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ER+, menopause, and severe depression

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Good evening all,

I had a stage III ER+ diagnosis in 2004, so incredibly fortunate to be 18 years' NED last February. Here's the thing, I refused oophorectomy because I was terrified about quality of life by going into instant menopause at age 35 after having extremely high estrogen since birth I guess. I spoke with a number of high estrogen, younger women who had horrible effects from ooph and I felt like it was just too much. I always figured I would be better off going in to menopause naturally, if that time came for me. So, that has apparently now happened, or I'm at the end of perimenopause, and I am in the most severe depression of my life. Add to that, everything that could possibly go wrong has, all at once, like things go sometimes, but what has changed is that I am completely incapable of getting out of this funk.

I took Celexa for panic attacks for about six years, these started during chemo and finally became so disabling that I tried meds, which worked great. Recently, maybe last 6-8 months, I have entered a depression so severe that I am unable to cope. I was started on buspar with the Celexa, then Celexa was stopped and Prozac added to buspar. No improvement. Prozac dosage doubled. No improvement. Now wellbutrin is going to be added to Prozac. All the while, I'm thinking this is definitely hormone related, but of course I am not a candidate for HRT. I'm wondering, has anyone tried a low dose ER for severe depression, because nothing else was working? I am more sure than ever that passing on the ooph was the right thing for me, but if this is how I'm going to feel from now on, I don't feel like I want or am able to do it. This is not a life. I know an ER+ person asking for estrogen sounds crazy, but I feel that I have gone crazy and if small amount of estrogen would stop this, I wouldn't hesitate as of today. Anyone have similar experience or thoughts? I would really appreciate hearing them!!

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  • sunshine99
    sunshine99 Member Posts: 2,627
    edited June 2022
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    mpetago, what about a consult with BOTH your MO and your PCP? I know that my PCP (years ago) suggested a hormonal supplement, but my MO freaked out (sort of.)

    There has to, or should, be some balance between risk of BC recurrence and your quality of life. If you're living and trying to cope with severe depression, then one would hope that there has to be SOMETHING that would help.

    I'm so sorry you're having to deal with this.

    (((hugs)))

    Carol

  • gladis
    gladis Member Posts: 43
    edited June 2022
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    Mpetago, my heart goes out to you.

    Panic attacks are my side hustle and depression knocks like a demented neighbour.

    (I try to use my humour even though my daughter tells me i'm not that funny)😔

    My very best friend is battling something similar.

    ...would you consider edibles? The right strain will give you a cerebral lift while you still function normally.

    (My bf can not as she is a single parent of a severely handicapped son.

    She is on prescribed meds, which they are changing, again- as it 'muted' her personality -hard)

    Hug!

    Gladis

  • mpetago
    mpetago Member Posts: 54
    edited June 2022
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    Thanks for the responses ladies! Ugh, I wish edibles worked for me! I've tried cannabis products enough times to face the fact that it is just NOT my friend lol The only thing it does for me is cause extreme paranoia that allows me to focus on remembering to breathe for ten hours instead of just being depressed. And that's on a mini dose.

    I really feel like as I look back at the times I've really struggled mentally, it was always related to some type of estrogen suppression as opposed to life circumstances. First for endometriosis in early 20s, then for breast cancer in mid 30s. When I finished my five years of tamoxifen (with monthly lupron injections for awhile because my period would not stop for anything), I felt like a new person, or my old self at my absolute best. And my estrogen levels were scary high again, like the level of a pregnant woman, except I was early 40s and not pregnant.

    This, plus reading that perimenopause and menopause can throw some women into severe depression due to hormone levels, is making me wonder about trying a small amount of estrogen replacement. Not even sure I could find a doctor to prescribe it, but if none of these drug combos work, and so far they aren't, I know I can't continue this way. My life is falling apart and I can't do anything but lay in bed staring at my walls. Oh, and picking my skin til it bleeds every day, that's the one new hobby I've picked up.

    As it stands today, if someone said you can feel like yourself for ten years but then you're getting breast cancer again, or you can just feel this way for the rest of your life, no question I'd take the estrogen and the cancer. Maybe this lasts awhile and then gets better, even for super high estrogen women, I don't know. I'm the only high estrogen woman in my extended family, everyone else had early hysterectomies or normal menopause (no breast cancer) and said they were fine afterwards. Doctor and psychiatrist aren't really hearing me, I brought up the possible hormone connection and they basically said, 'oh yeah, maybe, interesting.' Pretty much the way those interactions have always gone. 🙄

  • mpetago
    mpetago Member Posts: 54
    edited June 2022
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    I wanted to throw out this info I've found for anyone interested. A medical oncologist, Dr Bluming, co wrote a book called Estrogen Matters where he thoroughly debates the alleged dangers of HRT after menopause and argues strongly in favor of the substantial protective benefits it offers, EVEN in women who've had breast cancer. He also just had a journal article published in Cancer Journal called HRT after Breast Cancer, It Is Time.

  • sleepylibrarian
    sleepylibrarian Member Posts: 9
    edited August 2022
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    Hey, this is a late response because I'm new here and just scanning thru topics, but as someone who has been coping with moderate to severe depression and anxiety since early childhood, here's my two cents: it isn't unreasonable to choose quality of life over lifespan, but you should completely exhaust your other treatment options first before you choose that. My suggestions are:

    1) Try psychedelic therapy with psilocybin. The clinical trials being run on this are showing response rates, efficacy, and durability of response that is light years beyond any currently approved antidepressants, including in a trial with metastatic cancer patients. If you are in Oregon, you can do it legally and with the guidance of a pro, but natural psychedelics have been decriminalized in a number of other jurisdictions, and are on fall ballots in even more this year. (They are typically a low priority for police enforcement regardless), because they are not addictive and so do not drive crime, violence, etc.

    2) Try more antidepressants. Try at least three and try different kinds. I have tried at least nine antidepressants, and only responded to four (if I'm even remembering the whole list). Sometimes with even very closely related drugs, one will work and the other will do nothing. One of mine stopped working after several years of efficacy, and it took me three tries to find another one that worked. We don't know enough scientifically to know why. You just have to pay medical dartboard, try to hit that bullseye blind.