Therapy is what helped me the most long term, and I think is the only really solution for true anxiety. It requires finding the right therapist though - I went through a few before I found someone. I put this off for so long because of the cost and, of course, the anxiety just meeting a new therapist. I think for me talking to a male therapist in particular really helped for some reason.

I used various drugs to help me "get through life" before therapy. My anxiety was completely crushing, and I felt I had no other choice.

In retrospect, I wish I had just gotten good therapy in my 20s, because living nearly 3 decades with intense social anxiety just really freakin' sucks and drags down all aspects of life. And with real long term anxiety, it takes a skilled third party to get your brain patterns to change enough to overcome it long term.

I'd say I also think I'm a "highly sensitive person", which means my primitive brain reacts more strongly to external stimuli. I think it explains a lot of my struggle in retrospect. I still feel stressed in social situations, but I know how to deal with it now mentally - I consciously recognize what is happening, and calm down the screaming part of my brain, and the anxiety mostly goes away.