Hi Quinn, I've had this problem since i was a teen and now i'm retired. like you, i have avoided meds and i tried a shrink one time but after a few $100 sessions, i felt that the only good i was doing was helping to pay off his mercedes..... Early on i felt that i would consider meds only as a last resort and after taking a good look into a wholistic approach. I had this for years before i found out what it was after seeing a program on tv where a fellow was describing his feelings and mine were almost identical. My worst job was an office job where paranoia was a problem (i often thought that people were wondering about me, etc.) My least problematic work was the type where i had involvement with few people most of the day and involved physical labor. Exercise seems to help and i have often wondered if the chemistry change due to exercise or physical labor counteracted to some degree some effects of the chemical imbalance (if that is what it is) of sa. Depression was an occasional problem as well and here again, a long bicycle ride or a very brisk walk would help. Also, and this may seem strange, i have always felt that if things ever got critical, i could always move to a very rural area and have as little contact with people as i can comfortably deal with and find relative peace of mind. That thought was a sort of tool whenever i started to feel trapped and hopeless. Nowadays, i avoid uncomfortable social situations when possible, i'm active physically, i have a number of penpals (regular mail types and a couple of e-mail friends) and i now have a travel trailer to travel to various parts of the country. Over the years i have become distanced from some friends and family due to avoidance but i believe that avoidance cannot be avoided and that is the price we pay. We did not bring this curse upon ourselves so try to convince yourself that you have nothing to be ashamed of. So, to wrap up this long-winded response, it is my recommendation to work on coping techniques and keep in mind that it's a day-to-day struggle and that so far you have done ok.
All the best,
shep