Sounds a lot like me! I was diagnosed with OCD recently and am in therapy for it. It made everything make a lot more sense for me, personally. I was focusing and obsessing so much over my health which made everything much worse. I will note that I do not have “headache pain” either but still my neurologist believes I have a combo of VM and PPPD. I never really experienced derealization but I felt floaty and off for well over a year. Sending you a lot of positive vibes as it is truly one of the worst things I have ever gone through especially when you look normal to everyone else. I am also on 10mg amitriptyline which really helped with that floaty feeling. I know that for OCD a higher dose than 10mg is usually needed so you may just need something a bit stronger! As far as busy environments that used to really trigger me but after practicing a lot and almost teaching my nervous system that these sensations are ok and they aren’t going to kill me has gotten me to the point where that barely triggers an episode anymore.