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[GalwayGirl]

Hello all
I’ve been on and off here a few times and just really at my end and wondering if there is anyone out there who has been through similar.
I have been very unwell for almost a year with a severe agitated clinical depression (if you aren’t familiar with it please google as it’s very very debilitating). It occurred within the context of peri and significant life events and I went to the Newson on advice of a friend. I deeply regret this as I was seen by many different Drs online who just kept pushing HRT and not at any time did anyone assess whether or not I might also be clinically depressed which I clearly was - though I wanted to believe myself that HRT would fix it all. Fast forward one year and I am worse than ever-  now on 45mg of Mirtazapine and not able to tolerate progesterone so have been getting by with small amounts of cyclogest to bring on a bleed. It can make me feel wonderful like nothing as ever happened for about 2 days  then I crash into what can only described as almost psychosis. I am too frightened to try the coil and feel that I have to stop the estrogen and in a mad agitated state today I ripped my patch as my mood was hysterical and irrational. I am on regular diazepam just to get through each day.
I am desperate to know if anyone out there has such severe agitated depression and can’t tolerate HRT well ? I know my hormones aggravate my depression  but I also don’t feel that ADs will be able to reign in my hormones so I feel utterly lost. No one seems to have any answers other than it’s trial and error and I have to be patient  but it is truly insufferable. I was a successful director in the NHS before all this and enjoyed a good life full of activities - I am unable to work and depend on my 81 year old mother for support. Please if there is anyone out there that has survived this and can share how I would be so grateful to hear from you x

[CLKD]

Hysterectomy?

    Have U always had bad mood swings etc. during the menstruating years?  Dr Kath Dalton of the National Association for Pre-menstrual Syndrome - NAPS - advised me to eat every 3 hours 24/7 - to keep blood sugar levels more even.  Do have a read of the web-site.

Do U keep a mood/food/symptom diary?  Let us how how you get on ........... this too will pass!

I suffer both clinical and organic depression - many 'experts' won't recognise that there is a difference but I know that there is: as well as feeling low is no where near like depression!

[GalwayGirl]

Thank you CLKD - yes I have thought of hysterectomy but have read horror stories about this too. And indeed until you have been clinically depressed it’s incredibly hard to understand why you can’t get yourself out of it. I am past food diaries etc - when I’m in the midst of it nothing helps other than diazepam and that’s a problem in itself. And yes always suffered with my hormones - always hugely sensitive to changes in my cycle and it’s like that on steroids now. I’m just at my end very hard to see any light x

[CLKD]

Don't worry about the valium!  It's a Life Saver and quite frankly, once it relieves my anxiety, I don't need to top it up because I know it works.  Initially on 10mg 3 times a day for 2 weeks under GP supervision, then down to 5mg twice a day then as necessary - when I begged to be taken into Hospital for my safety the Consultant at the Private place told me to take more Valium!  Once my anxiety is relieved I can see the wood for the trees.

The anti-depressant medication keeps me on an even keel.  I now have an emergency anti-anxiety pill for when I'm floored by it.

Have U discussed hysterectomy with a Consultant?  Several ladies here have done well with the surgery, my friend had 'enough wind to fly a kite' after hers!  U don't have to agree immediately but being aware of the waiting lists for both appts as well as surgical intervention, might it be worth while getting on a list?

[GalwayGirl]

It would be great to message with you about this if you don’t mind ? I can relate to much of what you are saying and would be great to chat more - I’ve been on Valium for 3 months now so am slightly worried although until recently its only been 1-3mg a day xx

[Minusminnie]

I looked up severe agitated depression.  Are you able to see the same psychiatric consultant to get consistent advice ?
If you are experiencing psychosis your antidepressant will not be addressing that.   

This following article mentions a 2008 study about the addition of an antipsychotic.

https://www.promises.com/addiction-blog/agitated-depression-different-from-typical-depression/

Diazepam in my experience with my daughter's mental health is only given in the short term and difficult to obtain from a GP.  How long are you expected to trial this with the antidepressant ?

[Minusminnie]

You will find as a new member that you may have to make 10 relevant posts before being able to message a member privately . This used to be the case it may of changed.

Just mentioning as it can seem frustrating otherwise.

[CLKD]

Valium - medics are so scared of these types of drugs which can be life savers.  1-3mg is hardly likely to cause addiction issues unless a person is thinking "I need more or I won't feel well".  I knew that this drug eased my symptoms so never required 'extra', I would take 5mg the night B4 an event that I was unable to get out of, knowing that I could take another 5mg the next day: never required it.  Though I did drop off to sleep mid-afternoon much to MinLaw's annoyance 

[CLKD]

I agree that an appt with a psychiatrist to discuss the psychosis issues is important to get a balanced view point on which treatments you require and when to use them.

[flo69]

Hi Galwaygirl, I sent you a PM, I hope you can reply, either way, you are not alone and many of us find progesterone an impossible add-on to tolerate.
I take tibolone, supposed to be the NHS go-to for women who say they can't tolerate progesterones, but more often women are told not to be silly, of course you won't kill yourself because of taking HRT and are then tortured to the point of despair before tibolone is even considered.
It's bad medical practice fuelled by misogyny imo.

Diazepam isn't normally used long term because tolerance to it builds quickly. Has your GP stuck you on it and forgot you?

Cyclogest is more than able to crash my mood from my usual happy to absolute black hole despair in under three days.

On tibolone my mental health has no crises whatsoever, not even a little crash. I'm so much better now than before menopause and as long as I avoid all advice from my useless GP, I hope to stay well!

[GalwayGirl]

Many thanks for your replies and support- there are just no simple answers which is the most difficult part to deal with. I would not wish this on my worst enemy. It’s the most difficult and painful thing I have ever experienced.

[CLKD]

Half a day at a time?  When do U next C your GP about medication?  As for sending PMs, members have to be present and engaged here for a set number of responses.

Has the Valium eased the worst symptoms?  When do U feel worse, 4 me it was early in the morning when the cortisol: waking hormone: kicked in  . 

How does the depression affect you, I wrote a spiel several years ago: U can dip in there - make notes ;-).

My GP prescribed Propranolol - a betablocka - which worked well for several years. 

[CLKD]

I suggest that you try the every 3 hour eating regime too .......... the idea being not to increase what you eat but to check that most of what you fancy is healthy rather than processed and spread your choices through 24 hours.  I had biscuits by the bed, when my Puppy needed 2 P in the early hours she soon learned that there was a treat 

[Minusminnie]

Many thanks for your replies and support- there are just no simple answers which is the most difficult part to deal with. I would not wish this on my worst enemy. It’s the most difficult and painful thing I have ever experienced.

I imagine that you have already seen a psychiatrist as you have a diagnosis. Also that you are seeing one privately given that you have seen one within a year or so.  I hope so as within the NHS you do not get consistency of care from one consultant.

You mentioned trial and error is that for a certain time period with your current medication ? As you mentioned feeling worse is there some hope in trying something else at some point ?

[Mariab]

Hi galwaygirl.
I really feel for you and empathise as  I also suffered when entering perimenopause...I became a nervous wreck, I suffered with depression and huge anxiety to the point I was suicidal for a while...it has got to be the worst thing I've ever had to face...it's truly gut wrenching...
I am on citalopram 30mg along with a low dose of estrogel and the coil...it took a long time to find this balance...and took nearly 2 years to recover to a manageable level...I still have episodes which catch me unaware but thankfully it's only.for a few days now rather than weeks on end.
There is light at the end of the tunnel and you will get there...it's a horrible waiting game with alot of trail and error this unfortunately is unavoidable and feels hopeless at times..but the point is you will get better and believing that really helps