Absolutely, panic attacks and anxiety can often be exacerbated when one is killing pathogen and creating die-off. This always happens for me when treating babesia. Are you doing a lot of detoxing? You may want to cut back on the amount of antimicrobials you are taking, or consider easing into them via pulsing (not taking everyday). Especially in the beginning, herxes can be very difficult to manage.
The pau d'arco and coptis are usually good herbs for these infections. Others that you may want to explore down the line include allicin, houttuynia, byron white formulas like A-bart (strong).
But for now just slowly ease into treatment, and it's ok if you have to cut back from even very low doses, some people can't tolerate 1 drop of antimicrobial tincture in the beginning, have to do like 1/4th of a drop (put one drop in glass and drink 1/4th of it).
In regards to the antibody tests, they have their various issues. Often they can signal infection may be in play, and then much comes down to clinical dx and also how does patient respond to therapies. If you herx to bart therapies it would indicate bart is in the mix.
You may also want to explore things to help with the anxiety. I found higher dose l-theanine helpful. And implementing various detox like epsom salt baths, infrared sauna, burbur, pinella, binders, etc. Lots of things to try. Some patients have MCAS issues related to the infections (mast cell activation syndrome), I think it's especially more common with patients who have stronger issues with herxing. In my case I've found comboing antihistamines to be helpful for tolerating therapies and flares. Could be worth exploring at some point, especially if you find that over time you have continued issues with herxing. https://www.lymedisease.org/lyme-sci-mcas-agony/
I've also always liked this overview from Wayne Anderson on the infections and various symptom manifestation: https://conniestrasheim.org/blog/2017/3/6/a-deep-look-at-the-symptoms-of-six-major-lyme-related-infections