I can really relate to this, have always had similar issues where I completely focus on a couple of tasks that aren’t particularly important or urgent and can’t motivate myself to take care of the stuff coming up that’s actually important.

I think your therapist is right, and I’ll add that failing to accomplish something for yourself in a timely manner is not a moral failing. As Americans the way we think about getting stuff done is shot through with this Protestant work ethic ideology that has been around since the time of the Puritans— it’s so all-encompassing that it’s easy to believe in it without consciously thinking about it at all. At the end of the day, you’re not harming anyone by being late on your own taxes and there’s nothing that you need to feel guilty about.

I think you’re right to put your health and well-being first, especially if there is potentially medical stuff at play. I used to get bad fever and fatigue a lot before I started getting treated for my own issues and pushing through it to do some trivial chore at the expense of your health is the worst thing you can do. The mopping can wait!

Sorry to hear you’re having a bad time and I hope things improve soon on both the health and executive function fronts.