But before I get to that, at what level do your anxiety and depression typically manifest themselves?

Without knowing the answer to that, I’ll still spout off and say that I suspect tthe reason you have trouble with Concerta (and by proxy, Ritalin) is that your dose was too high. Concerta comes in a once-a-day time-release dose, right? Hard to really manage the dose that way, when (as you know) ADHD hits you at different times during the day.

I found success in dealing with ADHD with Ritalin (I usually get generic methylphenidate) in very small doses, like 5mg, two or three times a day, depending on what I’m doing and how it’s acting. I dose up before meetings, when working on my schedule or todo lists, or at other times when I feel the need for less blurriness. The rest of the time, I don’t.

If your psychiatrist doesn’t trust you to manage your own dosage, find a new one.

I’m sure you’re aware also that the symptoms of ADHD are very much like sleep deprivation, and the two exacerbate each other.

Another aspect to ADHD is mental discipline. You know what it’s like to forget something, like where you put the keys or the rent, or to be faced with three tasks and not know which you should do next. You also know what it’s like to choose to do something fun or easy instead of a hard thing. Separate those two classes of things. Drugs can help with the first class of problem, but they won’t help with the second.

(By the way, I wrote this comment as something fun instead of doing something hard that I should have been doing!)