OP stated he’s 18 months out of insomnia, but the adhd-like symptoms still prevail up to a point where he is suffering so much that he hides his (or her) identity when speaking about it. He describes himself as “permanently cognitively impaired”. I used to believe in all that fear mongering about stimulants for years, but as long as you stick to your doctor’s prescription, start with low doses and pay as much attention as possible to yourself and how you react - through therapy supported by mindfulness - the risks are very low compared to the risks of having a “cognitively impaired” life. That state, however you label it, does not only hurt your performance at work, it hurts your relationships (healthy relationships are correlated with mental health and longevity), it increases your risk of car accidents (some of them kill) and it exposes you to financial risks. It’s not a good place to be, and I support everyone in that place with a simple message: go to a doctor, get therapy, get medication, be mindful about it.