I'm struggling to effectively introduce this as briefly as possible, so I apologize for not being able to give the tl;dr just to be able to pose this.

Some background: I am an engineer (multiple degrees), 40M, diagnosed with ADHD in 5th grade, and have been on meds for the most part since then. It's always been a struggle, but I made it through college and had a successful career as an engineer. I've never actually functioned anywhere near my full potential -- but until we had kids (we have 3), minimally functioning at a perfectly acceptable level was always achievable.

This changed after having kids, partly because my spouse has an intense and demanding job, so she's not super useful as a co-parent (I'm not criticizing her, it's just reality).

I haven't worked a W2 job since 2 weeks before our first kid was born because of circumstances that had catered to my wife. We've made changes now and this isn't an issue anymore. I could go back to working a W2 job, but it's not in the best interest of my career right now. It would probably make re-introducing decent structure and accountability easier, but for a professional job this means committing at least most of this year and the opportunity cost of that is going to be significant.

My biggest barrier right now, is that I can't for the life of me figure out how to get focused and organized. I have a very long list of serious things that need to be worked through (mostly business related), and I'm in this cycle of fog where I can't get clarity on any of it until the end of the day. But by then I have to deal with the evening routine of a house full of kids, and once they are in bed, I'm usually just trying to focus on starting over for the next day. But then I wake up tired and dazed, and go through the first few hours (or more) completely fogged. It might get better after that, but it still might not be until late afternoon that I'm actually all that focused.

For a solid 2 months I've been strictly prioritizing getting past this, but it feels like it's not going to happen as long as I'm in this environment (because of how fogged I feel).

The reason I'm explaining all of this, is because I realize that ADHD isn't typically well-suited for inpatient programs and there are a lot of inherent problems that compromise long-term success (and I know that therapy in your normal environment is typically better). But I still can't get past the thought that if I just isolated myself somewhere, I could actually accomplish re-wiring myself so that I'm not living in this perpetual fog.

That being said; if an actual inpatient program exists, it's something I can consider. I can also arrange to just go to a hotel for a week with a strict plan of working through my own person "inpatient treatment program". I'm planning on seeing my psychiatrist soon to discuss this, so my real goal, here, is to be able to interact with similar people on this narrative so that I'm better prepared when I talk to my psychiatrist.

So... who feels this same way? Or do you have insight that can help show me that I'm looking at this the wrong way?

Because I know this is coming, I will add: I can often sleep about 8 hours a night. I have to be up by 7 am. I can usually achieve being in bed between 10 and 11 pm and asleep by 11 or 11:15, if not 10:30 pm. I have sleep apnea, but I typically have mask compliance that's equal to the number of hours I spent asleep, and have very low leak rates. My middle child is usually in our bed disrupting my sleep by 2 or 4 am, but I'm usually able to be asleep until almost 7 am. If I'm not careful, I can feel so tired in the morning that I can't function the first few hours of the day (it seems to be a risk about half of the time).

I have an office in my basement. I have an entire wall made of several 4' x 8' white boards; I would be worse off without them, but it isn't helping me stay mindful of the important tasks.