Sleep first. Bad night, bad day, more symptoms. Fix that before changing anything else.

Ask for the longer appointment slot. Ten minutes is not enough for a complex history and pretending otherwise wastes both your time.

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

I would stop trying to convey how bad it is and start saying what you want them to do. Tolerance was my main issue with a book about a drug too.

Same here.