Wow thats a lot to try and unpick. I will start with the medication side of things. Many medications have multiple benefits for a variety of conditions. I too take antipsychotic medication which stabilises my mood and helps me to sleep (most of the time). The meds can’t pick and choose which of your anxious thoughts to help with so if it works for some of your specific thoughts there is no reason why it can’t help with all of them.

Having checked out your profile I think I have a bit of an understanding of the kind of difficulties you face being neurodiverse myself. I can’t answer the question about breathing changes after smoking as I don’t smoke but I am asthmatic and as a kid my family often told me that I was breathing too loud. I never noticed myself but I had a genuine reason for it and it wasn’t something I had any control over. Do you have any respiratory conditions? How long have you smoked? Has this happened before? Is it worth booking an appointment with your GP to discuss this with them? Of course it may be anxiety related or it could be that the anxiety worsened because of irrational fears over the observation of your family. It’s all to easy to allow anxiety to spiral out of control.