### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
i have anxiety and depression . I been seeing a doctor every three months for years. About six months ago he put me on prozac 20G didnt seem to help so he increased it to 40G a day. Unfornately I notice the past month or so I have been getting more depressed. I get up in the morning do my chores and then back into the bedroom to watch tv until its time to sleep. I feel like a walking robot - same thing day in and day out. I have been through alot the past couple of years; and I dont know if my current situation is making things worse.

### output:

Hi and welcome to Chat Doctor. Thanks for your question... Though many people respond well to anti-depressant medication, there will be a proportion of people who will respond only partially or will have a poor response to the initial treatment. Prozac (Fluoxetine) is an anti-depressant, which belongs to a class called SSRIs and SSRIs are in fact, the first-line medication recommended for depression. You also seem to have been on a good dose for an adequate duration of time.  If you feel that your depression has not improved at all, then, you should discuss this with your psychiatrist to plan the next course of action. Usually, the next step in management would be to switch to a different class of antidepressants or take a combined approach of medication with psychotherapy. Personally, I feel that the second option would be more appropriate in your case, as you mention that you have been going through a stressful situation recently. Ongoing stress can definitely be a perpetuating factor for depression and make things worse. Hence, ad Chat Doctor.  Sometimes, there can be certain medical causes, like thyroid problems, etc. which can also perpetuate your depression and cause treatment resistance. Do check with your doctor if you need any further investigations regarding this. Activity scheduling i.e. planning and carrying out regular and timed activities and assignments may be a useful technique to tackle your motivation and lack of initiative. Cognitive-behavioural therapy (CBT) is an excellent form of psychotherapy, which can help you overcome your relativistic views and enhance your motivation. Please discuss these options with your psychiatrist. All the best. - 