Susan's Place Transgender Resources

I have had social anxiety since I was a child.  Since starting hrt it has slowly become worse.  I tried to go grocery shopping three times in the last three days and each time ended up not being able to get out of my car when  I got there.  I have had a panic attack at work almost everyday the last few weeks.  I don't understand what's going on.  It never used to be debilitating but I feel like I'm getting close to not being able to go anywhere but work and my apartment.  It feels so debilitating.   It didn't start to feel like it was getting worse until I started hrt.  I'm so frustrated :(  Hrt makes me feel more like me and normal.  How can it be increasing my anxiety as well?  Has anyone else dealt with anxiety on hrt?  Does it go away?  Should I ask my Dr for anxiety meds at my follow up?  Do you think she would take me off hrt if it is increasing my anxiety? God, that would devestate me.

I noticed after getting into transition, which included HRT, that I would get more anxious about being misgendered and having my dysphoria triggered.  I think that's perfectly normal, and HRT simply coincides with that, rather than causes it.

Some of my friends have said that adding progesterone to their regimen helped them feel more calm and stable.  I personally had the opposite reaction, though, so YMMV.

And, of course, there are other medications that can help with anxiety in particular, if you're reticent about coming off HRT.  Regardless, it's something to discuss with your doctor.  Or perhaps starting with your therapist -- it might help to more precisely identify what you're actually anxious about before turning to a change in medication.

+1 on the therapist. I've had really bad social anxiety all my life until I saw a therapist and a doctor for it and the obvious gender issue. I currently take the generic version of zoloft for my anxiety, and have been taking it since before starting hrt (my therapist also is on zoloft). It has certainly helped. I used to be basically mute all up through high school and college. And I've had the opposite reaction to hrt; I've found it's lessened that anxiety for me even more. But like said above, talk to a therapist or doctor and get any help you need from them.

When first starting HRT I noticed far greater emotional lability and capacity.  Like going from black and white to technicolor movies.  Part of what came with that was learning my new range and responses are OK too.  I had panic attacks about forgetting my medication and about being vulnerable to haters.  I never worried about just walking my dog after dark when living as a man.  I still think of this as a second chance puberty and I certainly recall my once teenage daughter going through all kinds of clothes, appearance and yes anxiety issues as her sexuality and identity emerged.

There is a learning curve and I hope you will cut yourself some slack about how dynamic we can be.

When I started HRT I thouggt the T would cure my social anxiety but nope. I felt calmer on T but the anxiety was still there. I've had it since I was a child so it's seperate from me being trans. I think bcos my dysphoria was under control and didn't become my main focus it made me more conscious of the anxiety. Going to therapy had helped massively (cognitive behavioural therapy) as it taught me what causes it and ways to cope with it.

So definitely recommend therapy and then maybe anxiety meds if therapy doesn't completely help you. A competent doctor shouldn't talke away your HRT as it has obvious other benefits for you mentally.

Progesterone is also a hormone that has anti-anxiety effects due to its metabolites, namely, allopregnanolone.

Quote from: Tessa James on November 01, 2016, 05:50:02 PM
When first starting HRT I noticed far greater emotional lability and capacity.  Like going from black and white to technicolor movies.  Part of what came with that was learning my new range and responses are OK too.  I had panic attacks about forgetting my medication and about being vulnerable to haters.  I never worried about just walking my dog after dark when living as a man.  I still think of this as a second chance puberty and I certainly recall my once teenage daughter going through all kinds of clothes, appearance and yes anxiety issues as her sexuality and identity emerged.

There is a learning curve and I hope you will cut yourself some slack about how dynamic we can be.

Oh, puberty.  The first one was horrifying.  Hopefully, this one won't be (I have a feeling it won't ;) ).

I think perhaps I am judging myself too much.  I am worried I am not doing this right.  I am worried I am going to fail at transitioning, whatever that would mean.  I was told so much growing up that gay and trans people were disgusting that sometimes I really do believe that's what people think about me.  It's so hard to let anxiety go.

I've had social anxiety for a while. Before I started HRT , I was on Xanax for a while. Now that I'm on hormones it has gone down significantly. Talk to your doctors about it medicine if your not on it. If you are you need some therapy time or meditation. Meditation and medication help me personally .

Love,
Alexis

I think most of us at the beginning go through that. Sometimes it can creep up on you down the road.  I think it's just normal. Eventually, you'll feel more at peace with yourself and that will dissipate. I still take a little bit of Buspar to help with things.  I recently had FFS and it made a HUGE difference.  I am not concerned with my looks as I once was (trying to hide that manly brow I once had). 

Have you tried looking into support groups in your area?  Maybe talking to others that are in your same situation might help.

HUgs

Progesterone is known to have anxiolytic effects due to the action of its metabolite allopregnanolone (and pregnanolone) which is a GABA agonist.

Prog Neurobiol. 2014 Feb;113:79-87

"certain 3α-reduced metabolites of progesterone such as 3α,5α-tetrahydroprogesterone (allopregnanolone) and 3α,5β-tetrahydroprogesterone (pregnanolone) are potent positive allosteric modulators of the GABA(A) receptor complex."

"Reduced levels of allopregnanolone in the peripheral blood or cerebrospinal fluid were found to be associated with major depression, anxiety disorders, premenstrual dysphoric disorder, negative symptoms in schizophrenia, or impulsive aggression. The importance of allopregnanolone for the regulation of emotion and its therapeutical use in depression and anxiety may not only involve GABAergic mechanisms, but probably also includes enhancement of neurogenesis, myelination, neuroprotection, and regulatory effects on HPA axis function."

J Neuroendocrinol. 1995 Mar;7(3):171-7.

"Previous studies from this laboratory have shown that progesterone (PROG) treatment in ovariectomized rats produces an anti-anxiety response similar to that observed after the administration of prototypical anxiolytic benzodiazepine (BDZ) compounds. The PROG-induced anxiolytic response was highly correlated with an increased level of 3 alpha-hydroxy-5 alpha-pregnan-20-one (allopregnanolone) in the blood and brain, and was also associated with a facilitation of GABA-stimulated chloride ion (Cl-) influx in cortical synaptoneurosomes. This correlative evidence suggested that the anxiolytic effect of PROG was a result of its in vivo reduction to the neuroactive steroid, allopregnanolone."

Neuroendocrinology 1993;58:478–484

"Progesterone is readily reduced in humans to its A-ring metabolites, allopregnanolone (3α-hydroxy-5α-pregnan-20-one) and pregnanolone (3α-hydroxy-5β-pregnan-20-one). The latter have been reported to have anxiolytic, hypnotic and anesthetic actions when administered to laboratory animals and (or) humans."

I can personally vouch for its efficacy.  ;D