I’m sorry about your rut. It may help to reduce your caffeine a bit.
Lots of coffee causes anxiety. In addition it gives you a temporary pep but makes you much more tired overall in the long run.
I’m not suggesting taking a ton of prescription medication but majorly reducing the caffeine. At least try to stop by 2pm so you can get a good nights rest. Try extra vitamin b for energy instead. Camomile tea naturally helps a bit with anxiety.
I don’t know if a different doctor would help as with autoimmune diseases it’s either treat the symptoms, prednisone, or chemo like drugs none of which seem to be great options. It might be worth checking?
Also if your doctor hasn’t already get your thyroid checked as those little antibodies like to go after them for some reason. Thyroid medication does help if it’s an issue. Just be sure to take it exactly as directed.
With my autoimmune problems I just basically try to live as healthy as possible and ignore the rest. Sometimes it sucks, like my lungs don’t work but the only medication I found that works isn’t one I could get for long term use. For diet I just try to be healthy as possible. I just manage it as a marathon not a race.
Anyhow good luck.