Should I use my extra time?

I was diagnosed with anxiety disorder (and major depressive disorder, but irrelevant) 4 years ago, which made me qualified for extra time. I've always avoided any accomodations because I find it unfair (I guess I'm high functioning?), embarrassing, and honestly shameful. I live in a place where mental health talk is really stigmatised. Before anyone comes for me, I seriously don't hold these standards to anyone else, and I've worked through self hate in therapy but to no avail. I got high grades in previous tests and mocks so I never planned on using the extra time at all.

But, recently I'm reconsidering. Since exams are in a few months and my extracurriculars are being insanely demanding, things have worsened. Last night I had an anxiety attack so bad I couldn't feel my legs for hours. My last further pure maths exam, my heart rate was 100 (my resting is 80) for an hour and I almost fainted after the test. I'm terrified as to how severe it'll be in the real exam.

The issue is, I don't know whether this is just an excuse, or if it's due to my lack of revision. I've been fine in other subjects, and again, I've never taken any accomodations and did fine. Another issue is the social shame - I can lie and say I have a heart condition (might as well be true at this point), but people always find out. Also, before anyone says "it's not a big deal", people know me as a good public speaker etc etc and I don't want that to change.

Does anyone else have any experience with this? Anything would be helpful, thanks