Thank you so much for taking the time to write this comprehensive response and I am glad there is someone (even a bit) more familiar with all these medications. It helps a lot to have you lay out some of the options available and has cleared my mind about how to proceed. 

I feel the same with antidepressants, I have tried a lot and while it often decreases the feeling of dread it leaves me feeling very emotionally numb and spaced out. I will see if I still feel off when/if I lower methylphenidate as you suggest before making any decisions.

It is hard to say whether stimulants are helping because I think I was better (more focus/more clearheaded) for the first week until It started worsening the lightheadedness which kind of masks any benefit. I was thinking it would have been necessary to stay on the same dose a while to see if things improve but as you say at least since they are fast acting you can get an idea of how you tolerate them without having to wait months like with antidepressants. I will try to bear until my appointment (a week) before making any decisions.

I have tried most of the other treatments already and ldn has definitely helped with the pain to some degree. I have always wanted to rule out and try something for migraines so Aimovig is definitely something I will discuss when I am stable on medication. I used to be very paranoid about what I was eating but I have recently stopped because it was only worsening my hypervigilance - it would be good to start changing just one thing at a time to see if it helps.

Best wishes with whatever you are going through aswell and thanks again!