It seems to me you have accomplished quite a bit. From your description you enjoy a level of success that many fail to achieve: a successful startup with an ex

It seems to me you have accomplished quite a bit. From your description you enjoy a level of success that many fail to achieve: a successful startup with an exit before college, completed college, and an executive level position ("at work as a VP"). I found this description of anxiety by Tim Keller (who borrows from Rollo May) very useful: “Healthy fear is specific and constructive. It sparks physical energy and mental clarity. It enables you to summon your deepest capacities to protect something that you value that is threatened. Fear is specific and constructive Anxiety is diffuse. Where fear galvanizes you into action, anxiety debilitates you and paralyzes you so that you are unable to make a decision or act. Fear is a thunderstorm that passes back into sunlight and green grass. Anxiety is a cold drizzle, it’s 34 degrees and raining all the time so that your soul starts to mildew. Anxiety is a threat to your sense of self, when your identity and sense of security are eaten away. It’s deeper and more destructive." Tim Keller in https://youtu.be/-8tdA8YMOYM?t=586 [link starts at 9:46 min mark with definition from Rollo May, Keller’s story begins at 11:06] What if you take the next 18 months and make a solid contribution at work, help your people develop, and focus on making and meeting your commitments by keeping them small. Don't plan for home runs or large scale-ups. Think base hits and reliable performance. If "by any measure I am living the American dream" you should enjoy it. Zoom in for traction ("small predictable steps") and enjoy the ride. You can pick a date in late 2022 to start making a few medium size plans and see if you can get better at making and meeting commitments. My $0.02 your mileage may vary.