Mental illness and transitioning

[Sir Real]

So I am mentally ill.  I'm not entirely sure what's going on yet (who knows when I'll be back to a psychiatrist) but it includes depression, psychosis, and dissociation for sure.  The endocrinologist didn't even ask why I was taking my cocktail of meds, he just wanted to know what they were, so no worries there.  But I've heard a lot of people say how when they started hormone therapy their mental illness started to go away too (namely depression that I've seen).  I'm just curious what people have experienced.  My therapist seems to think that everything I'm going through is because of dysphoria, but of course I won't know for sure until the right hormones are flowing through my veins.  But this is making me wonder about 2 things. 1) the stress of being in the wrong role causes mental illness and going to the right role lessens or cures that and 2) there seems to be a connection with starting the actual HRT - perhaps the brain is designed for a certain hormone and when it gets the wrong one goes haywire and correcting that makes the difference? I know that this doesn't apply to everyone since everyone has different choices on how far they go in their transition and different things make different people happiest.  I mostly mean people who at least need to take HRT and live in the role of the opposite assigned at birth.  Anyways, I know they'd need actual studies to verify but it's interesting to think about.

I'm just curious about everyone's personal experiences.  Were you diagnosed with a mental illness? Did it seem to get better, worse, the same on HRT or other parts of transition?

[FTMDiaries]

I haven't been diagnosed with a mental illness, but I have had major bouts of depression and anxiety over the years, caused by my dysphoria. These have completely evaporated now that I'm on T. I'm much calmer, more sociable, rarely anxious, and I haven't had a bout of depression since last year.

There is plenty of anecdotal evidence to suggest that this is common amongst transsexuals. Indeed, at my GIC they've noticed that both FtM and MtF patients seem to respond very positively to hormonal treatment.

And there are actual studies that have verified this. Here are just two examples: http://www.ncbi.nlm.nih.gov/pubmed/24275005 and http://www.ncbi.nlm.nih.gov/pubmed/23574768

[Jessica Merriman]

Hi Evan. Originally I was diagnosed with PTSD (career caused), depression, anxiety, high blood pressure and insomnia (severe). PTSD flashbacks and nightmares were several times daily. After HRT I have normal blood pressure, no PTSD events, happy, no anxiety or depression and just plain feel great all around. I fall asleep within minutes of laying down and sleep all night long. I believe HRT saved my life because I was headed for a stroke or MI quick. My symptoms were relieved about the second day of HRT. 

[Klaus]

Thanks for the link, FTM Diaries. That looks like a promising study. Evan of Spades, I'm largely in the same boat you're in, about to begin HRT with diagnosed OCD, bipolar disorder and anxiety. I've also heard a lot of anecdotal cases where HRT treated various mental illnesses, although I don't have high hopes for being able to go off lithium or anything. A considerable reduction in anxiety levels would be awesome, though.

Even though I'm pre-T I did notice a serious change in depression and anxiety immediately once I started passing (or at least trying to pass) full time as male. Just being able to be honest about something as simple as the clothes you wear is a huge weight lifted, so I'm not surprised that so many see such massive changes with HRT. Hopefully this is going to trigger a lot more studies in the future.

[spacerace]

I'm just curious about everyone's personal experiences.  Were you diagnosed with a mental illness? Did it seem to get better, worse, the same on HRT or other parts of transition?

I have bipolar disorder and have been on T for ~9 months. It stayed the same. My grandmother had it as well, including the psychosis, so mine is not related to dysphoria I believe - it is strictly chemical and genetically based. I didn't expect it to improve.

Now, my social anxiety has lessened considerably. I don't need anti-anxiety medication anymore.

I would wager that the people who have their mental illness clear up are people with depression and anxiety because of all of it. Additionally, if someone who has to deal with disassociation, that could go away too once you are stable with your true self. The same could be said for someone diagnosed as borderline.

[Adam (birkin)]

Hi Evan. Originally I was diagnosed with PTSD (career caused), depression, anxiety, high blood pressure and insomnia (severe). PTSD flashbacks and nightmares were several times daily. After HRT I have normal blood pressure, no PTSD events, happy, no anxiety or depression and just plain feel great all around. I fall asleep within minutes of laying down and sleep all night long. I believe HRT saved my life because I was headed for a stroke or MI quick. My symptoms were relieved about the second day of HRT. 

Reading your posts always makes me so happy. I love how healing transition has been for you and how happy and collected you are now!

For me...getting on T definitely sorted something or other out. No one (doctors or therapists) were able to find out why my emotions were like this huge rollercoaster. I'd feel all the extremes over the course of one day. I'd go from blood boiling angry, to deeply depressed, to bouncing-off-the-ceiling deliriously happy all in one day, and for no identifiable reason. When I started T that went away in about a month - the only time, and I mean the only time, those feelings returned were when I had to go off T for 2 or 3 weeks last year. I had been on gel so my levels plummeted after 3 days or so.

I still have anxiety, and it's a constant struggle. I can't comment on whether or not T made it better. But I do feel that, for the most part, I am much more balanced and healthy now than I was before. And everyone else has noticed too.

[ErinS]

I was completely emotionally unstable most of my life, and even once I began to have an inkling of my true issue I did everything I could to suppress it. I went to several therapists and psychiatrists and described my symptoms without mentioning the source, and basically convinced them I was bipolar and asked to be medicated for it.

The meds helped, and I tried to avoid dealing with the real cause. But I basically reached a point in my life where I had the courage to face my trans feelings and immediately a big chunk of my problems went away. I ended up quitting those meds, starting HRT, and my symptoms disappeared and I've never been happier or more stable.

As always, YMMV.

[Incarlina]

I've had seasonal depressive disorder the last 25 years. HRT immediately made things better, but the last winter it came back in a new and stronger shape. My endo suspects it's a thyroid issue this time. While waiting for a new diagnosis my "mild depression" has been temporarily upgraded to "mental disability". The depression is gone again, but physical and mental fatigue remains.

During the deepest part of the depression and anxiety I started fearing that HRT would turn out to be the problem, but no doctors have suspected that, since it initially delayed the onset of my yearly depression, and because I'm now happier than ever before even with this fatigue.

[Teela Renee]

My depression went away. But by PTSD (non gender related) Got alot worse.

[PidgeTPN]

I have anger issues, when something upsets me I can get very volatile and confrontational, while steadily on HRT I notice that all goes away and I become FAR calmer. My grandmother was the first to notice it because we used to get into fights over the littlest things, she also has anger issues but her medication doesn't tend to help her that much. She noticed that it takes me longer for an upsetting situation to make me go off.

[Edge]

I've been diagnosed with bpd (currently considered in remission) and have symptoms of ptsd. While T does have an overall positive affect on me mentally, I am still nuts due to the fact that my mental problems are mostly caused by something other than gender dysphoria.

[sad panda]

I'm currently dx BPD (though my therapist things I might have a deeper dissociative disorder) and GAD, and actually found that my issues got worse on HRT, though I had just left my family at the time which was a major life change for me.