It is quite common to need treatment adjustments after several years, as medication effectiveness can change. Since you are still experiencing unhappiness and irritability on escitalopram and alprazolam, your current regimen may need a review. Please do not stop or change your doses abruptly, as this can trigger withdrawal symptoms. Your psychiatrist may consider slowly tapering you off your current treatment and switching to a different antidepressant class, such as an SNRI (like duloxetine) or another SSRI (like sertraline), or adding a stabilising therapy. Please consult your prescribing doctor to safely discuss these alternatives and find a plan that works best for you.