The verdict on Adderall XR so far is; good. I don't feel overstimulated as long as I remember to have a lot less coffee than usual, and I don't have insomnia if I remember to take it early in the day. I do feel more focused and calm. It's not a cure-all but it seems to be a somewhat-cure-some, and I'll take that right now.
The challenge is to make something of this window of opportunity before bad habits drive me back into the same troubles. Since my big problems are with things that are problems for everyone (exercise, routine, organization, chores, bullshit), and I've had a lifetime of being a total fuckup at this stuff, it's going to take a lot of work to improve things.
The EMDR, or as I like to call it the Mesmeric-Optical Phrenotherapy, is useful too. It feels like voodoo, but slowly I'm chopping away at the big nasties. Situations, images, problems that triggered me into a full-blown phobic anxiety fit are increasingly accessible without as much fear and loathing. Unlike 20 mg of stimulant, this is a slow technique, but the changes seem to be permanent. When I'm dealing with something I've fucked up, I still feel nauseous and helpless and enraged, but it doesn't take me right down to the ground. I just get grumpy instead. Pretty good result so far.
The reduced appetite from the Adderall is a benefit, too. Especially since I need to lose about 30 more pounds over the medium term or I'm going to DIE.