Perimenopause can be a period of increased risk for both anxiety and clinical depression. Individuals with a personal or family history of depression may be at the greatest risk for a recurrence or new episode during this transition. These feelings are not simply a reaction to life stress; they are intrinsically linked to the hormonal changes that impact brain chemistry and neurotransmitter function. Symptoms can range from feelings of apprehension, nervousness, and tension to a persistent sad or empty mood that interferes with daily life. It is crucial to understand that these are real, treatable medical conditions, and one should not hesitate to speak with a primary care provider or a mental health professional for evaluation and support.