I need some med help im taking?

Paxil 40mg.. and have been for almst 1yr (b4 that it was 20-30mgs) my dctr sys that thats the highest dosage for paxil... and for the lst 4mo I have noticd im very irratble and stressd... ( Poss due to my 2yr old being in the burn cntr at Chldrn mercy hosptl for 3wks ) An accdnt on Memrl Day.. I have 2 yr old twin girls and one trpd and fell in a firepit that has smoldring coales frm the night b4... Worst day of my life... Shes doing better now .. But seams like snce then things have jst went down hill... And im not sure if the Paxil is working ... Has anyone been on Paxil and had it stop working and had to switch to something else... and if so what works......... PLEASE im despret.........