I am not sure I would say I had it bad - there were bad (sometimes extremely so) times but ultimately I am not in such a bad situation (I have a two very valuable masters, a highly coveted job with an income significantly above the average of my peer group, I have decent looks, am in not too bad - although it certainly could be better - shape and while I suck at the romantic side of life, I managed to have a multi-year live-in relationship with my ex, at least)
My realizations? I would say conventional game advice is spot on, the times where I had not been all that interested I very naturally was the aloof guy game wants to project and it most certainly works (my ex still mentioned years into that relationship that it got to her I ignored her [1] one of the first days we had met and that it made her wonder). So definitely read the game stuff but try to stay away from the more misogynistic parts of it - most guys are jaded enough as they are, no need to get worse in that regard. Also, keep it to yourself, society overall largely is not ready to hear about it - it's about as un-pc as it gets (though one play interesting games if ultimately usually pretty fruitless by discussing game concepts with girls).
As for managing anxiety on dates, that usually has not been all that big an issue for me (on the few dates I actually was on, I never felt particularly anxious, even if things did not go all that well). I am not all that bad in a 1 on 1 setting - if I can get to it. If I had to come with a regime to treat anxiety on dates, I would probably recommend an SSRI (at least for me they move my mindset closer to outcome independence which is really what you need to have) with the qualification that you should really try and figure out how strong the sexual side effects are for you, otherwise a date that was going very well might get awkward very quickly. However, in my experience, SSRIs are not all the same and no two people respond to them in the exact same way (for example, Cymbalta, technically an SNRI, was worst on both ED and middle of the line on anorgasmia, Effexor mainly gave me mainly strong anorgasmia, Escitalopram lowers my sex drive the most and Prozac, ironically, so far has the least side effects of all).
Ultimately, I KNOW I need to find a way to get over my approach anxiety, first and foremost (its kind of obvious, too, that if you fail at the beginning of the funnel, all other skills are totally useless). For me, SSRI/SNRIs do precious little in that area (neither does alcohol, BTW) and I have yet to convince my shrink to let me dabble in dopaminergics (trying cocaine would definitely be easier and while I have in principle no issue with people doing it, I am seriously too afraid that I would like it way too much - it's nasty, highly addictive stuff and somewhat of a legal liability [2]). Additionally, in the medium term I will need to move to a job that actually leaves me time for meeting girls and going on dates...
Most of the remaining stuff I realized is somewhat specific to my personal situation. I have a relatively low sex drive overall (with some occasional spikes) which is both a boon and a bane. It's a boon because it makes the whole situation less painful but that equivalently means there is less chance that I go and fix the thing. It also ultimately is not celibacy that gets to me (if it did, prostitution is legal where I live - still I have about 0 interest in it) but lack of intimacy. What I will say as for general points: Lack of intimacy CAN be medicated away (at least in the medium term) but it's likely to eventually blow up in your face and most likely in a situation where you facing problems in other areas of life, too.
Additionally, there is a big topic about confidence in my own abilities plus something related to the way my brain operates. I am an off the chart T in MBTI and on the far right of the IQ scale, so I am usually very confident in intellectual pursuits but tend to be bad at emotional stuff - which dating and relationships ultimately are all about. I also have an intensely one track mind: I can do ONE thing and ONLY ONE thing at a time - it's so bad that I can sit in a conversation and listen to the content but totally miss body language or watch body language and totally miss the content (I have a feeling that I am on the spectrum but I can't be bothered to get tested, it's not like it can actually be treated anyhow)... Focused on the right task and in the right mood, the extreme single mindedness can yield astonishing results, focused on the wrong thing, it tends to generate chaos, obsessions and depression.
[1] In reality, I flat out had not seen her that day
[2] It's unlikely that one would get into serious trouble for personal consumption in Switzerland - fines, sure but prison is not really a big risk
Bang on the money. Know this is old but Isochroma recommended tianeptide on another forum, and it would make sense as it stops the internal chatters. Women like guys who don't think too much, my brain is slinging thoughts like a gatling gun. Not at all healthy. I also have low libido/testoserone and want intimacy aswell as sex, definitely a non-masculine trait. I can more or less out-talk and out=think all my peers in most situations, but when it comes to drinks and then a nightclub the men are separated from the boys. Something is missing, and it damn needs medicating in some form. Exposure won't work for this ailment, its something deeper.
1)Society needs to accept that women and men are different. They are not equal. That's why there are different standards. So there should be no whining about why there is a bigger onus on men. Reality has to be accepted. Men are better at logic women are better multi-taskers. and the sooner everybody grows up and accepts these facts the better.(Its a joke that the top female tennis players and the top males get the same salaries though women play less sets - society trying to redress a perceived imbalance). Isin't it ridiculous that when I jump out the window gravity pulls me down?? Its such a double standard I never get to pull it down to earth. This is the way the world works, thus leading to
2) Game - Women don't actually want to go down the dinner date route. They just want to be taken. They will pick up on your confidence/positive aggression if you have it, its the prime factor.The dinner date thing of the sixties is nice and quaint. but it is only there because that was how society said women should behave in these matters, its not what they actually want. A sixties gal will still be attracted with positive aggression because it has nothing to do with society and everything to do with evolution,(which doesen't give a rats about our opinion on the subject, like gravity, it's just there). It works and its logical if your looking for sex but if your looking for a long term investment you need to have a different approach. There's nothing wrong with having solid game in the toolbox, and its not "cheating" or "deceiving" women any more than putting on make-up is cheating as it gives guys a false impression of what a girl looks like. This is the way the game works, get good at the game, period.
3)Before I get banned off the forum for suggesting it, nothing supplies you with positive aggression more than cocaine. Take it 3 or 4 times in the club to get your aggression.(then ditch it) You'll pull a couple of babes, become competent thus increasing confidence. Society dictates that you can use this drug(alcohol) which is socially acceptable but not this one(cocaine). I think alcohol is worse, I always wondered why I got severely depressed after it. It binds my guts together, which is I believe the serotonin center.(Pure conjecture).
4)"You don't need a pill", Of course you do, everyone does. I was once on the all things natural camp, before I realized that we are all bags of chemicals. Good mood is a release of neurotransmitters. The same as love, as it serves an evolutionary purpose(the period of affections lasts for 9 months, then after this is deep "love" for 11 approx). So there is nothing wrong with manipulating these. The confident guy in class?? He just had more neuros. Who cares where they came from the end result is the same. When I'm on phenibut(amazing imo) the same problems that were freaking me out are now insignificant. My perception and therefore reality changed, with the simple increase of a neurotransmitter. Most people's magic pill is alcohol. The magic doesen't do it for me, so I go to alternatives. The real you is the person at his/her absolute best without the reptilian system interfering. Give a girl a glimpse of it every few months and everything's fine, its quite a lasting image.
As an aside try turning that brain of yours to meditation, could yield interesting results. Overthinking is the worst disease of the 20th century and one I also suffer from quite badly.