What's are realistic expectations regarding medication?

My anxiety doesn't seem very responsive to various meds, and I'm not sure if it's the wrong meds or wrong expectations. I don't expect medication to silence my anxiety, but it would be a relief if its yelling turned into a shout.

I feel anxious often, it's like annoying noise in the background that easily spikes in volume. Socializing, working, mildly excessive noise and stimuli, feelings of inadequacy, sometimes meditation and guided imagery, all trigger it. I have toxic shame and my thinking patterns contribute to the spikes. I feel "activated" most of the time, or fearful.

I definitely need to shift my thinking patterns and reframe. I wish my meds could do more heavy lifting because goodness the feeling is an exhausting obstacle in my life.

I've occasionally tried gabapentin for acute episodes to no effect (I'm wary of that medications side effects anyways). I've been on, at one point or another, brintellex, wellbutrin, Zoloft, Luvox, zyprexa, lexapro, vibrid, busbar. Some of these meds helped for a few years and then lost effect.

I'm on brintellex, Wellbutrin and busbar now, it feels like a wash with anxiety (but has helped with depression)

I'm unsure if my expectations are off with meds. My psych seems reluctant to change them. He has recommended exercise and now meditation. I've averaged about 90 miles on my bike a week since last March, it helped a good deal at first but now I'm getting diminishing returns. I haven't tried more meditation but in the past I became hyper-conscious and then anxious, instead of relaxed.

That's what happens to me when I try deep breathing, it makes me more aware of my body and more anxious. I wish I had something helpful to say but unfortunately all I can do is offer a hug.