Saturday, January 30, 2010

Hormonally Generated Depression

I began menstruating at 11, started having hormonal complications at 14 with heavy bleeding & agonizing cramps that progressed into what I now know to be Premenstrual Dysphoric Disorder, (PMDD), a severe form of PMS that follows a predictable, cyclic pattern. Like clockwork, I began my period on or around the 26th of each month & went through HELL for at least 10, if not more, days from ovulation until shortly after my period began.
Mood symptoms predominant in PMDD:
Feelings of sadness to despair, or even thoughts of suicide
Tension or anxiety, panic attacks, mood swings
Frequent crying jags, irritability or anger that affects relationships
Lack of interest in daily activities, trouble thinking or focusing
Tiredness or low energy, food cravings or binge eating
Trouble sleeping & nightmares & feeling out of control
Physical symptoms include bloating, breast tenderness, headaches & joint or muscle pain

Along with PMDD, I had 'normal' on-set unipolar depression around the age of 18. For around two weeks out of every month, I led a relatively good life, while in the back of my mind knowing that ovulation & downward spiral would inevitably follow & would be HELL. I had to remain vigilant about talking myself off the ledge & had serious anger problems, along with high levels of anxiety. Then when my period finally began, for 2 to 3 days I had Dysmenorrhea, (painful cramps), accompanied by nausea & diarrhea.

This monthly chain of events continued from age 18 through 36, when I was seen by a Dr. who immediately recognized the severity of my hormonally associated depression & prescribing my first SSRI anti-depressant. By the time I reached 40 the Dysmenorrhea had progressed to Endometriosis; (pain, irregular bleeding, & infertility & was told it would be very difficult to carry a baby to term. After giving birth to my son at 41, I had a partial hysterectomy, almost bringing my reproductive odyssey to a close, although peri-menopause & finally menopause were yet to come. //i think these too have finally finished about right now at 55.

Wish I'd Known These Things: 

1) Counseling starts BEFORE or at the same time as any medication therapy. You need support while stabilizing on any medication regimen. One does not truly work without the other.

2) Get FREQUENT medication re-evaluations with a Psychiatrist, OR Psychiatric Nurse Practitioner: your regular Doctor should NOT be prescribing psychotropic drugs unless they are qualified to do so & should refer you to a mental health clinic.

3) Get the book, 'The New Mood Therapy', which walks you through counter-acting negative thought patterns. It's a pain in the butt until it becomes integrated, but it IS worth it. The basics are: "My life is shit" counteracted by a more balanced view, "There are certain aspects of my life that are shit, but I also have two lovely children." Sounds forced & initially it is. But you DO eventually AUTOMATICALLY replace the ALL or NONE thinking with more REALISTIC thoughts.

Also, get an old out of print book called, "Hope & Help for Your Nerves" or ANY book by Dr. Claire Weeks. It cured my agoraphobia in my twenties by cuing me to breathe through anxiety/panic attacks instead of avoiding them. "Face don't Fight" Eventually by walking through the fear, the panic subsides & becomes integrated.

 4) Stop drinking NOW, except for a beer or glass of wine once in awhile. SERIOUSLY. Alcohol is a depressant &; WILL make you feel worse, plus it does NOT mix with whatever prescription medications you are on. IF you are an active alcoholic, don't even bother with psychiatric drugs. You might as well start your six foot under nap right now because the combination WILL kill you. 

5) If you have hormonally based depression & are using the pill, GET OFF. It plays complete havoc with your moods. Some women can tolerate it, but not those with hormonal depression.

6) Your gynecologist was telling you the truth. I had a partial hysterectomy about a year after my child was born & honestly, it was the best thing I ever did. There were NO more periods or pain & it did get me on the path towards better mood management. Having a hysterectomy now is no big deal, because it can be done with a laproscope through your belly button. You wouldn't be doing this just for the hell of it, but to address your hormonal issues.

7) I am currently diagnosed have Unipolar depression with some Bipolar complications, compounded by hormonal issues & anxiety. I take Effexor XR which addresses BOTH depression & anxiety & is the ONLY thing that works for me without 'fading out' over time. I'm not talking about the NEW Generic Effexor under a different name, because that one doesn't work for me. IF you can't take Effexor, (which is also prescribed for PMS by the way), ask to try something else. (You will know within about two weeks if one doesn't work)

Ask to try the following; Seroquel 30 mg tabs, but only take 15 mg, a half hour before bedtime. This is GOING to make you sleep, so do not take until you want to sleep. It also helps with Bipolar I Disorder. If you feel a little too high or irritable during the day, you can literally take a TINY NIB of Seroquel & it will even you out. NO NO NO!

8) RUN, don't walk to a vitamin store, or this is where I order online. Cheap, good & fast. Vitaminlife.com

These vitamins in COMBINATION will ALSO help you deal with anxiety, mood swings, & insomnia.
TAKE EVERY DAY, starting ASAP!
Enzymatic Pre-Menopausal or Menopausal Non Hormonal Formula AM PM. Take White one in AM, Purple at Night about an hour before you want to fall asleep.
Woman's Multi VITAMIN & MINERAL one a day.
Calcium, Magnesium & Zinc, TOGETHER in one pill. One in morning & one at night
200 mg. Lecithin gel tab at night for nervous system
1000 mg Flax Seed Oil gel tab at night for heart health
Vitamin D 1/2 pill in morning: most don't get enough.
B-Complex 50mg. 1/2 in morning


So there you go. TAKE CONTROL of your own therapy. YOU are paying him/her with YOUR money!
AND REMEMBER THIS! YOU ARE STILL STANDING AND IT TOOK A HELL OF A LOT TO DO SO.

Diane xo

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