CBT is also something he can practice alone. Maybe at school you could speak with a teacher or someone, maybe the nurse, and have a quiet place for him to go when he starts getting into a rut.

If you bail him out, then it reinforces behavior he probably doesn't know he's got.

If he starts to get anxious, and it escalates to unbearable for him, then you show up and bail him out, it teaches him that how he handled the situation (getting super anxious and ill) got the result he wanted (out of the situation and feeling better).

If he gets like that, but is "forced" to go to a quiet spot, just be in silence, understand he is okay, use the CBT to get out of the mental trap of anxiety, he can calm himself. I guess it's like a meditation. He needs to learn to do that, otherwise life is going to be depressing and hard work.

Maybe you could travel out the 45 minutes, and then make sure on the way back to discuss what he learned, or discuss his life, discuss the good parts about him. Make him see that he's a good person. I read a lot about this and anxiety seems to stem the most fro personal insecurity, somewhere deep down in there.

I'm commenting from the perspective that self-taught CBT has saved me from myself a lot of times, and in general is very useful even in daily life. It's such a great skill to be able to gift him, so if you can see it helping, an hour and a half of driving will seem like nothing in terms of the befits he'll get from seeing the therapist.

Hopefully meds will help, but they definitely treat the symptoms, or at least make them manageable. It needs to be paired with therapy, or the meds will become the coping mechanism, and if he ever decided to go off them, not other mechanisms will be in the place and he might slowly start to go downhill again.

P.S. I'm not a doctor, I'm just speaking from personal experience, so grain of salt and all that.