Followed up with my psychiatrist yesterday. the good news first is that my depressive symptoms are essentially gone. Lexapro worked like a charm to resolve my depressive issues, and the Seasonique birth control is doing a fairly good job of evening out my hormonal fluctuations. Not perfect, but it's definitely made a big difference.
On the other hand my anxiety is still daily, and hasn't really improved since I started getting it treated in August. In spite of some GI side effects the lexapro gives me, we are both hesitant to take me off the lexapro because it has been so effective for the depression that neither of us want the possibility of having the symptoms come back if we switched agents completely. She considered increasing to 20 mg to see if that helps the anxiety, but I declined that due to the aforementioned GI side effects, and because I really feel that it's not been helping the anxiety symptoms at 15, so I've no reason to think there will be a dramatic difference at 20.
We discussed two other options: adding buspar or adding a very low dose of Remeron. The latter she suggested because I almost always wake up with anxiety in the morning, or occasionally the middle of the night, and she felt this might help snap that cycle. but as I'm a very fatigued person, I don't really want to try something that can be as sedating as Remeron. For now, I'm continuing on 15 of Lexapro and will continue trying to make lifestyle changes to manage the anxiety. I do have some Ativan for as needed, and will kind of monitor my anxiety from there. If it's no better in a month, then I will probably add the Buspar