I don't have a great answer for you because I feel like this all the time. I sit on my ass and make lists of everything i need to do, but it's insanely hard to get up and do them even on medication some days. It's normal to feel...trapped I guess. My neurologist told me he's never had a narcoleptic patient that didn't also deal with depression because of the nature of the disorder.

That said, ritalin was terrible for me. Made me insane. I can't say I've found a regiment that makes me feel anything close to normal, but I've found one that at least allows me to work a job. Modafinil helps for masking the sleep deprivation (as long as you did actually get some sleep, only works past a certain point). Helps me get up and get moving. I still feel tired, but I can truck through. Still get sleep spells, but nothing like when I'm not medicated. I can drive and everything. Concentration can still be hard. I have amphetamine salts I use to help with that some, not something I take every day though.

If your insurance does not approve modafinil, which they should if they approved xyrem, you can try to order them from India with bitcoin. That's what I was going to do a couple years ago when I didn't have insurance (or a job) and they were $400 for a month. Significantly cheaper there and I've had a friend do it and told me they worked just the same. Not ideal by any means, but if you get desperate.

Take break days too, especially with ones like amphetamine and ritalin. They build tolerance easier than modafinil.

Therapy too. Like mental health. Coping with the emotional consequences of the disorder matter a lot. I know I've had this for 15 years (whew) and I still feel angry a lot. I thought I would be able to explain it to people without feeling bitter by now but I can't.