I have been having panic attacks for the last eight years and it is only lately, last seven months or so, that I have been off medication and haven't had a panic attack for more than a year. Thank you God.
I cannot answer the questions in your letter but I can share my experience with you and the way I have learnt to cope with this and it may be helpful.
My panic attacks have started by prolonged severe phsychological stress/ trauma, which created an immediate and automatic fight or flee response from my body, without the intervention of a rational thought. eg. After severe problems with my husband, I felt that if I was ever to get sick I would be totally alone and helpless. This triggered an immediate response every time I would feel even slightly sick and a severe panic attack would start. No matter how much I tried to calm myself, the attacks would keep coming back and would not go away until I would get a tranquilizer.
Then after years of psychotherapy and medication, I have learnt to recognize the triggers and how to avoid them. If an attack became imminent I was able to rationalize it, or rather talk myself out of it.
Just by inserting, so to speak a rational thought, into the automatic process I found that I could stop an attack from developing. e.g. Say I feel a little unwell. Before my body starts sweating or hyperventilating automatically , I say :" Hold on here. Are you going to have a panic attack just because of a little pain? It maybe nothing. Just a cold etc." This normally slows down the panic response and gives me time to do something about it, like take some painkillers, or do something which will keep me busy. In this way I have learnt that I am not powerless and that I have the ability to control my mind and my body.
I do not know if all this has been helpful to anyone, but the whole point is to be able to stop the panic from developing by rationalizing the process. That is, to let your mind intervene in the automatic process which the brain has started because it has perceived a consious or subconsious trigger.
I have also found that praying helps me tremendously, precisely because it involves the mind and prevents the body from getting into the automatic panic mode.
Anyway, what I am saying is that there is hope and that we must not give up no matter what comes in our way. What doesn't kill us makes us stronger.