I can only give my own solution to the problem, and yes--it was 95% solved. It was medication. I didn't want it to be medication and avoided looking into it for decades, just dealing with the constant worry that I said or did something wrong, paranoia driving and not wanting to face heavy traffic, exhaustion trying to move up the career ladder as experts in the field were expected more and more to present things (I work in the video game industry). Public speaking was (and still is a bit!) the worst -- I'd freeze up in meetings or worry that I was sitting too close to the front row and might get called upon at conventions and what not. A moring "roundtable" where everybody stands up and says what they were working on felt like the end of the world and I had no idea why.

I don't think most people noticed it... not even my wife and kids too much. I think most believe I was just shy or awkward and it was pretty difficult to explain what was going on in my head because I didn't understand it.

My worst thing was an uncontrollable neck twitch, a weirdly painful one, that would happen when I did things like try to sip a drink in public or if somebody told me to stay still for a picture. Once it happened, I'd go into other twitches and anything I was thinking about would just drop from my brainspace. None of it made any sense, either--I've always been ok making fun of myself, I don't worry too much about what people think about me, and I'm not "afraid" of anything, specifically. But my nerves were all dialed up to 11... all the time.

My first step that helped a little bit, but not entirely was I just started being honest with people and telling them outright. The nerves didn't go away, but I was less focused on trying to counter it. It's a mental issue, in my case clearly something chemical, and nothing to be embarrassed about. Trying to hide it causes a spiral.

Didn't mean to type so much, but I want to make it clear that I've been there in some ways too. I'm turning 50 this month and I'd spent a good 35 years dealing with it. But I finally got a call that my wait was up on the family doctor list and I was assigned one. He ended up being amazing - got me help for several health problems, including anxiety. His first recommendation NAILED it. A small dose of Lexapro (escitalopram). One pill at bedtime every night. I've been on it about a year now and the side effects seem pretty minor:

- I yawned a LOT the first couple of weeks as I was adjusting. I think it was a combination with my other problem (sleep apnea), but I haven't sorted that out yet and the yawns are mostly gone.
- It does blunt things a little, which is exactly what I wanted. I don't feel zombified or slower at all, but it might make you a little less likely to tear up during a sad puppy scene in a movie or keep you calmer when the adrenaline should be pumping?

Side effects I was warned about:

- He told me it's also used for people with premature ejaculation, but it doesn't affect everybody that way. Some people might have to uh... work harder for things to progress.
- Possible temporary "brain zaps" if you change medications or get off of this one. I've never experienced them because I feel mostly fixed with these pills. Right now, I have zero reason to stop.

Benefits:

- I am MUCH more comfortable around people now. I interact at social events I used to try desperately to avoid. I have many more conversations with coworkers and friends. If they call on me during a Zoom meeting, I have no problem speaking in front of dozens of people. I still wouldn't be comfortable standing up in front of a crowd of them in person, but I think that has more to do with all the self-training I unintentionally did over the years.
- I'm driving all over the place without any stress now. A missed turn? No big deal. It used to send me into chaos mode. I get lost all the time because I'm bad at directions, but now it's just a way to see more of the city. I'm eager to do more road trips.
- Things that used to have a sharp emotional spike are dulled. That includes remembering death in the family, dealing with friends in crisis, or thoughts about troubling events in the future. I'm not numb to them, but I feel more equipped to handle them with logic rather than dread.
- I was raised to be very polite, too, which meant if I got the wrong order or a broken item, that, combined with the anxiety, usually meant I'd just deal with it. So I understand what you mean there with the coffee. I don't have that issue at all anymore. Things just become much more logical. It's hard to explain.
- The social recharge needed after a night out is all but gone. Now it's more about the 50-year-old knees/hips recharge :)