“ Have tried a ton of antidepressants and vyvanse, nothing's worked.”
Could just as easily make it worse. I had gone on a lower dose of an antidepressant and had exactly this problem. I had to go on medical leave until I could get back on my previous dose and stabilize.
Sleep and exercise, especially cardio, are all that worked. The drugs interrupt sleep. They can easily hurt more than help.
Exercise helped improve my mood big time but it didn't really make me better at task execution or sticking to the task and so now, i stopped exercising too, and everything's fallen apart.
Couple things...
'Sticking to a task' is an emotional problem not a willpower problem. Often times uncomfortable activities prompt us to switch to something else less painful in the moment. Eg, 'I don't want to write this email (because I will potentially say something dumb and be judged)' can be alleviated by playing mobile game (now I don't feel the discomfort of writing the email).
'Everything's falling apart' -> There is a tendency to point towards the extremes in this comment (and others). You would need to speak to a licensed professional to get a full diagnosis with proper treatment (lots of underlying conditions that can be associated with this). However, in general Id recommend a couple things: 1) Focus on getting enough sleep, eating properly and meeting your other human needs: connection, purpose, stability. 2) Focus on building empathy with both others and yourself. Focus on why other people do things that aren't perfect, accept that. Focus on why you do things that aren't perfect, accept that.
It seems weird. Like why do I have to smile at someone who wrongs me. They don't deserve it. However, executive disfunction is an emotional issue. There's not any one trick that will solve it. To do well as a human your subconscious needs to know that your conscious will meet your needs. When that doesn't happen it will take over whatever you 'think' you should be doing and lead you to do something else. Getting back in touch with your executive function means getting back in touch with what your body subconsciously needs.
Practically, I would recommend these concrete actions: 1) Focus on a consistent wake up time, this is easiest if you commit to something else in your life that requires you to be present. 2) Focus on having at least one healthy meal a day. 3) Do at least 20 minutes of physical activity a day. This can be as simple as walking to the donut shop and eating a donut. 4) Make a log of what you do instead when you fail to do a task. Review it without judgement.
Thanks, i can definitely relate to a lot of what you wrote. Are you a mental health professional yourself?