Anxiety in your case may be a symptom of an underlying problem. The history you describe–self-medicating with marijuana, nicotine, alcohol, sleeping lots, having difficulty getting motivated, having (obviously) tons of free-floating anxiety and using a spouse or primarily relationship as a support lest everything fall apart–all these are also totally consistent with AD/HD. I suffered with existential anxiety, major depressive disorder, and Complex Posttraumatic Stress disorder (plus being unable to complete my doctorate or work despite testing in the gifted range) until 46 years old until I started researching intensely and using all the professional resources I could access to find out what was wrong. Eventually, I was diagnosed with, and treated for, ADD, combined hyperactive and inattentive type. Correct diagnosis changed my life. Consider exploring ADD, as it is a strong possibility from your description. Start with Halowell, Delivered From Distraction and Answers to Distraction and see if any bells ring. Sari Solden, Women with ADD (get the 2nd Edition!) is also very good, even if you're not female, as she deals extensively with recognizing "inattentive" or internally dreamy type ADD in both women and men. Your medication & medical treatment is generally on the right track & should be helping some, but dig deeper. Good luck!

Sometimes ignorance truly is bliss. Imagine the burden of constantly worrying about universal creation…yikes.

Thanks for the info. This blog is always a pretty good read.