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[dawncowp44]

New member advice needed, sorry for the long post. In 44 (for info)

In September I started struggling with anxiety & insomnia. Within a few weeks I'd realised I was probably peri-menopausal & My GP agreed.  I also realised that I'd been having symptoms (hot flushes, brain fog, memory loss) for about 18 months.

Straight away i knew i wanted to go the HRT route but due to levels of anxiety I went onto Sertraline whilst waiting to start HRT. I finally started HRT in December (patches & constant Progeaterone tablets as I haven't had periods years as I have the implant). The sertraline seemed to blunt the anxiety but never got rid entirely. There was also no noticeable improvement with the HRT. After 4 weeks I changed onto gel & the dose was doubled. Within 3 days my hot flushes disappeared.  A week later I swapped from Sertraline to Mirtazapine as I was still only getting 2 - 4 hours sleep a night.

I was having 2 or 3 good days then getting anxious about something small & having 3 or 4 not so good days.  My sleep seemed to have steadied to 5 - 6 hours a night. My mirtazapine was upped from 15mg to 30mg but put down 2 days later as it messed with my sleep & made me really jittery.

I'm now on day 10 of the increased dose & I've been constantly bursting into tears all the time & feel miserable. It feels hormonal rather than a side effect of the mirtazapine increase but I am just waiting to hear back from my GP as to whether I can up my Estrogen.

I've always been really independent having lived ob my own for 16 years and regular travel solo, but I'm really struggling to be on my own.  The only people I can really stand to be around at the mo are my dad & his partner but I worry about hanging around too much.

I feel like i need to be off work as I just seem to feel worse there but then I'd be spending so much more time on my own.

Is this familiar to anyone? Can anyone give me any advice? A light at the end of the tunnel.

[CLKD]

Yep.  Sounds familiar and yes there is light at the end of that Tunnel!

Some find that keeping a mood/food/symptom of use.  Don't worry about spending time with your Dad, it's probably your worry that you are there 'too often' ...... ask him ?

What were your periods up to in the last couple of years?  Hormones may still be waxing and waning so will react somewhat to replacement and if it feels hormonal, it most likely is.

Some find that increasing oestrogen very 3rd night rather than every night helps, to give the body time to adjust helps.  It's a bit Trial and Error.

Browse round.  Make notes ;-)

[MadCatLady]

I went on a real emotional rollercoaster when I started HRT at the end of November. Starting Boxing Day, I literally cried for 10 days, and was having these awful waves of anxiety. It was terrible, but it gradually eased throughout January and is completely gone now. I actually feel good now.

I've just had an increase in oestrogen and that hasn't caused any return of the anxiety. I reckon mine was caused by the progesterone. But my body seems to be adapting to it ok now. It just took a couple of months, but I got there.

I really hope this will ease off for you soon!

[dawncowp44]

Thanks CLKD

I've had the contraceptive implant for over 15 years so not had periods for years, I think this is why peri-menopause took me so much by surprise.  It's really good to find I'm not a total outlier.

Just to add to this.  I've realised my current problems are also probably linked to my Mirtazapine dosage.  I am 13 days in on my 22.5mg dosage and my sleep the last 2 nights has been pretty bad.  It seems that a dosage of 15mg helps me sleep but leaves me tired & wooly headed but a dosage of 22.5mg whilst negating any benefit to my insomnia leaves me clear headed and jittery.  I hate that I have to choose between better sleep a clearer head.

Has anyone experimented with a combination of meds for both insomnia & anxiety?  It's clear to me that whilst helping me to sleep better, I don;t function well on a dosage of mirtazapine that would also adequately deal with my anxiety.  I'm going to talk to my Dr about keeping on a very low dose of Mirt & maybe trying something else for the anxiety

[CLKD]

Good idea to mayB consider dropping to a lower dose which may clear your head: and anti-anxiety medication i.e. Valium for short while to ease the anxiety.  Bach rescue remedy can help too, I used the mouth spray and never wondered whether it worked/not.

Yoga.  Deep breathing.  'me' time.  Anxiety strikes me suddenly ...... so I have an emergency pill to take.

[CrispyChick]

Hi Dawn

Can I ask how you're getting on with the mirtazapine now??? What initial side affects did it give you?

Thanks.

[Mariab]

Hi,
This is so familiar....I have been on hrt since July 23 and citalopram since October 23...
I was very ill to start with , with awful anxiety ..I was off work for 5 months ...
It took a long while to.balance everything enough for me to get back to 80% which I am still now but I except I will probably not be the person I was before however I cherish everything so much more now...
There definitely is light at the end of the tunnel, no matter how bad you feel now it will get better.

[joziel]

It boils my piss when doctors give women anti-depressants and anti-anxiety meds without properly and fully exploring hormones FIRST.

Of course they are options and of course some women need them, but you end up in a mess if you try to change too many variables at once. You don't know if you have too much of one thing, too little of another or are having withdrawals from something else.

It all ends up in a total mess which you then try to medicate with even more drugs.

There's no need for this car crash, unless someone is literally suicidal or it's a mental health emergency.

Start hormones. Experiment with doses. REALLY explore getting estrogen and also progesterone well up (serum, not dosage). And if you STILL don't feel better, then keep that HRT stable and add in the anti-anxiety meds. Otherwise you end up in this sort of mess.

[sheila99]

As above. They wouldn't give you mind bending drugs for a vitamin deficiency so they shouldn't do so for oestrogen deficiency. Adding back oestrogen is not an overnight cure though, my anxiety and insomnia took 3 months to go completely with little improvement in the first month. If your other symptoms have gone then the dose is most likely correct but you need to give it time. Personally I'd knock off the ads and consider a few cycles of sequi hrt because some progestogens can cause insomnia (Utrogestan does it for me). At 44 it's unlikely you're post meno though of course it's always possible.

[dawncowp44]

@CrispyChick I've totally come off Mirtazapine now. I went on to Amytripyline for a week but decided to come off all ADs as I hated the side effects (tiredness, dry mouth, increased anxiety).

I've also changed onto Lenzetto spray which I really believe is working (only 2 weeks in so hopefully will just improve) I'm now getting a steady 5 - 5.5 hours sleep (relatively undisturbed). Although still feel pretty crap in the mornings. I've also realised I've got some work to do with regards my perception of myself and hope to talk to  CBT to start exploring this