I get generalized anxiety without the panic attacks (or without bad ones anyway) but it has sometimes been pretty bad. By way of establishing my credentials as someone who has lived through this shit, I remember on one of the first anxiety attacks I had, like 3 days in, comforting myself with the thought “well if this continues, I can always kill myself”. It seems like a ridiculous thought to me now, but that’s where I was at at that point.
I think that by even having a debate with yourself about whether you’re really suffocating, you’re playing by the anxiety’s rules and granting it a power it does not possess. It’s ultimately irrelevant whether you believe it or not, since the panic attack will pass just the same. You might have a bad time in the meantime, is all.
I found learning calm and concentration meditation helpful in building in an understanding that the mind is like an ocean which sometimes becomes stormy, but will naturally become calm again of its own accord if left to do so. It’s not that meditative techniques are very helpful when I have acute anxiety, it’s that repeatedly observing the process of a calming mind builds in a bedrock confidence about the inevitability of this. I think this is the same thing Chesspain means about “believing you will be OK no matter what”. To continue the storm metaphor, it’s like a dog scared of a thunderstorm. Sure, it’s better if you can calm the dog down in the moment, but ultimately it doesn’t matter if it goes apeshit, because storms don’t last and when it passes, the dog will calm down.
This can sound like One Weird Semantic Trick, but it’s a process of building confidence and certainty. It doesn’t defeat anxiety in the moment, but gradually situates you as an external observer rather than someone who is required to become embroiled in the circus going on in your mind.