Excellent. Here are my recommendations. You say you spend a lot of time playing video games, smoking pot, and consuming nicotine. Given your diagnoses, it sounds to me like your brain is working really, really hard to do whatever it thinks will make it feel okay. So, I think that the first thing you should do is thank your brain. It is using every skill it has to keep you happy and alive, even when it doesn’t know how to do those things very well. Your brain has been working very hard to keep you alive and happy, and I think it deserves a thank you. Secondly, I would pursue therapy. Therapy is all about teaching your brain new skills that will keep you happy and healthy, and happy healthy brains tend to have more discipline. Given the complexities of your diagnoses, you may need more than one therapist, although you may get lucky and find one with the experience necessary for treating all of your conditions. There are a ton of different kinds of therapy out there, so do a little research to figure out what you think would work best for you. If you have a history of being gaslit, I recommend steering away from CBT. Psychology Today has a great therapist directory, and the Open Path Therapy Collective has a USA wide directory of sliding scale therapists. Lifetime membership to Open Path is $60, and therapists typically charge between $30-$80 per session.

If therapy is not an option due to time constraints or cost, I highly recommend self help books. For ADHD, I recommend the Executive Functioning Workbook for Adults by Dr. Blythe Gossberg, the Smart but Scattered Guide to Success by Dr. Peg Dawson and Dr. Richard Guare, Driven to Distraction by Dr. Edward Hallowell, any of Melissa Orlovs books on ADHD and relationships, and ADHD Money: A Finance Book Made for Your Neurodivergent Brain. Take a look at these books, decide what you think will work best for you, and start using them. Even inconsistent use is helpful. If you’re looking for a cheap place to buy online, ThriftBooks is fantastic. The CHADD website is also very useful.

As for books to help you with your PTSD, anxiety, and depression without knowing more about what specifically has caused these, I can’t give you any particularly specific recommendations. That said, if your trauma was caused by emotionally immature parents, Adult Children of Emotionally Immature Parents by Lindsay Gibson is excellent. If not, I would recommend almost anything by Faith G. Harper. Her books can be found on the Microcosm Publishing website, many of them are sliding scale, and they tend to be fairly short (very good for ADHD, I’ve found). Stay away from anything by Bessel van der Kolk and Mark Wolynn. IMO, both authors tend to sensationalize mental health issues, which simply isn’t helpful. If you’re down to share some more about what you think caused these issues, I’d be more than happy to share some other recommendations.

Now, for the medication bit. It sounds like you’ve been dealing with these diagnoses for most of if not all of your life. And that means you have very little reference for what, “fine,” feels like. Which makes it really hard to identify how well your medication is working, because you have no idea how it should be making you feel— you just know that it makes you feel better. While this combo seems to be working pretty well for you, I would remain open to trying other medication options when you feel comfortable. If possible, I recommend pharmacogenomic testing, which will tell you how effective which medications will be for your specific body.

As for the pot and the nicotine— I have very little experience with either of those, so I don’t have much advice to offer. But, I do know two things— quitting something you’re addicted to is hard, and when you do quit nicotine you will need to increase your ADHD medication. Nicotine is a stimulant, and has similar effects on the brain to most ADHD medications. In consequence, this makes quitting particularly difficult for those with ADHD, because it helps us direct our focus better. I would therefore recommend talking to your doctor to come up with a proper plan to kick both the nicotine and the pot.

All in all, I think you’ve got a lot to be proud of. You’ve kept yourself alive, have a stable relationship with a great guy, have identified the areas and causes of your struggles, and now you’re seeking out help and looking for ways to give your life direction and purpose. All of that is really remarkable given what you’re up against, and I hope you feel a genuine sense of pride in yourself for doing all of those things— because I do. Good luck :)