Any other symptoms?

This has been going on 6 years?

You've tried Seriphos? I had similar adrenal issues. Had to take about 5-6 of these a night to get my cortisol down so I felt calm enough to sleep. Also took a heaping teaspoon of Gaba and a few Holy Basil caps. valerian and melatonin too. I think the trick is you have to take enough of these to block the cortisol (that's if your problem is high night time cortisol). You have to play with the dosage until you find what works for you. I took 5htp too when the Depression kicked in. That helped sleep issues as well. If you've done all the above with no results then maybe a whole bunch of energy healing sessions for the adrenals would be helpful.

Peace
Steve

"I don't sleep, I have wicked anxiety, I feel generally apathetic and irritable, the list goes on.."

Are you doing anything for anxiety from the angle of brain chemicals?

Any experiments with support for the neurotransmitter, GABA--magnesium, glutamine and or GABA as a supplement, theanine, maybe some medication?

Ever had your blood pregnenolone or progesterone tested. They are upstream from cortisol
http://en.wikipedia.org/wiki/File:Steroidogenesis.svg

Was lithium low on a hair or blood test? I've heard from a number of people who like the less intense effect of even a couple mg of Li supplement, Li orotate or similar, including me.

I'm surprised you say you are apathetic. Are you unmotivated as well? I would have assumed you make lots of adrenaline and noradrenaline but if you have symptoms of catecholamine depression, maybe you don't make too much of them on a regular basis. I think liver sulfation is involved in breakdown of them.

Epsom Salt is magnesium sulfate. Some prefer the more subtle effect of a foot bath.

Do you have high copper. I think it is involved in production of noradrenaline.

I personally know someone with a symptom list like yours. He also had inattentive ADD that was a major limiting factor in his life. He was on a psych med for sleep problems and anxiety. He was unmotivated except if really interested in something (classic ADD). However occasionally he could become very intense. His 4x saliva cortisol also was largely high but he was not smoking on the day of the scan. He said he felt amped up due to the lack of cigarettes.

Amazingly a stimulant medication--Adderall--for his inattentive ADD plus occasional use of a couple mg of Li orotate were the key factors! They actually allowed him to go off the anxiety medication!!! That was wild. The anxiety was apparently psychological. He was on the verge of loosing his business and home since he could not get motivated and get his life organized due to ADD. He did not tolerate supplements well. They could cause a panic attack!

I don't envy psychiatrists! They need to be magicians to get it right.

Maybe a trial of various psych meds would provide a clue. If something kicks in somewhat, maybe that is a tip about a particular neurotransmitter that needs to be supported.

I would start with low doses of Mg, GABA, and get the blood test for pregnenolone or progesterone (if male or female with predictable cycle)