@jebz88 First, I'd like to welcome you to Mayo Clinic Connect. I see you have already received support that you've found helpful. I understand the struggle with anxiety and trying to figure out what works best.

While I mostly understand how benzodiazepine medication such as Ativan works I can only comment on my own experience. As @frouke commented, this class of medications is insidious. You are very wise to be concerned with tapering off and how to do that. For now, and from what you've written the anxiety and panic attacks you experience ramp up at times. I went through that same scenario when I first experienced panic attacks. This was over 30 years ago and I worked with a psychiatrist who helped me find an antidepressant (desipramine but there are better antidepressant medications with fewer side effects now available) medication that worked to bring down the anxiety and the depression I was feeling so I could better cope. Since I took the antidepressant daily I didn't have to "react" and worry about panic attacks. I learned coping skills for when I did feel anxious.

Are you already taking antidepressant medication that works for depression and panic attacks? There are many medications that your doctor can try with you to see what works best. It takes patience on your part to go this route as it takes time to get to the dosage level that works best for you and for your body to adjust.

Here is information from Mayo Clinic:

Serotonin and norepinephrine reuptake inhibitors (SNRI):

--https://www.mayoclinic.org/diseases-conditions/depression/in-depth/snris/art-20044970

Selective Serotonin Reuptake inhibitors:

-- https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825

There are other medications too that are not in the above classes that work for anxiety and depression.

Are you seeing a mental health therapist who can help you develop coping skills and help you with the stress you are experiencing?