Does your pdoc have any ideas specifically for fixing your sleep? Ambien used to work well for me, then it stopped. Now I take 7.5 mg mirtazapine/Remeron for sleep.

Another idea is, if you have a smartphone or other device that you can download an app to, is to download an app like Sleepbot and record yourself sleeping. I did that a couple of months ago and unexpectedly discovered what sounds like sleep apnea, so I'm going to be going for a sleep study soon. I was waking up tired every day with lots of headaches and low energy.

I've had depression in some form (sometimes moderate, sometimes severe) for most of the last 30 years. Every now and then I end up on a meds combo that works pretty well and I get a couple of years where I feel decent. I'm on Cymbalta and Remeron at the moment and doing pretty well, comparatively speaking.