Proper Stimulant Medication Management

I took about three months off from Adderall use as a scaffold for resetting my tolerance and getting my act together (I regularly overused my 15mg prescription, taking about 30-45mg daily during high pressure stints). For the last 2 weeks I have been taking Vyvanse, 20mg at first and now 30mg daily.

I find that I absolutely can't stand myself when I drink coffee with this medication. I have debilitating panic attacks if I don't (a) exercise in the morning before sitting in a classroom with this medication in my brain (b) use coffee to any degree of excess and (c) happen to be in the wrong frame of mind i.e. letting myself think about my family life or any self conscious thoughts for too long.

I suffer from clinically diagnosed depression, anxiety and (good God!) post-traumatic stress disorder related to an adolescence of nihilism, isolation and restless angst and despair related to the individualism and sedentary qualities of high school. And all of this -- combined with the physiology of ingesting stimulant meds -- just kills me. But without the stimulants I am completely worthless to myself and have a horrifically "blank slate" orientation toward the world.

I take a couple of different anti depressants and I guess I'm just wondering: How do I control or account for the side effects (ie sensitivity to crippling anxiety) of stimulants?

I've tried all the non stimulants and they simply do not work.