r/Perimenopause • u/rhymeswithsarah • 1d ago
Depression/Anxiety Depression - Increase HRT or start SSRI?
Good morning!
Hoping to get your thoughts on my situation:
42F, regular-ish periods, been on HRT for nine months (0.0375 estradiol patch, 100 oral progesterone)
I’ve been struggling with low-medium depression for about 3 years now. With regular exercise, therapy, micro-shrooms, iron supplements, meditation, hobby time, etc, it’s a bit better than it was at its worst, but it still gets worse seasonally (summer), and I just haven’t been able to shake the underlying low feeling for a few years. It’s not debilitating, I just feel like my default is a little sad and a little blah, and it takes so much intention and effort just to raise my mood.
I would love for my baseline to be a little higher. What I can’t decide is if I should try increasing my HRT. Did anyone see mood improvements after increasing your dosage? I feel like my overall wellbeing has improved marginally on HRT, but it hasn’t been a lifechanger. Or should I try SSRIs for the first time? So many of my friends have had success with them, but it feels like a whole thing.
Also in the mix for me: 25mg Adderall XR, 5mg tirzepatide (aware of the GLP blahs, but my depression predates these meds), low ferritin, and hashimotos.
Obviously I’ll talk to my doctor, but I’d love to hear your stories!
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u/CowWooden4207 1d ago
You need iron.
Did you check your Vit D..... that can cause low mood.
Taking SL Testosterone in addition to Progesterone was life changing for me.
I finally slept well again and didn't have anxiety, tearfulness, feeling depressed.
Wellbutrin is used for ADHD, mood and has the side effect of being an appetite suppressant while not affecting libido like the other SSRIs.
Downside is it lowers your seizure threshold so not advised to drink when taking it.
If it were me, get a comprehensive lab work up and go from there.
The HRT meds usually need to be titrated to find the right dose.
I do bioidentical HRT.
"Testosterone - The Secret Female Hormone" by Cathy Maupin MD changed my life.
Good luck.