I am really in no position to answer this, as I am horrible at accounting for myself and have no professional experience or education to do it. Secondly, I have the same disorders as you, so I could be telling you the worst thing to do possible. However, I would THINK that trying the small CPA firm route would be best because you won't have time to be bored and you'll have a lot less time to dwell on your problems. You are more stable now (I am assuming) then you were last tax season when you had your breakdown... only you know what your chances of success are, but I think you can handle it! Anyway, nothing is in stone... if it doesn't work out... find something else!