I've used Todoist for the last few years. It's not perfect. But it's been game-changing in terms of reducing anxiety because I never worry that I'm forgetting something.
Like you, I don't know how folks in similar positions manage. I think a lot of people just drop the ball on a lot of stuff or wait for stuff to become suddenly urgent. I don't think that's a terrible approach -- I still drop a lot of balls because there's just too much. I just try to do it more intentionally.
I'm not knocking folks with other systems, text files or otherwise. Do what works for you!