The only other thing I could find is your BackBlaze backup software.
Makr sure that this is setup to perform backups only when you are away from your Mac for prolonged periods of time and it is NOT trying to perform backups while you are actually using your Mac.
You only have 8 GBs of RAM installed so, I am NOT sure if just the external SSD is going to help your situation.
OS X and macOS Sierra need a full 8 GBs of RAM for nominal operation, now.
The physical RAM in the newer Macs has that integrated Intel GPU that gets all of it needed VRAM from the total amount of install physical RAM.
It is, probably, NOT helping the RAM and borrowed RAM for the GPU when you are running your Cintiq tablet which requires even more GPU VRAM that is borrowed from the physically installed RAM.
So, your available 8 GBs of RAM is NOT going very far to use with running applications, the iMac's own screen graphics and the Cintiq tablet!
The integrated GPU is pulling physical RAM for VRAM to drive graphics on two screens instead of just one.
My advice?
Sell that iMac!
If you absolutely need to stay with the less expensive 21 inch screen model iMacs, get the top of the line iMac with ALL the optional i7 CPU model, 16 GBs of RAM and the 512 GBs (NOT the 256 GBs) internal SSD.
That top of line 21 inch screen iMac model should give you enough power and performance and ensure some futureproofing for quite some time!
😉
If you can swing it finamcially, look at and consider a mid range 27 inch screen iMac with a mid range CPU, better, faster discreet, independent GPU, and an SSD ONLY option.
The 27 inch models can have cheaper user installable RAM and the 27 inch screen models can take UP TO 32 GBs of install RAM.
Good Luck to You!