I have gad, ocd, depression, and derealization. It's hard to cope with life right now. I'm on medication, but it's not helping. What do I do?

Talk w/psychiatrist. If you're feeling it's hard to cope with your life, you need to discuss this with your psychiatrist. More exploration of your case can be done; adjusting or changing of medications; also adding psychotherapy to your treatment are further possibilities. The better you take care of yourself at home also, the better you'll feel. Good exercise ; rest, healthy eating, and connecting w/others helps.
Meds + cbt. Meds + cbt is better than meds alone; getting a consultation is also an option.