Multiple conditions all drug resistant

Hi, I am a 32 year old woman currently working with a psychiatrist and a therapist. I am on 200mg lamotrigine, 60mg fluoxetine, 30mg buspar, and Xanax as needed.

I have a history of PTSD from intrafamilial child torture starting at infancy and extending until adulthood. I have an autism diagnosis. Other diagnosed conditions that go hand in hand with all of this: treatment resistant depression, major anxiety disorder, and insomnia. I have been diagnosed with ADD but find that it is my dissociation and lack of motivation from depression that creates an inability to focus or start tasks.

Every drug I have trialed seems to work in reverse or is not effective at all. I’ll start with benzos as an example:

Xanax is generally useful for short term panic. However, klonopin, diazepam, both considered longer lasting benzos, do not work at all. I feel absolutely nothing and they do not help me sleep, with klonopin specifically keeping me awake.

Stimulants have failed at every junction. Again, my belief is that I cannot be present or active when hampered by severe depression.

Tranquilizers: absolutely nothing keeps me asleep.

Sleeping aids like trazedone, prazosin (for nightmares), lunesta, and zaleplon on do not work (aside from benzos this is the extent of my trials for sleep.)

Depression/anxiety/ADHD related trials:

Celexa, sertraline, guanfacine, duloxetine, venlafaxine,

Gabapentin, methylphenidate (Ritalin and concerta), adderall and vyvanse, straterra, clonidine, and these are just the last two years so I’m sure I’m forgetting some.

I’ve tried TMS which took me all the way to inpatient in terms of suicidality, I cannot give the commitment of ketamine, I want to avoid ECT, I holistically try do everything possible within my limits: I exercise a few times a week, I try to take care of my hygiene as best as I can, I try to complete basic household tasks and sometimes succeed, but the majority of my day consists of missing time due to dissociation, extreme OCD (contamination issues with no particular compulsions but affected thought processes, and more, severe depression and suicidal ideation, constant anxiety and paranoia. I am quick to anger and irritation due to that paranoia (or perception of criticism). Basically, I am sad, mad, anxious, and exhausted. I am allergic to tricyclics, and have not tried antipsychotics aside from seroquel. My doctor is very flexible, willing to brainstorm, but I’d like some ideas for atypical treatments. In short, I am not just treatment resistant for depression, but seem to have a high threshold for any drug reaction.