@gseaborn, I think the first step is to isolate what causes you anxiety and panic. Not the root cause, but the every day things that trigger you. I know that being in crowded rooms where I can’t move or hear well causes me to feel claustrophobic. I know that loud noises, especially machinery and banging or (angry) yelling causes my PTSD to “kick in” and I can’t function. Figuring out what triggers you can allow you to find ways either to avoid the situations or to find ways to calm yourself when you’re in them.
After that, you can delve into what in your past or present, whether psychological or physical or both (trauma, neglect, abuse, etc.) that is at the root of your condition. For that, I’d suggest therapy.
28.75 years of recovery, 2+ years of therapy, out patient mental health treatment, medication, and I still have attacks. Now though, they don’t control me as much as they used to. (I can ride a crowded bus without throwing up. I can attend social functions.) I’ve found that listening to music with headphones while I’m out walking or shopping really helps. It can be distracting but sometimes that’s the point.
Bottom line, what is the immediate is cause your panic attacks and why do you have them?
Good luck. You’re not alone.