I am in the exact same boat as you right now. I wake up at 4:30 daily and can't fall back to sleep despite only having 5 hours of sleep. Daily I am depressed , constantly anxious and in psychological pain, I ruminate on negative thoughts. I was ready to give up on medication because it just doesn't seem to be doing its job my doc lowered my dose of lexapro from 20 which seemed too high down and was making me lethargic to 10 without any steps, I thought it was my chance to come off of medications and try the natural route, but I think if I was to just find the right medication it would be better, but it is hard to find a good pdoc who is willing to try various medications and my insurance limits me to the older stuff. Many pdocs to me seem to disregard the patient and go simply by what is "supposed" to work for the patients symptoms. For instance I was stuck on effexor for a while because the pdoc said it is the best most powerful drug for my symptoms so it must be working, yet it made me feel aweful. I have come to the conclusion that the pdoc is just as important as the medication in the road to recovery as their attitude can stifle any progress. If you find a pdoc who is willing to try different options and you can be patient it is well worth it, because recovery is more likely than with then than with the ones that spend a minute and say you are doing good and never change anything other than adding more useless drugs to the mix. If the antidepressant isn't working what good is adding a mood stabilizer if the person never had bipolar like mood swings prior to the medication.

Also every medication has its pro's and cons there are no all around perfect antidepressant. It is give and take because they are ardjusting your brain chemistry so where it adds to say energy and feelings of well being, it might cut out of thd ability to fall asleep naturally. Thats to say they all have side effects. Messing with the brain's chemistry is nothing to be taken lightly.