Friday afternoon, I will call my HRT doctor for my blood test results. I forgot to ask him last night about a possible link between my now higher estrogen dose and depression. I will ask him about this when I call, although I suspect I will stay with the injections. My mood changes may be a temporary result of a sudden, large increase in estrogen.
When I first started treatment for gender dysphoria (aka, "Gender Identity Disorder - NOT!
) at the University of Minnesota, I was warned that taking estrogen could worsen my lifelong depression. After psychological testing indicated that my depression was in remission, my therapist dropped this warning.
There were probably several reasons why my depression was, for the first time in my life, in remission:
1. In early 2007, I started taking an older type of antidepressant sometimes used for 'treatment resistant depression.'
Danya (imported) wrote: Mon Sep 06, 2010 1:39 pm
For the first time in my life, I knew what it was like to be free of depression.
This was a medical miracle, because I had tried all kinds of drug and therapy treatments and none of those had done the trick.
As I have noted before, though, being free of depression does not equate with being happy. That came later, and to a greater degree than I expected, when I started working on my gender 'issues' at the U of M.
2. Working through my gender identity life choices was liberating. The U of M is considered one of the top centers in the world for treating transgender persons. My therapist, a young post doc, was very with it. She greeted my initial, tentative identification as a eunuch with nothing but support. As I further explored my gender identity, and it started to evolve more towards male-to-female transsexual, she was just as nonchalant as she had been with the eunuch ID. All of her responses showed she truly felt "What's the big deal, whichever way you go." She was totally into the idea of the gender identity continuum, spectrum, gradient, grid or whatever.
Back then, I went to one support group for trans people in Minneapolis. After the leader, I was the most confident and at ease person there. That's when I decided never to go to a support group again. I have no doubt that these are useful, and even life savers, for some people.
From this experience, I decided that simply having a transgender identity in common with someone did not mean I had much in common with them in other major portions of my life. While I have trans friends today, and am glad for it, I do not seek out transgender folks to fulfill a need for community. When I need support, it is as likely to come from non-trans friends as trans friends. Accepting this was also freeing and I continue to feel entirely comfortable both with trans friends and all types of other friends.
So, for at least 3 1/2 years and possibly continuing to the present I have been blessed to be depression free. I always knew this might not continue and that may be happening now. I will do everything I can to keep things going as they have been.That may not be enough.
There are several reasons why depression may become an ongoing problem for me once again. If it does, I hope to be able to at least manage it better than I did before the 'miracle' antidepressant turned my life around.
I continue to be under a lot of stress. Long-term stress can contribute to depression and physical problems.
I am under stress because my life continues to be very unsettled.
I have nothing that resembles what most adults view as decent living quarters. Renting a room in someone's home is not so much the problem as the physical conditions in this townhouse. My roommate asks why I seldom cook at home. I have not told her, although it would be better if I did, that it is because she does not keep a clean kitchen. She leaves dirty pots and pans on the stove. To discard vegetable filled broth, she flushes it down the toilet. The counter tops are never clean.
I don't have enough space for my clothes.
This can be a big deal for a woman.
My roommate's cats, who do not get along with each other let alone me, leave fur all over the place. My roommate seldom vacuums her areas of the house. There are times when I do this for her.
When I got home this evening, my roommate was nowhere to be seen. The cats acted like this was their worst nightmare come true.
Here they were, as usual avoiding each other, and dependent on me for dinner.
Once I have recovered from GRS, and have found another job, I will move to better living quarters. I will probably continue to have a roommate until I land a more stable job. After that, a small apartment will be great.
My job situation continues to be up in the air. I am grateful I was able to find a second contract job very quickly. The fact that once I posted my resume on the internet I was deluged with recruiter calls gives me the confidence I need to go ahead with GRS as scheduled. After surgery and recovery, I will do whatever it takes to land another job very quickly. That may mean moving again and I will do that if I must. Moving, though, is a another major life stressor.
Then there is the stress of continuing, high monthly expenses for electrolysis culminating in the huge expense of GRS. As long as these continue, I am unable to save much money. In fact, I am using a significant portion of my life savings to proceed.
For electrolysis, I decided there was no option but to go ahead. I know there are transwomen who hold jobs, and some that even find jobs, before starting electrolysis. When I transitioned on the job in Minnesota, I had completed nothing but ineffective electrolysis treatments. After being laid off, I concluded that my long-term economic goals were best served by being well along with electrolysis before starting a new job. I had far too much facial hair, some of it very dark.
I agree with people who say none of this should matter. In an ideal world, or at least in a less rigid culture, it wouldn't.
The latest stressor may be my greatly increased estrogen dose. Until now, estrogen served only to elevate my mood. I felt calmer and more at ease with myself. Now, however, it seems like for the first two - three days after taking an estrogen shot, my mood plummets. This is just the danger my U of M therapist warned me about. If the rest of my life were on a more even keel, perhaps there would be no problem. I will follow-up with my doctor and, if necessary, go back to a lower estrogen dose.
I need to be very careful with depression. By February, when I will be without insurance for a few weeks, and April surgery time when I may have no insurance, I won't be able to afford my 'miracle' medicine. The co-pay alone is outrageously high. The cost, without health insurance, comes to more than I pay in rent each month. This is not my most expensive medication, either.
Last week, I spoke with my psychiatrist about switching to the much less expensive pill form, replacing the 'patch system' I now use. There are serious side effects with the pill, however, requiring very strict dietary precautions. One error, and your blood pressure can sky rocket.
He wrote a prescription for this pill. Since then, I've decided I do no want to deal with broad range of diet restrictions. Or the possibility of sky rocketing blood pressure if I happen to eat meat that is slightly spoiled, or forget to avoid snow peas, chocolate, caffeine and a long list of other foods. I am also concerned that I would eat a meal I did not prepare, only to find it contains something very bad for me.
Most likely, I will abandon my miracle cure for depression in favor of something I can afford like generic Zoloft. I am concerned, though, about the time it will take to get off the drug I use now and the weeks it will take for Zoloft to start working. When I'm trying to make a very good impression at a job that could become permanent, I need to be in a very good emotional condition.
In the past, when depression got really bad, strenuous exercise helped. During my first episode of Post Traumatic Stress, I exercised 2 to 2 1/2 hours every day only stopping when my mood lifted. So I am motivated to do whatever I can to avoid or alleviate depression.
The cost of GRS is high, about the same as purchasing a moderately priced car. When I look at it that way, it helps. And while I do not expect GRS to magically change my life [I know, right now, that I am beyond a doubt a women] it will open possibilities in my life. If I one day meet the right man, I will be able to enjoy intimacy in the same way a natal woman does. I know, too, that I will feel more complete.
When I transitioned on the job, I never imagined I would be laid off a little over a year later. When that happened, I never thought I would lose my townhouse. Early on, I never imagined I would quite deliberately research my options in other parts of the country and then act on my conclusions. When I moved to Illinois, I doubted I would be without a permanent job after my COBRA health insurance benefits ran out. Everything is continuing to change and, just like most people, I find it difficult to deal with change. Over the last 17 months, practically everything in my life has been upended. Although I initiated some of these changes with my eyes wide open, I knew these, too, would be stressful. In the end, I do what I think I must for my long-term good. Even when that means temporarily introducing more upheaval to my life.
The one constant comfort is that I know who I am, a woman. I am able to live my life the way I want, even if my financial circumstances have drastically changed. This keeps me going through the occasional days when I wonder if I've made all the best choices after all, when I have major doubts about my current career path and the other rare times when all I want to do is give up. Even then, if I cry to release my emotions, the next day I am fine.
I panicked at the office today. The job seemed too easy and that bothered me.
I thought I must be overlooking something important. This was also the day after my estrogen injection, though, which may be affecting my emotions.
On the drive home, I listened to Elgar's "Enigma Variations" and once again escaped into music. Each variation is based on his perceptions of a friend. My favorite has always been variation 10, "Nimrod." It has a haunting, almost elegiac quality that is nonetheless quite lovely and deeply moving. Elgar wrote this variation when he was himself depressed. He wrote fine music; I write posts on EA.
By the time I arrived at the house, I was calm and confident again. The music had worked its magic on me. Writing here tonight has made things even better.
How strange and marvelous this thing called life is.
If I behave like a hussy now and then, I probably will not report it here.