This comes up often enough that it's worth addressing directly: therapy and medication aren't competing options, and wanting one doesn't mean you've failed at the other.
A few signs it may be worth a conversation with a psychiatrist or prescriber, alongside therapy rather than instead of it:
Your symptoms are making the therapy itself hard to do. If anxiety, depression, or sleep problems are severe enough that you can't concentrate in session or engage with what comes up, medication can sometimes lower that intensity enough for the actual work to happen.
You've noticed a pattern, not just a bad stretch. A few hard weeks are different from months of the same symptoms not shifting, regardless of what's going on in your life at the time.
It's affecting your ability to function day to day — work, relationships, basic routines — not just your mood in the moment.
I'm not a prescriber, and I don't make medication decisions — that's a conversation for a psychiatrist or your primary care provider, who can properly evaluate your specific situation. What I can do is help you think through whether it's worth having that conversation, and coordinate with a prescriber as part of your care if you decide to pursue it.
Needing medication doesn't mean therapy isn't working. Sometimes it's what allows the therapy to actually land.