Perimenopausal depression and suicidal thoughts; help needed.

[Anonymous]

If you won’t go see psychiatrist see your hrt prescribing doc today. Call them and say you are having side effects and need to be seen urgently. Dont wait.

[Anonymous]

I don’t think oral is the best. Most doctors prescribing HRT prescribe a patch. I would see a gym or endo person not a PCP.

[Anonymous]

My heart goes out to you, OP, and I'm thankful that your symptoms have no been SO bad that you were unable to think of your husband and children and all who love you.

The scary thing is that suicidal symptoms CAN get even worse, and the pain so unbearable that you literally cannot think of your family. It is not something you can just will away. So I am really happy that you are not giving up and you are fighting this with all you have. There are a LOT of avenues you can try. I wish any of them were a guaranteed win, but there is SO much you can try that might bring you substantial relief.

First, I would consider upgrading your HRT care to a certified menopause specialist. If you're in the DC area, there are several around. If you've got $$, throw money at this...some of the concierge practices are phenomenal and I wish I could afford them! But there are also specialists at regular prefixes that take insurance, so you need not be wealthy to get more specialized care.

At the very least, I'd switch to estrogen patches to maximize their absorbency. And as your ovaries have likely produced less estrogen lately, you probably need a higher dose.

Secondly, for immediate relief, and hopefully ongoing help, I highly recommend Ketamine IV therapy. I was the first person in DCUM to post about my ketamine experiences about 6 years ago...it was absolutely miraculous and transformative for me. And although the ketamine stopped working after many months (and I've re-started it three other times since), literally just the memory of being in complete remission from depression keeps me going with hope these days. I now know with certainty that my depression was never laziness or a character defect or malingering or any of the negative self-talk that always had be turn on myself with loathing and condemnation every time depression hit me hard. One infusion - ONE! - brought me more relief than years and years of SSRI's and therapy. And my suicidal symptoms were 100% relieved. My major depression also got dramatically better over time...so much so that I lost 70 pounds, started to write a book, started a Master's program, etc. all within a year of starting ketamine therapy.

What I loved the most about it was that I wasn't "on" medicine every day. The ketamine would be out of my system mostly within hours and entirely by the next day, but its effects on my neural pathways lasted for days.

I honestly think that ketamine should be the standard front line treatment for anyone with even a hint of suicidal thoughts. Go to the ER, get hooked up to an IV, get a bag of saline and ketamine for about $20, and 85% of people would have substantial, immediate relief. And for the 15% who don't have any effect...well, no harm in it. The worst side effects are slightly elevated blood pressure and temporary dissociation...easily lifted in a couple of hours.

It breaks my heartbeat this is not more widely or cheaply available. It would have saved the lives of several people I have lost to suicide, including my brother.

For me, its effects were temporary but even after one infusion, what it can do for a suicidal person is provide a permanent infusion of hope. Just the feeling of a *complete* lifting of that dark, heavy shroud...I think knowing that complete remission is possible is what has kept me from ever falling back into true suicidal thinking ever again.

I've heard that others have had a similar experience with TMS but I'm more wary of that as I think the science behind it is still kind of Dark Ages stuff, whereas ketamine is a known and very safe drug (except when used in high quantities recreationally of course).

I wish you every good thing and a complete recovery from this. You are a great mom and we need you in the world.

[Anonymous]

ketamine was a game changer re: suicidal thinking. definitely worth looking into. I saw James Simon for HRT. He is helpful and will prescribe testosterone for women if needed. watch your risk for breast cancer.

[Anonymous]

Please go to the ER or go to your PCP or a walk in clinic today if you are having suicide thoughts.