Gad/depression well managed w/paxil for 2mos. the last week my symptoms have increased- need to take 1-2 ativan/day to cope. advice/is this normal?

Add CBT: I would suggest finding a skilled cognitive behavioral therapist to assist with psychological portion along with your physician who manages medication. That way, you are working with a medical doctor to manage medications while having a therapist assist with cognitive restructuring, providing behavioral tools (such as worry exposure), and other techniques for coping. Good luck!