I'm sorry you are feeling this way again. I'm very close to your age, I'm 47, and we sound like we have had a similar OCD/anxiety flare-up. I too thought that perimenapause might have something to do with what I went through but not entirely. I was doing well for years and this past May I had a trigger, septic system died, and I went over that OCD cliff once again. I wasn't anxiety free or OCD free those years prior to May but it was managable like you have been with your depression.
In any case, I'm wondering if there is a trigger that you may just not be aware of. Or if you thought about it, maybe you can pinpoint something. In any case, we are where we are.
It is good that you are going to try celexa. As you probably already know it takes a good 4 to 6 weeks to really start to see the full benefits from the medication. I took klonopin during that time to help with the more anxious days. That might be something to discuss with your doctor...a benzodiazipine to help with the crisis times. I myself prefer klonopin to Xanax. But worth talking to your doctor about.
I also had to fall back on my CBT training from years ago. I had to breath my way out of panic attacks. I had to practice replacing my negative thoughts with positive ones on paper. I had to imagine pulling a red handle and say STOP in order to halt the catastrophizing process in my head. Did you ever learn CBT?
For what you are going through I think that for now you need to just be aware of when you go to pick at your nails, you have to stop yourself in anyway you can. If it means wearing socks on your hands when you are at home...then do that. Don't think for a second it is ridiculous. Our minds are capable of making us do the most irrational stuff. Imagine pulling that red handle and say STOP. When you have anxiety because you cannot pick at your nails, practicing your breathing. if you don't know the technique let me know.
Lastly, and mostly importrantly, you know you can get better. You did it before and there is absolutely nothing stopping you from gettng better this time. This is a momentary bump in the road. I knew I would get better this past May, I just knew it was going to take a while. And here I am back to my old self again...on meds of course, but who cares. I'll take them for the rest of my life if I have to.
So hang in there, think positive thoughts, and try very, very hard to stop yoursrelf when your hands go to your feet. Try the socks when you are at home.
I hope I have been of some help and comfort to you. With the right help, the right medication, you will get better! Just in case you find that Celexa is not for you, I take Wellbutrin. It has less side effects overall but again, each medications works differently for each person. My first medication was Prozac years and years ago and that worked too.
Take care and keep me posted with what I know is going to be progress!
Sorry, I clicked the best answer button my mistake and I wasn't done typing my post...now I have to start over again since what I was typing disappeared.