It probably isn't far off to describe my struggle to manage these as mental illness rather than a productivity hurdle
You might try asking your healthcare provider for help finding a therapist or social worker. They can help you assess the issues you are facing in a way that's different from what you'd get from friends or family (for example such discussions are generally confidential), and they can check-in with you regularly if that's useful for managing your problems.
Regardless, I wish you the best of luck with your challenges and hope you find a solution that works for you.
I don't have the qualifications to actually diagnose mental health problems, but having suffered from OCD myself I suggest you seek professional help.
To me the whole idea of an adult hiring someone to act as a parent or kindergarten teacher seems ridiculous. If an adult actually needs that level of supervision and prodding they should consider talking to a professional about possible ADHD or other issues. Hiring people to satisfy narcissistic tendencies just seems degrading to the person hired.
A single person working from home has none of those factors. They are left to manage their own time and priorities. Some people handle that better than others, and some people get anxious, upset, overwhelmed when they can't manage themselves. Hiring someone to essentially babysit and keep you on track may work, but it works in the sense that paying someone to feed you means you don't have to shop, cook, and feed yourself. The anxiety and the underlying problems don't go away by outsourcing them.
People who have too many details to manage and too many things to do (not just things they imagine they should do or want to do) hire assistants to handle some of the tasks. They don't hire someone to stand behind them and tell them to get to work.