How do you tell the difference between the drug working and just a good week?

Same shape here, different drug. The thing that helped was documenting the refusal rather than re-arguing it. They refer rather than write.

Interdose restlessness is distinct from the original symptom and worth naming separately. Not on sleep and dependence but the pattern is familiar.

Careful with attribution. You changed the timing, the dose and the season. That is three variables. Not on sleep and dependence but the pattern is familiar.

Worth asking what specifically was measured. Pain scores move with mood and function does not.

Half of what people describe as tolerance is a change in the underlying condition, and the two need different answers.

I would stop trying to convey how bad it is and start saying what you want them to do.

Sorry for the basic question, but how do you actually start one of these diaries?

Is it normal to feel worse before better? Nobody told me that.

Following this because I am in the same place and have no idea what to ask at the appointment.