First - I'm not terrible at video games. Please don't try to make your e-peen larger by putting me down and spewing some bile about "git gud nub".
What I am looking for is suggestions on what I'm doing wrong - usually on harder difficulties in games there's some careful planning, or equipment, or blend of skills and perks that make higher difficulties possible. What I'm getting is feeling like I've tried everything and I'm out of options, and I'm genuinely unsure of how a player is meant to do the game on these harder difficulties - like, what was Obsidian intending for us to do?
I've had this experience a lot for the past 10 or so hours of the game - my weapons do pretty good damage, but enemies just absolutely shred me if I get hit at all. My companions fall over like wet paper, and if I'm not cheesing the AI's pathing, or shooting from 10 miles away on top of a rock that they can't get me on, I'm dead in 3-5 hits that come so fast I can't even mash the F key enough to out-heal it or dodge to get some breathing room.
I'm near the end of the game. I'm doing the Eridanos content, and I'm
(I don't think that's too much of a spoiler).
I'm level 36, and I'm wearing the absolute best armor I can possibly find - 108 chest / 84 head. I have all the defensive perks that seem relevant, and Dodge at 60. I dodge, I use the slow-time ability to stun / do headshots, and I have Dialogue skills up really high.
Imgur link to perks screenshot
I'm frustrated because I feel like I'm doing all the things I'm supposed to be doing to be able to survive fights better, but none of it is working. What am I doing wrong?