Can menopause cause new psychiatric symptoms?

QUESTION:

Dear Good Doctor,

I'm a female and when I turned 40, was placed on Prozac for PMS & some depression.

Is Paxil good or bad for GAD if I also start on BuSpar.  Would Celexa be a better option (along with BuSpar).

This year I've missed 3 periods & believe I've entered pre-menopause.    I developed G.E.R.D.  (gastrointestinal acid reflux disorder) in June and am on Prilosec.

My problem is lately, the Prozac seems ineffective, and now I'm becoming anxious, introverted, withdrawn, nervous, and even a little compulsive!!

I've had major stressors nearly every year of my life, especially in last 7 years, with last year being worst.  I have a good job as legal secretary & like my boss & co-workers and have low stress there.

Is it possible the hormone fluctuations could be causing me to develop an anxiety/nervous disorder?  To tell you the truth, I think something like a mild tranquilizer is more what I need.  I've always bitten my nails, but lately I'm simply frazzled daily.

So basically question is this: can PMS/depression change with premenopausal hormonal changes to premonopause/anxiety disorder?  And if so, what medication would you recommend?  Thank you

ANSWER:

Hormone fluctuations or lack of hormones can cause many anxiety and depression symptoms, or worsen previously mild symptoms.

My screening test ( http://www.BiologicalUnhappiness.com/screen.htm) could be of assistance in making the other diagnoses that may be present, and worsened by your hormonal problems.  Once the diagnoses are made a comprehensive medical treatment can then be made.