hi Sir/madam I have gone through your question and understand your concerns According to the history provided by you, I came to a conclusion that, your suffering from stress related disorder which includes both depression and anxiety disorders.Sleep disturbance is one of the main symptom of the above mentioned problem. Regarding treatment: if I were your treating psychiatist, I would choose other drugs in the antidepressant group leaving paxil and Zoloft. it includes 1)SSRI like escitalopram 2) mirtazepine 3) SNRIs like desvenlafaxine 4) NDRIs like bupropion For aborting acute attack, you can use benzodiazepines like clonazepam Regarding sleep disturbances, I prefer benzodiazepines for short duration of time (or) mirtazepine itself gives sleep without any addon drugs. I also recommend you to add cognitive behavioural therapy as an add on present treatment If all individual drugs fail, adjuvants can be included to present drug like thyroxin or lithium I would also recommend you get investigated for thyroid abnormalities with serum T3,t4,TSH levels last but not the least, as your problem is related to stress, practice stress relieving techniques like relaxation and breathing exercises, mindfulness, regular physical activity, following sleep hygiene techniques which all acts as stress reducers.