I appreciate you detailed response...it seems you're apparently doing what is recommended by experts. So the plausible reason could only be there's something that is not as well done as needs to be.

The second thing I'd like to ask. Mayo has listed eight items under perception/thinking/emotional response and another eight (starting with fatigue that you've mentioned) under physical symptoms. Are there any relevant to your condition?

Lastly, you say the second time u went back to Pilates studio your anxiety hit back. Did ANYTHING (a trigger) at the last day(s) at the studio, i.e, 4 years ago, happened that led you to stop using studio? After all u were OK before rejoining the studio for Pilates, right?

Finally since you say u have GAD even tho u r doing CBT (on ur own) w/ mindfulness /meditation, what exactly in another person or persons makes you anxious, knowing, presumably that people ARE no less broken that you and me. Indeed since YOU have CBT knowledge and Meditation YOU may be a beneficiary to them -- just like if you knew how to treat blindness in a town most were blind. Won't YOU WANT TO help THEM?

I ask u this because we ALL are good/pretty good at Something and therefore we ALL benefit when we SHARE our unique gifts. I'm saying this bc I believe And practice this view of humanity.

And that can also give us JOY in our otherwise very routine life. I hope u did your walking and Pilates finding joy as this is central to all movement that we learnt as toddlers, without a pediatrician telling us to stand up much less run and jump and climb.

I look forward to your post. All Best!