My PMDD/Panic Attacks have shifted

As if it weren't hard enough...my PMDD symptons have recently shifted. I used to get panic attacks during my lutal phase like clockwork, and about 6 months ago they shifted to happening during ovulation and now they are starting in week 1. If PMDD is caused by a sensitivity to progesterone shifts, what is going on with me? I'm 46 so maybe perimenopause is kicking in and playing little games with me? Anyone else have a panic attack cure? I used to take high dose progesterone but not sure if that's still appropriate to do this early in my cycle. I also take 10 mg Sertraline, Ashwaganda, B6/12, D/K, Lithium and lots of good old THC but all of this doesn't always work. And I mostly get panic attacks while sleeping which absolutely kills my day. Thanks sisters for any advice.