Well it’s totally up to you who you listen to. He’s telling you this for a reason. He sees thousands of women and understands better than anyone here what would happen, perhaps he thinks you weren’t on the higher dose long enough for it to affect you this much? Your colleagues don’t know what might happen with combining the medications for anxiety/depression & HRT, but your specialist will, he’s also aware of more of your case history. We do know our bodies, but as you keep asking questions daily maybe you don’t understand enough about menopause and HRT? That’s why you see him, right? If you’re carrying on with the patch as advised, then that’s what he wants you to do isn’t it? Perhaps it would still help you to listen to what he says about it being psychological and seeking extra help, outside of work, for that. You are testing a lot and seeking a lot of advice, you may want to pause and think if doing that is helping you or just confusing you.