Thank you for giving us your story Ladyturbowrx - things seem a lot more clear now.
HRT is probably the right thing for you but as you are peri meno the patches were probably too high a dose - I had this problem when I tried the combined patches in my peri stage - I felt really awful.
The roller coaster of the peri meno stage can play havoc with our mood, sleep etc. - do be aware that many women suffer in this way so it is quite normal and you will get your life back - you just need the right treatment to get you through.
It also sounds to me as though you are suffering some depression, possibly meno related but also to do with what's going on in your life right now as well.
Getting the flushes and poor sleep under control is very important and only HRT will truly sort this.
Can I suggest you ask for Oestrogel with a separate progesterone (either Provera or Utrogestan) as this will give you the chance to start on a low dose and only increase as you get deeper into menopause.
The Oestrogel is applied each day either morning or evening and I would suggest you stick with one pump per day as this is a low dose and will very gradually build your oestrogen and make you feel better. Here is the info about the Oestrogel which you should print off to show you GP:
http://www.menopausematters.co.uk/treatafter.php - it's at the bottom of this page.
Just to say the standard dose is 2 pumps per day but I think you should start on a lower dose of one pump per day as I did in peri meno.
The progesterone has to be taken for 10-12 days each month and will result in a withdrawal bleed a day or two after you finish the progesterone tablets. Here is the info you can print off to show your GP:
http://www.menopausematters.co.uk/to_progestogens.php - both Provera and Utrogestan are well tolerated generally although Utrogestan can make one feel very sedated so I would possibly try Provera first.
I also think you may need to go back on Citolapram again for a few months to get back on track emotionally as the HRT could take some time to deal with this.
Don't give up on HRT - it is trial and error. You may also like to ask for some CBT to help you for the longer term when dealing with the depression - it can really help.
Keep us posted DG x