Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.
First, let me say the clarity with which you describe Jesse is remarkable. You are not only a loving and caring parent, you are also a highly intelligent and astute observer. And so I sense that what I'm going to be telling you is what you have known within yourself for a while but have not yet brought out into full awareness. And I think it's important to that now.
I've had some similar problems presented to me brought up by the 20 year old himself. Imagine the difference here if these observations were self-observations brought to me by Jesse himself. That would be very different wouldn't it! It would mean that not only is there a good level of self-insight (he probably wouldn't tell me half of the symptoms you were able to list off cogently), but it would mean there was a motivation for hope. Not yet a commitment and certainly not confidence, but motivation for hope.
The catalog of possible disorders is impressively large and wide: OCD and anxiety for sure. But depression, ADHD, and even perhaps Bipolar Disorder though that one is a long shot. But if Jesse were writing to me, I would be talking to him about motivation. Because he would be showing me that he had hope for something better. That's a precursor of motivation. I wouldn't be worrying about commitment or confidence yet. Motivation. I would surprise him and tell him that the standard motivation books and tapes by the big motivation stars is what I want him to spend a lot of time reading and listening to when he's lying around. Anthony Robbins, Stephen Covey, etc. I'd have him going to You Tube and watching every motivational speaker he can find. Every day. Because that's how commitment happens. Through motivation. And confidence follows the commitment.
But he didn't write. It was you. And so you know the truth I'm getting to. You are enabling him to stay a kid. You even write so yourself in the most revealing sentence: "I am so drained as this is a high maintenance child to raise"
Notice you didn't use the past tense: he WAS a high maintenance child, but the present tense: he IS a high maintenance child. This is what enabling is about. If he were drinking, I would send you to Al Anon (the family part of AA) meetings to get support and skills in how to stop the enabling. That he would be given a deadline to find his own living quarters or pay rent, food, etc. Would he swim or sink? We don't know. That's why Al Anon is everywhere. Because you as a parent can't know in advance. You have to take a chance that he will find his bottom and then climb up and out into adulthood. You can't do it for him. That's the harm in enabling. The family keeps regenerating the dependency.
So, this is more than tough love. This is a crash course in growing up. He's 20 and not a child. Were he 17 maybe I would have said a wilderness survival trip. But now he's 20 and he's got to do a REAL LIFE survival trip into adulthood. The goal here is to get him to take the responsibility for getting better. For him to write someday. So, maybe there IS an Al Anon meeting that will accept you or maybe you can do some reading on enabling behavior. But he is not going to get better from whatever problem(s) he has because YOU are worried about it...
I know this has been tough and I am asking you to be brave. But Jesse needs to be the one who recognizes he needs help, and that has been my goal in answering you. I wish you the very best!
Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX