Even a four month old puppy can be impacted by their environment. There's even evidence that high levels of stress in the mother while she's pregnant can produce puppies who have more extreme stress responses for their entire lives. My own 17-month-old (or is it 18 now? This year has been such a mess) had an accident at 8 weeks at the (excellent and caring) breeder where his head got stuck in a wire grate, and I do believe that it's contributed to his weirdness about wearing anything that feels restrictive - harnesses included. If I had to guess, I'd say this girl probably has both early environmental and genetic factors contributing to her nerves. I'm not one to jump on 'if a dog acts anxious it's been abused', because that's usually not the case and impossible to prove for most dogs, but here it does seem like there's solid evidence that she grew up in a stressful environment.
I'm going to second nosework! It's an enormously confidence building sport, and one of the most accessible 'sport' options out there for people with mobility or space restrictions. We've done a lot of training just in our small apartment during lockdown. It's dog driven and super positive, and many dogs find it inherently rewarding. It also employs behavior (sniffing) that's naturally calming and rewarding to many dogs. It's way easier to do using a book or an online class as a guide than many other kinds of training/sport, in my experience, and you certainly don't have to make it a goal to compete! It's just as useful to practice finding kibble and treats around the house and yard when it comes to trying to build confidence.
And I'm also going to second consulting about behavioral medicine. It can be an enormous benefit to dogs who are so anxious that they cannot function, even in a home environment. A poster here has a thread documenting her own dog's journey with anti-anxiety medications (Medicating Molly) which may be worth a read-through - the dog in question is now off meds entirely and competing in agility/going to dog events and handling life so, so much better than before, because the medication allowed her to learn how to better cope with the world. I also love this article on the topic: Behavior Medication: First-Line Therapy Or Last Resort?. This is definitely something to discuss with a vet or veterinary behaviorist, but I think it's an option a lot of people overlook or are resistant to when it really can change an anxious dog's life for the better.
I'm going to second nosework! It's an enormously confidence building sport, and one of the most accessible 'sport' options out there for people with mobility or space restrictions. We've done a lot of training just in our small apartment during lockdown. It's dog driven and super positive, and many dogs find it inherently rewarding. It also employs behavior (sniffing) that's naturally calming and rewarding to many dogs. It's way easier to do using a book or an online class as a guide than many other kinds of training/sport, in my experience, and you certainly don't have to make it a goal to compete! It's just as useful to practice finding kibble and treats around the house and yard when it comes to trying to build confidence.
And I'm also going to second consulting about behavioral medicine. It can be an enormous benefit to dogs who are so anxious that they cannot function, even in a home environment. A poster here has a thread documenting her own dog's journey with anti-anxiety medications (Medicating Molly) which may be worth a read-through - the dog in question is now off meds entirely and competing in agility/going to dog events and handling life so, so much better than before, because the medication allowed her to learn how to better cope with the world. I also love this article on the topic: Behavior Medication: First-Line Therapy Or Last Resort?. This is definitely something to discuss with a vet or veterinary behaviorist, but I think it's an option a lot of people overlook or are resistant to when it really can change an anxious dog's life for the better.