St John’s Wort is mainly used for depression. And there might be some effect on anxiety. But the evidence is not clear on that. I currently only take Seroquel for sleep, so no drug interactions. But the evidence for anxiety seems slim.
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I’m in a similar boat and am very sympathetic. Just about every good suggestion has already been mentioned, and some of them have helped me a bit also (lithium and exercise in particular). CBT also helped to some extent when I was in my 30s, growing in my faith helped a lot more as I got older (just mentioning as part of my story, not suggesting to anyone else), but getting on testosterone replacement largely squashed my anxiety almost instantaneously a couple years ago. That’s when I realized how much of it had been a hormonal problem that started with puberty.
About a month into TRT, the internal upwelling of constant anxiety vanished except when my estradiol started to get too high. In that case, I would take a small dose of an aromatase inhibitor or a DHT-derived compound and feel better again. Since starting TRT, I feel pretty calm most of the time. It’s just another possible puzzle piece to consider investigating.
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Have you considered clonodine? It is an antihypertensive, non-sedating but not a beta-blocker. It is an antiadrenergic medication (α2A-adrenergic receptor agonist) which can be taken 2 or even 3 times a day, also comes in a transdermal patch. Used in childhood anxiety, ADHD, autism, tics, hyperarousal and more. Wikipedia has an ok page about how it is used. Of course there may be side effects, etc etc you’d have to work with your provider to see if it might suit you.