Is this the start of menopause or something else?

[Yorkshireteaalwayswins]

Hi all. I’m 43 and have suffered bouts of depression and anxiety for most of my life. I have been on sertraline for 10 years, mostly successfully but I did have to increase my dose two years ago.
Until a few months ago I hadn’t suffered any anxiety for about 14 years but on holiday in May, I had it badly for a few days. It’s not like a panic attack but like days of racing heart, nausea and general panic. I can’t focus on anything or sleep. Once home, it dissipated but it just started a few days ago again.
I have noticed that each time has been in the week leading up to my period and I’m trying to work out if this is a link.
I’ve wondered for the last year if I was heading into perimenopause as I have definitely had brain fog and my periods are very light and short but I don’t know for sure. My mum went through the menopause in her early 50’s but my sister (47) has endometriosis, triggering early menopause, and has had a full hysterectomy in the last 6 months so I don’t feel I have anyone to directly compare myself to. I am child-free and on the pill so don’t know about endo in myself.
Can anyone advise? Do I need an antidepressant review? Is it time to ask about HRT?

I should have also said that I have been taking mounjaro for 5 months but I am stopping now due to cost but also in case this is having any kind of impact.

Could it not be that your antidepressants have lost their effectiveness and you need a new type? Ten years is a long time. If you have pre existing mental health problems, hrt is not the miracle cure you may expect it to be. Imo, it helps with hot flushes but little else.

Also, have you considered whether you might have ADHD? In women it can often present as lifelong anxiety & depression.

As Oestrogen mitigates some of these symptoms, they worsen during peri / menopause.

This is something I’m wondering as I had to increase the dose two years ago for no reason that I could think of. I hate the idea of changing medication as I know how hard it is but if this one is losing its effectiveness, then it would be the next step.
It’s useful to hear that it hasn’t been as effective to you as you thought it would be and I am sorry to hear that. I hope you’ve found something else to help with other symptoms.

Thanks for this. It’s odd but I’ve seen some symptoms of adhd that I really identify with but others that don’t seem ‘me’ at all. It may be something I have to look into some more. I didn’t know that peri/menopause could exacerbate the symptoms so that’s interesting.

If it started a few months ago and you have been taking mounjaro a few months while nothing else has changed, it's likely the mounjaro. Not listed as a side effect but hundreds of women have reported increased anxiety and the jitters from being on it.

Now you've stopped it your symptoms will probably go away.

Practically everyone has some symptoms of ADHD.

I have wondered about this. “Low mood” is mentioned as a side effect but I don’t think it’s spoken about enough. I disclosed my antidepressants when I applied so maybe it could have flagged as an increased risk but I suppose that’s on me to monitor my mood.
I can’t afford the jabs now anyway and it looks like it could be for the best.