Hi,
Another thought, as it's forming in my head, I believe this 'crash' I have experienced and subsequent landing area to which I seem fixed, is the result of twenty years (at least) of trying to obtain affect regulation by all sorts of means that have mostly taken my life in a variety of disadvantageous routes. Coming to a stop like this is the 'end of the line' in attempting external/maladpative adjustments or distractions (skipping school, smoking, drug taking, trying to be cool with the 'bad' kids, high level effiency, academic/career mania, exercise, constant 'mediator' in situations, helping others to the detriment of my own advancement, shopping, appearance, sleeping, avoiding patterns, general living for the weekend, non-agency promiscuity) . The reason I have stopped, (including work) is that I physiologically can't take the emotional-neuro-biologoical-ANS (mental) strain anymore. The only options my body will accept from now on are those which are positive regulations even if in 'sensible' terms they appear to an outsider to be 'not in my best interests'. So in a weird way this is what I've been aiming for. It' just its knocked the crap out of me getting here.
I totally empathise with this - as this is so similar to my experiences. It is 20 years since the most severe trauma and since then I did similar to you - live to high level efficiency - push myself constantly with regard to work, exercise and so many of the things you have quoted, whilst dealing with chronic insomna, avoiding triggers, managing anxiety etc.
Over the last 12 months this started to fall apart and within the last couple of months everything has crashed down around me - like a breakdown - and I cannot work. Work was my rock for a long time and I pushed myself to be the best - like you stated to the point of mania - mediocrity was not an option. Now I am unable to work, I don't even want to leave my house. My body only tolerates activities that involve the least amount of anxiety, which doesn't leave a great deal of options right now.