I agree with the recommendation for talking to the doctor; I’m in a similar position. This might be completely unrelated to your situation, so take it with many grains of salt.

What I’ve been learning is that a lot of my own burnout cycling seems to be cycles of intense and constant masking. I struggle with social situations, following “chronos” time instead of “Kairos” (if you will entertain the misuse of these), and eventually get so buried in obligations and actively resisting my natural impulses that my wants and needs get muddied and untended to and the pain of pretending or entering social modes builds up too much. Being in a mode, “professor mode”, “friend mode”, “colleague mode”, “spouse mode”, they all build up the tension and while I can seem socially adept, if I’m not in a mode I’m pretty useless. My Uber drivers can attest. Sometimes I do need a break from social activities while I break down the mask that builds up. A decalcifying of the brain. My friends seem to understand.

I’m a teaching professor, and I love the work, it has high flexibility but strict accountability, lots of room to experiment and find novelty, but a massive social burden and ridiculous workload. The only thing I’ve found to help so far, besides medication, is doing less. Fewer work obligations meant more time to de-mask, it meant I could take the more time on my tasks that I refused to admit to myself I needed compared to colleagues, more time to do stupid random impulsive (but safe) BS which I’ve found is the most relaxing to me, and that naturally led to meditating, exercising, and eating a bit healthier, which made things feel more manageable.

I don’t know what the long term prospects of this realization are for me, but consider that ADHD usually means that tasks will take longer and more effort than typical people. Admitting to myself that it’s a disability and I don’t need to work twice or three times as hard as other people to make up for it all the time has been really important.

You also mentioned trauma; a lifetime of letting people down without knowing why really turned me into an over-supporter as an adult. Fawning response to stress - feeling the stress build up and instinctively doing whatever you can to help other people at cost of yourself, rather than fighting or running away or freezing up - and then when you’re alone you fight yourself, freeze, or run away from everything. I’ve been told it’s a form of invisible self harm, and it’s nefarious because the goal is to make everyone else see things as all right.

So I don’t know if any of this clicks true for you, and I don’t fully know the solution to these, but awareness of my own issues has helped a lot, and I think awareness and recognition is key to getting started. Years of therapy, meditation, medication, it’s all making progress, but it’s slow, and awareness has been key to any of the positives. For me, it seems like working less and admitting to myself I have a disability, undoing years of traumatic people pleasing at my own expense, and learning to unmask more in social interactions and at home are key, however that path is treaded.