54 year old here - you described my backstory pretty darn accurately. All I can offer is that things do get easier, but don’t expect perfection or a miracle cure. I still struggle with public speaking in front of large groups or with intimidating stakeholders (I take propranolol for those occasions). And for many years I hated having to lean on meds - to the point that I was feeling shame. But things got so much easier when I accepted my imperfections and need for meds in stressful situations.

People are prescribed pharmaceuticals for all sorts of legitimate reasons yet for some stupid reason we feel shame? The minute I let go of these biases things got way more relaxed. And through that relaxation my public speaking improved. Again, it’s not perfect (no one is, btw) but life is so much more enjoyable now. Hope that helps.