whilst responsibility for issuing the prescription lies with the clinician, taking it is on us.
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CLKD

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Re: GP booked today - low mood/depression? Post-menopausal
« Reply #12 on: August 06, 2024, 04:49:28 PM »

OP says that she had rages on an HRT regime.  Also "HRT not currently indicated as my other physical symptoms aren’t really there anymore/have gotten a lot better".

It is known that HRT may take a while to kick in whereas ADs can ease symptoms quite quickly after which HRT can be considered. 

Hopefully this prescription will help . 
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