This is Dr. David
I am sorry you are having such bad anxiety and depression symptoms.
many patients over time can become tolerized to treatments for their anxiety
and they often will need higher doses of medications to help treat their symptoms.
you should not be resorting to drinking alcohol and smoking to try to decrease anxiety symptoms
you should talk to your doctor about increasing the dose and frequency you can take your clonazepam to help
you should ask about other medications like hydroxyzine and buspirone which can help decrease anxiety symptoms.
it may be time to taper off of the duloxetine and try another medication like paroxetine or sertraline to help decrease anxiety symptoms.
you should be seeing a psychotherapist regularly as well to learn cognitive behavioral therapy to help decrease anxiety symptoms.
you should be on a regular exercise schedule to help decrease anxiety.
you may need beta blockers to help decrease your heart rate and stomach acid reducers as well
you should ask your doctor about help with cutting down your smoking and alcohol use.
let me know if you have questions.