Is cognitive-behavioral therapy helpful in managing ADHD and anxiety issues?

Hello doctor,

I have a lot of anxiety. I sometimes cancel meetings because I do not feel adequately prepared. I am overwhelmed by noise and colors and thus prefer not to travel too far. Specifically, I avoid cities and crowded places. I feel disturbed not just by people, but also by perfumes, loud chewing, noisy phones, slurping, whistling, hooting, complaining, shouting, and delays, it is just too much. I fear rejection so much that I sometimes perceive it even when it is not happening. Additionally, I avoid calling clients back in case they are loud, angry, or I fear they might "abandon me." I prefer texting, although I do not always open texts without mental preparation, fearing they might be mean or unfair. I fear abandonment; calls induce anxiety because I often think people are calling to tell me they are leaving me. I have been like this since I left home at 18 to go to college. I am very untidy, and it seems like I mess up immediately after cleaning up. I can never find stuff or be ready on time. A few years ago, I burnt out and left the city to work on myself in a small town. I can hyper-focus and make lots of money. I am bright, creative, intuitive, resourceful, and highly qualified as a public speaking coach. However, I struggle to maintain a routine or structure for my coaching or business plan and to keep employees. I come up with a new idea or project every day/week/month, so I keep moving the goalpost, only to lose interest in both the project and the employee in a short time.

It is affecting my work as a coach since I start meetings while still looking for pens, notebooks, slides, etc. Then I hardly follow through. The big issue now is I am not working at all. Today, for instance, I had low energy all day and just got a burst from 6:30 pm to 8 pm. I missed a meeting. I am feeling sad, angry, and bored. I did not even have food in the house because there was too much work to go shopping, noise, dirt, too many colors on buildings, hustle, and bustle, etc. I do not smoke or drink at all, but I have asthma and sinus issues. I am on a steroid inhaler daily and often on Montelukast, Levocetirizine, and occasionally Deflazacort or Prednisolone. I am experiencing work stress. My partner "stole my clients" due to anxiety; she would take over whenever I "could not rise to the occasion" (sometimes I just "freeze"). Eventually, she went behind my back and cut me out. I also do not know how to proceed or how to build the right team for my next action. Yet, I have been doing this work for 12 years, and it needs to be new each time—new business cards, new web templates, new office, new images. I am not motivated or committed to past successful strategies. I even changed my social media handles to start fresh.

More work stress: I want to move house, I move once or twice a year. I have closed my shop after three months and rented a different one. Additionally, I rented a garden studio to be a meditation teacher (it is what has kept me going - meditation, especially by the river). However, I am not a patient person, and since only two people came for the first meditation class, I converted the room into an homestay. Now, I am thinking of offering kids' public speaking classes. So, I am currently paying rent for four places that are relatively small and located in low-cost areas. I do not particularly like them, but I hesitate to commit to a larger, nicer place because I fear I will change my mind after a few months and want to move again. I feel ungrounded; I have never had a place where I feel safe or at home. This lack of stability is exhausting. On a personal level, I am dealing with stress from losing my mum last month.

Please help. Thank you.

Thank you doctor for the reply,

I have answered these questions in the section above. I mentioned that I neither smoke nor consume alcohol. Where can I find the HAM-A assessment tool? Kindly help me find a solution before our chat window closes. I was called lazy as a child, but it is not true. I work very hard but only when I get that "internal spark" ignited. Also of importance is that I come from a culture where they do not believe in "mental health" as a real thing. Thus, there is a delay in getting treatment. However, last year, I heard about "ADHD in adults" and studied it for months. The symptoms fit like a glove, giving me hope. That is why I am keen on getting that ADHD assessment.

Please help. Thank you.

Thank you doctor for the reply,

I did not want mental health medicine in the past because, First, as I mentioned, I like to meditate and am a highly spiritual person with high intuition and a connection to people and the environment. I have been very successful in 'reading people' and 'reading energies,' which is helpful even as a transformational coach. I appreciate the benefits of my hyper-sensitivity, but it can be overwhelming. Second, I already take too much medicine. I have always been heavily medicated for my ENT (ear nose throat) and chest allergies, plus I take lots of supplements. I already have a bag full of medicine. Third - the main reason - I did not want to admit that 'I am crazy,' 'mad,' or 'unable to manage my mind.' There is a huge mental health stigma in my community, and I fear being seen as a failure, weakling, or even cursed. I am afraid of being shamed and losing my leadership or role-model image. Fourth, I suffered from long-term Prednisolone addiction and had a very difficult tapering and recovery. I am afraid of getting addicted again.

I was very hyperactive as a child. I am open to medication now because, first, I adopted a girl six years ago, and my irregular emotions and actions are hurting her. I am unpredictable. Second, I have always depended on others, but now I am divorced, and my parents are gone. Third, I have so much potential, and I get appreciated. However, I am overwhelmed by loud sounds, busy movements, delays, and colors. It takes a lot out of me to interact with people, and I often wish they would cancel, even clients. It takes me even longer to recover after an event or work. No, that is not it. I hardly get stressed. I am very confident, and enterprising, take risks, and can talk to anyone. I love being alone after heavy social interaction. I have traveled alone, even to India, slept in strangers' houses, and took the train alone. I was motivated, enjoyed it, and I am very brave. My score on the HAM-A was 7 out of a possible 56.

Thank you.

Thank you doctor for the reply,

My HAM-A score was 7 out of a possible 56. Scores in the 0-17 range may indicate mild anxiety levels. I am ready to start an official medical regimen, as I have been relying on supplements. Regarding emotions, I easily get upset and frustrated when I feel emotional or unsupported, or abandoned. About the test results, some questions are ambiguous to me, like my concentration level, which can be 0 if I am not interested or feel pushed, but 100 when motivated or excited. The same goes for interviews. The emotions seem too externally dependent. Even with you as a doctor, I still want to feel 'loved' and seen. As for time blindness, I have no internal monitor for durations, no sense of time, and no sense of urgency. One more question doctor, what did you mean by anxiety? My new score from a different website is 12 points, indicating mild severity.

Thank you.

Thank you doctor for the reply,

So, what do you believe is my condition or disorder? Kindly provide the prescription in a formal manner so I can take it to the pharmacist.

Thank you doctor for the reply,

This is helpful. Understanding that anxiety is an issue is beneficial. This awareness is enlightening and motivates me to take daily action. Can you recommend a cognitive behavioral therapy (CBT) therapist?

Thank you doctor for the reply,

How long should I continue taking the medication?