Perimenopause & Anxiety?

[LynnS6]

I'm mostly just venting because I'm frustrated, but tips would help. I need to get myself functional again in the few days because we're going camping and I want to enjoy it. I also HATE feeling this way. I've got an appt with my psych for Sept 7 and can't get in earlier. I need tips on what to do to help with panic attacks and help me function over the next couple of weeks.

Also, I suspect I'm in the beginning stages of perimenopause; I've never reacted well to hormone changes.

Backstory:

I had pretty severe PPD/Anxiety after each of my children were born.(As in not sleeping for days on end, pretty constant panic attacks.)  I was put on Paxil, which helped tremendously. At one point in time I was on a pretty high dose of Paxil (80 mg), but I've been on a maintenance dose of Paxil (20 mg) for a couple of years, and was feeling good enough that I was thinking of talking to my psychiatrist about weaning off completely. Right now, I'm down to seeing her once a year for a check-up.

And then.... in the last 3 days I've been hit by a recurrence of symptoms:

Panic attacks

Burning/tension through my shoulders

Stomach tension/loose stools

Insomnia

Exhaustion which remains even if I get enough sleep (which I can only do with sleep meds, which I HATE)

Slower mental processes, inability to focus

Obsessing on  how I feel; inability to get my thoughts onto another track (which is why I'm posting here)

Crying (out of frustration, I feel)

The only things I can think of that have changed are:

1. My monthly cycle is getting a bit wacky. I'm 45. Sometimes I have a longer than average cycle, and last month, I had a 3 week cycle (very unusual for me, it's usually 4 1/2 week cycle, sometimes 5. I should be about midway through my cycle now, but I have no idea, really.

2. I've been on summer break since mid July. Usually I teach until mid June, take 4 weeks off, teach for another month, then take 4 weeks off. This summer I taught until mid July and won't go back until mid-September. I know that my mind is intellectually bored staying at home. (Or to put it another way, I suck as a stay-at-home mom).

My support network is a bit sparse right now, other than my dh, who's great. My best friend is undergoing chemo for early stage breast cancer. My other friend who often helps out is a work friend who's having a hard time with some reorganization in the department, and has really dialed back her work friendships, including me. Other friends are more casual and many are traveling at this time of year. I'm a bit of an introvert who needs 1-2 good friends, and I don't do well at maintaining a large network of friends. (I have plenty of acquaintances.) My family is miles away. (Closest is 80 miles, but this sister has little patience for mental illness because she suffered a lot when our oldest sister had breakdowns.)

If you've made it this far -- help? I've started on fish oil again. I'm on my Paxil still. But I'm in a fog, can't get anything done around the house or even focus enough to play with my kids. I'm dreading this camping trip, but I'm dreading the idea of staying home for 4 days with nothing to do even more!

[AllisonR]

Hi Lynn,

I read your post and O.M.G! it is a mirror of my life right now. So I am going to post inline the comparisons. Maybe we can bounce ideas off each other? I hope I am not hijacking! I am pretty much in the same boat and would love tips. FYI: This is my first time posting in mental health (I think), just went to a Psychiatrist today, 1st time in decades. 

And my opinion on your trip - even if you are not feeling well, camping would be better than staying home and agonizing about how you screwed up and wasted time NOT camping. Plus you might get better during the trip. When I am ill, a vacation seems more hectic and stressful leading up to it, but after a day it gives some fresh perspective and that helps a lot. Enjoy your trip.

Originally Posted by LynnS6 

I'm mostly just venting because I'm frustrated, but tips would help. I need to get myself functional again in the few days because we're going camping and I want to enjoy it. I also HATE feeling this way. I've got an appt with my psych for Sept 7 and can't get in earlier. I need tips on what to do to help with panic attacks and help me function over the next couple of weeks.

Also, I suspect I'm in the beginning stages of perimenopause; I've never reacted well to hormone changes.

Backstory:

I had pretty severe PPD/Anxiety after each of my children were born.(As in not sleeping for days on end, pretty constant panic attacks.)  I was put on Paxil, which helped tremendously. At one point in time I was on a pretty high dose of Paxil (80 mg), but I've been on a maintenance dose of Paxil (20 mg) for a couple of years, and was feeling good enough that I was thinking of talking to my psychiatrist about weaning off completely. Right now, I'm down to seeing her once a year for a check-up.

I had PTSD after my 1st child - not sleeping for days, mild hallucinations and waking dreams from lack of sleep, horrific panic attacks, anxiety, trigger-happy hyperalert... Didn't get any drugs though - political/cultural issues here. IMO, these events made us more prone to severe PPD/anxiety/PTSD with future events. A minor trigger becomes major because we have already had one or more severe attack.

And then.... in the last 3 days I've been hit by a recurrence of symptoms:

Panic attacks

Burning/tension through my shoulders

Stomach tension/loose stools

Insomnia

Exhaustion which remains even if I get enough sleep (which I can only do with sleep meds, which I HATE)

Slower mental processes, inability to focus

Obsessing on  how I feel; inability to get my thoughts onto another track (which is why I'm posting here)

Crying (out of frustration, I feel)

And then.... in the last 5 months I've been hit by a recurrence of symptoms:

Panic attacks

tension through my shoulders/back - cramps

tingling in hands and feet, and up arms and legs

Insomnia

Exhaustion which remains even if I get enough sleep (which I can only do with sleep meds, which I HATE) I m on supposedly natural, herbal sleeping pills, but it still takes hours to get to sleep and then they are working too well, and I am so tired all the next morning

Slower mental processes, inability to focus - can not remember ANYTHING without a list. Literally anything. Can only problem solve at about 20% my normal level, but can fake it enough in society that no one knows (I think the memory problems are exaserbated by the  lack of sleep) Followed by the opposite - enhanced mental abilities, hypercreativity, great productivity, ability to hyperfocus on new ideas, experiment and complete them successfully with much joy

Obsessing on my job in all its awfulness, obsessing on my health, on my kids happiness, on whatever.

Short fuse, snappy, annoyed, anxious

The only things I can think of that have changed are:

1. My monthly cycle is getting a bit wacky. I'm 45. Sometimes I have a longer than average cycle, and last month, I had a 3 week cycle (very unusual for me, it's usually 4 1/2 week cycle, sometimes 5. I should be about midway through my cycle now, but I have no idea, really.

2. I've been on summer break since mid July. Usually I teach until mid June, take 4 weeks off, teach for another month, then take 4 weeks off. This summer I taught until mid July and won't go back until mid-September. I know that my mind is intellectually bored staying at home. (Or to put it another way, I suck as a stay-at-home mom).

1. My monthly cycle is getting really wacky. I'm 44. I have extremely heavy, prolonged bleeding every month (should lose 80mg max whole period, I lose that in 1 day. Anemic and iron/vit/mineral deficient due to blood loss. I started on blood medicine a year ago an after 2 months my blood was back to healthy and normal, and I was feeling much better. Hormonally though I am all over the place, not sure how much is the perimenopause or something else. .

2. I have not been at work all week. And I will be on sick leave eventually. It is like a huge burden is off my shoulders. And I NEED, not want but actually NEED for my physical and mental health, this break. I can't keep popping sleeping pills and have my heart racing just so I can appear at the office. (Or to put it another way, I suck as a stay-at-home mom). Me too. Short term it is fine. Long term everyone is happier back in school.

My support network is a bit sparse right now, other than my dh, who's great. My best friend is undergoing chemo for early stage breast cancer. My other friend who often helps out is a work friend who's having a hard time with some reorganization in the department, and has really dialed back her work friendships, including me. Other friends are more casual and many are traveling at this time of year. I'm a bit of an introvert who needs 1-2 good friends, and I don't do well at maintaining a large network of friends. (I have plenty of acquaintances.) My family is miles away. (Closest is 80 miles, but this sister has little patience for mental illness because she suffered a lot when our oldest sister had breakdowns.)

So sorry about your best friend. That really sucks. I hope you can be with her. I know you need support, but maybe if you can give her some support it will make you feel better too. I luckily have good friends close by, but my family is overseas. And roman catholic, so the empathy there is not great as everyone should just suffer anyway and mental failings are dirty and sinful.

If you've made it this far -- help? I've started on fish oil again. I'm on my Paxil still. But I'm in a fog, can't get anything done around the house or even focus enough to play with my kids. I'm dreading this camping trip, but I'm dreading the idea of staying home for 4 days with nothing to do even more!

I'm going to look into Paxil - don't know it. My guess is that SOME of the fog is due to the lack of sleep and then the sleeping pills working in the day instead. But I don't know how to tell you to get off them. This is literally the conversation I had with my Dr. last week - Dr "It isn't good to stay up all night and get 0 hours sleep. It is not good for your body." Me "Yes, I know, and that's why I am taking the sleeping pills, so I get at least 2-4 hours, instead of 0." Dr "It isn't good for your body to take the sleeping pills, plus you can get addicted to them." Me "OK, I can't take sleeping pills and I can't stay up all night, So what is the 3rd option." Dr "well, I see your point." 

I really, really wish I could say just jog or do yoga or XYZ, and I think all these things help 1% or so, but really, I don't know. If I did, my post wouldn't look so similar. 

[LynnS6]

Allison,

Paxil has been a life saver for me. I spoke to my psychiatrist on the phone yesterday and we're increasing my dose to see if that helps. I can actually feel some improvement today already (a little more focus, a little less tension), so I'm hopeful. I know it's not a natural solution, the long term effects of living with anxiety are also really not good for my health.

My psychiatrist (whom I love) suggested that it's probably a combination of hormonal shifts due to perimenopause and the fact that I've been off my schedule for over a month. My breakdowns have all occurred when I've not been working. She said that she's seen a lot more teachers this summer because they haven't been teaching summer school (budget cuts) and they don't do well without a schedule.

I need to find my copy of Women's Moods (I keep loaning it out) and read the section on perimenopause. If you can get that book where you are, I'd highly recommend it. From what you wrote, I'd be a little concerned about Bipolar II -- the periods of hyperfocus might be a sign of that. Your diagnosis will make a huge difference in terms of what meds are good or not.

We're definitely going camping. The worst that can happen is that we need to pack up a little early and come home. I do much better with something defined to do with my days anyway, so I'd be careful about too much time off of work.

OK, my anxiety is creeping up just posting, gotta go. I'll see if I can check back later.

[AllisonR]

Lynn,

Thanks for your update. Glad you now are getting up to the camping trip. I hope it does you good! 

I will check out Women's Moods - see if I can get a copy off Amazon.

I checked Paxil on wikipedia, and among other things I read it makes your sex drive go way down, which put a huge frown on my face. DH and I have a great sex life now, after DS and DD it took a while - and to be blunt I don't want to lose it! 

Yes, I was diagnosed Bipolar - yesterday. I'll start therapy once a week, we chart my behavior for a while, then determine what drugs, if any, are needed. I am hoping none. 

You get more stressed from not working? I am having a hard time understanding this. I believe it, but just don't comprehend it. I get more stressed the more I am at work (granted it is a horrific, now useless and highly frustrating job. Ironically the job 10 years ago had the same amount of pressure, but this pressure was fabulously energetic and creative. But multiple mergers/acquisitions/stock market listings/multiple mass firings / move of headquarters later...  and that pressure becomes insufferable.

How much of the exhaustion and mental fatigue do you attribute to the lack of sleep? I NEED 9 hours, but rarely get it, and when I am either way up or way down, it is more like 3 or 4.

Have a great camping trip.

[LynnS6]

Quote:

Originally Posted by AllisonR 

Lynn,

Thanks for your update. Glad you now are getting up to the camping trip. I hope it does you good!

Thanks! I spent all of today in bed. My good friend called me after I left a message for her and I broke down and she gave me permission to stay in bed. Funny how I needed permission from somebody! We've got a date to go walking on Monday.  We don't leave to go camping till Wednesday, and I've got things to do Mon-Tuesday, so it's just getting through the weekend. I think I can do that.

I think the meds are kicking in. I haven't had a 'whole body' panic attack since early this morning. My shoulders are incredibly tight, and I'm still fuzzy. I was so fuzzy that I couldn't even read in bed. (Normally, I'm a voracious reader.) So, I spent my day dozing to NPR. Funny, that was the 'soundtrack' to my PPD too.

Quote:

I will check out Women's Moods - see if I can get a copy off Amazon.

I checked Paxil on wikipedia, and among other things I read it makes your sex drive go way down, which put a huge frown on my face. DH and I have a great sex life now, after DS and DD it took a while - and to be blunt I don't want to lose it! 

Yes, I was diagnosed Bipolar - yesterday. I'll start therapy once a week, we chart my behavior for a while, then determine what drugs, if any, are needed. I am hoping none.

Women's Moods was a book that made a huge difference in my life. It gave me intellectual understanding, for the first time, of the connection between my hormones and my moods. It's also got a great self-care program and info about when to try meds if self care isn't working.

I don't think Paxil is right for you -- it's an older SSRI, and I think it's not great for Bipolar. I did find for the first year or two that I was on it, that  my sex drive was decreased, but since I was nursing too, it's just hard to say. Since I quit nursing 3 1/2 years ago, it's not been a problem. While I understand the desire not to be on meds, I will say that they've made a huge difference in my life. I honestly don't think I could have lived with insomnia for 5 months. I slide down really really fast from "not so hot" to "I can't do this" (like in less than a week).

You get more stressed from not working? I am having a hard time understanding this. I believe it, but just don't comprehend it. I get more stressed the more I am at work (granted it is a horrific, now useless and highly frustrating job. Ironically the job 10 years ago had the same amount of pressure, but this pressure was fabulously energetic and creative. But multiple mergers/acquisitions/stock market listings/multiple mass firings / move of headquarters later...  and that pressure becomes insufferable.

How much of the exhaustion and mental fatigue do you attribute to the lack of sleep? I NEED 9 hours, but rarely get it, and when I am either way up or way down, it is more like 3 or 4.

Have a great camping trip

My job is stressful at time, but at the same time it gives me energy and focus. Maybe it's not so much that not working makes me stressed it's that when I'm not working, I've got nothing to energize me or take my mind off how I feel. My mind also needs to be pretty active, and so when I don't have enough to do, it starts to feed on itself, I think. My ideal world would be working about 30 hours a week. Enough to keep me energized, but not so much as to overwhelm.

For me, lack of sleep is huge. I know it's my trigger to slide into depression. There's good research to say that running on a perpetual sleep deficit definitely affects your cognitive functioning. But, it's likely that the insomnia is a symptom, not a cause, if that makes any sense. When my mental state is well regulated, I don't have to worry about falling asleep, except in the 2-3 days before my period. And then melatonin will often do it. However, when I start to go wacky, then I don't sleep, and it's a self-reinforcing cycle.

I hope that you can figure out something with your psychiatrist -- it sounds like a very uncomfortable place to be.

[LynnS6]

Well, I've decided not to go camping. I talked to my sister tonight. She'd been out in that part of the state and they're having forest fires, several roads that we need to take to get there have been closed off and on. While the place we're supposed to camp is 100 east of where the fires are, the air isn't good. And my kids will freak if we're anywhere within 200 miles of a forest fire.

Dh also has some deadlines he's stressed about meeting and staying home will be good for him. He actually mentioned it several days ago and I said "Oh no, I need to go."

We'll lose $120 for the camping reservation, unless I can talk them into giving me a credit or a refund. (Ds has had asthma in the past, I wonder if they'll take that as a valid reason to cancel.) I feel like a failure for not going camping. On the other hand, I had a bad day today, and the thought of doing everything needed for camping was really weighing me down.

The clincher is that my sister can come up to be with me on Wednesday, the day we were supposed to leave. I need support more than I need camping. I may spend the week in bed, but it'll be OK.

[AllisonR]

Well that is a bummer. Sounds like some of it was personal choice, and some of it was out of your control. I'm glad your sister is there to help you out. Though you said she isn't good with MI issues, so I don't know if that will be productive for you, or harmful. I hope the former. Take care.

[LynnS6]

It was good not to go. I'm not in a position to be organizing anything. We lost $50, but I can handle that. The cost of going would have been much higher.

My sister is here and helping the kids. I took an Ativan today (well, 1/2) but it didn't seem to help much. I'm afraid to take it, honestly. It's addictive, and it makes me sleepy without relieving the symptoms. My sister is helping, but she's also said some harsh things that I'm not sure I needed to hear right now. (Not untrue, but not what I needed.) On the other hand, she's cleaned my kitchen, and is helping dd clean her room.

I'm going to be looking for a counselor. It's been a bad week. I can only hope the meds kick in soon and I start feeling better. I've been feeling 'in crisis' for a week. I don't know how much more I can handle. I don't know how people do it for long periods of time.

[AllisonR]

Sending hugs your way. I hope you get some meds that work better.