Effexor Augmentation?

[Romany]

Diagnosed with MDD & anxiety disorder 1992,  medicated w/Tofranil & Xanax add CBT. Responded well, tapered off in 1996, held until a DX of Crohn's Disease in 1997. Then treated w/ Prozac, then Wellbutrin, then Celexa, then Remeron w/o much relief until Effexor in 99/2000 and Provigil to combat sleepiness and what looks like underlying and unresolved ADD stuff. I feel depressed again, mirroring the MD Episode in 1992 w/o the manifesting anxiety. My PCP prescribed a low dose of Abilify to augment the Effexor, but I felt cognitively disabled, lol. I have trouble concentrating, filtering white noise, generally agitated w/trouble completing mundane tasks, I have trouble getting to work and working when I'm there. I’m tired, I sleep and still oversleep and have gained weight. I have always been bright, but can't make it work for me like I did in college. I still see a CBT therapist regularly and she has added TFT and EMDR therapy. I feel like my options may be...If they are viable options...1. Advocate to try to augment the Effexor again? 2. Advocate to add an ADD medication like Adderal that can be used with Effexor? 3. Advocate to taper off the Effexor and focus on a medication for ADD that can be used with an antidepressant (although I worry about tapering off the effexor, heard horror stories 4. Go inpatient (which I have never been hospitalized for MH issues) and let them sort it out there, but that would really turn my life upside down and create more problems. I am at a bit of a loss, but I know I can feel better, I just don't know how to get there. Any ideas?