Rose, anything I could say would be meaningless in the face of your situation.

It is possible, though, that by itself it is moving more or less interminably, to a crisis. Something may eventually happen that will make this decision for you, even if you have not by then made it for yourself. Meanwhile, it is totally understandable that you feel burnt-out, numb, half-dead yourself. It's like a mountain climber said about making the last few steps to the top of Everest: By then he no longer cared about what he was doing, he just had some unshakeable impulse within him to keep plodding to the top.

It does seem, though, as if someone ought to be able to substitute for your Pdoc in getting you some more Ritalin right away. You are under tremendous stress, after all.