Is it anxiety or depression?

New to this site and looking for some input. I am a 42-year-old woman currently on 80 mg of Prozac and 300 mg of Wellbutrin. My doctor recently prescribed .5 mg of Ativan to take when I feel anxious, but I’m starting to think that is not what I need.

It all started with a diagnosis of OCD when I was 19 years old or so. I was put on Zoloft and then Prozac which did seem to help some. Not knowing what else to expect, any small change I thought I was picking up on was a positive.

It was shortly after that that I began obsessing specifically over death, fear of my own death as well as everyone I loved. I would play horribly scary games with myself like: “If that guy across from me on the subway sneezes before we get to the next stop, something bad is going to happen to my mom this weekend.” If that guy did sneeze, I would have this terrible feeling of doom all weekend despite how irrational I knew it was. Again, I was told this was the OCD.

I don’t remember exactly when the “OCD” label was traded in for a “depression” label, but that is when I was put on Wellbutrin along with my Prozac. I know that Prozac and Wellbutrin do help my depression, not because I feel like a million bucks when I’m on them, but I’ve dabbled with stopping them completely and I sink into a massive funk. When I got back on them, I then feel the difference. So I know I do need them. But because I still have this nagging anxiety, I wonder if I either need something else to go with them or if I actually need something else entirely different than these two meds. But finding someone willing to decipher my scattered thoughts has not been easy and the thought of actually articulating these scattered thoughts (as I am finally trying to do now) has always felt very daunting.

I've come to understand that I'm just generally a really nervous person. Other people may not know this about me because I think (and I really do hope) I hide it well. But inside, I am constantly worried that I’m being judged, anxious that I'm going to say the wrong thing, say something stupid, or not know what to say at all, etc. I feel this anxiety in any situation that requires me to be “ON” and focused. I have a lot of anxiety over conversing because I tend to have trouble focusing and paying attention since I'm always thinking of the next thing I should say. My lack of focus can also be embarrassing so then I have even more anxiety about that.

I am overwhelmed by so much: the amount of people in this world, the meaning of life, what is at the end of this life, the passage of time and how quickly it keeps slipping away. I actually feel like I could wake up tomorrow and be 90 just as easily as waking up tomorrow and being 43. I have a very difficult time NOT thinking about these heavy topics. I am overwhelmed by so many things to do, yet my to-do lists are often made up of a lot of minutia (maybe a way to feel a sense of control?). And I am very much an all-or-nothing person in many aspects of my life.

All of this makes me just want to hide and sleep. Bedtime is my favorite time of every day. I love that I can wind down, do crossword puzzles, just be within myself, and not be "ON." That is where I feel safe from everything that intimidates me and the daunting things that overwhelm me.

I don't know if I'm using this word correctly, but there is a strange dichotomy in my being. I absolutely LOVE being social, being with friends, laughing, conversing, connecting. But I feel a lot of pressure in situations that require me to be “ON,” and being alone (especially in bed) alleviates all of that.

So these are my questions to put out there: Is there anything that would work well with the Prozac and Wellbutrin as part of a daily combination? Is there something else entirely I should be taking instead of Prozac and Wellbutrin? Am I even depressed? Is it just anxiety? Is it a combination of both? Is it something else entirely?