Hi LizzyT
There is a lot of information about the risks and benefits of HRT on this site with up to date information in particular here - about the risks and benefits.At your age benefits are thought to exceed risks.
http://www.menopausematters.co.uk/balance.phpThere is also a good Menopause Matters magazine article about it here which talks about the cancer risks and the evidence - some of which is flawed and depends on how old you are when starting and probably on the type and mode of delivery of HRT:
http://www.menopausematters.co.uk/article-hrt-risks-and-benefits.phpAs for bio-identicals. In US this often means very expensive private practitioners prescribing compounded hormones, which have not been shown to be more effective or better than the stanrdard bio-identical hormones generally available. In US Dr Elisabeth Vliet clarifies this issue - here is a link to her youtube talk:
http://www.youtube.com/watch?v=9XfpAATJkC8In UK we get bio-identical hormones free or very low cost (ie standard prescription charge) on the NHS - the oestrogen as estradiol, and progesterone as micronised progesterone. I have used bio-identical hormones for most of the 7 years+ I've been on HRT - and have never been to a private consultant ie you don't need to pay for a naturopath to get hormones which are bio-identical to the hormones our body produces. The same compounds are available in US but sometimes have different names. You should be able to get the right products through whichever doctor or gynae you visit with your health insurance.
You have to take any horror stories with a pinch of salt - if you and your lifestyle are otherwise healthy, and there is no medical reason not to take hRT then why not give it a try.
Anti-depressants are not recommended as the first line of treatment for hormonally caused anxiety and especially not hot flushes!
HRT is replacing a deficient hormone and provided you choose the right type, is more natural than taking drugs such as ADs (which are beneficial for those who cannot take HRT or who suffered from anxiety throughout their life or for reasons other than hormones ie life events etc).
Hope this helps!
Hurdity x