In my experience a panic attack happens when I am alone. There is no one around to distract me from my own brain and my own thoughts. It is also my experience that a panic attack feels just like a heart attack but without the sympathy from friends and family that usually accompanies a heart attack.
During the early stages of a heart attack there is chest tightness, shortness of breath, there is sweating and radiating pain. Then either a friend or family member gets called so they can let everyone know you are in the hospital. Once diagnosed as a heart attack you are admitted to the hospital, have a procedure and your friends and family come visit you. You get flowers and Get Well Soon cards. Friends tell you how you have to make some changes so you can be around a long long time. Friends and family say: "I will exercise with you everyday, I could stand to lose a few pounds." Or "For now on there will be nothing but healthy food in my house so come visit me."
During some panic attacks there is chest tightness, there is shortness of breath, there is sweating and radiating pain. A friend or family member gets called so they can let everyone know you are in the hospital. Once it is diagnosed as panic, you are NOT admitted to the hospital, there are NO procedures, and only a few friends and family call you to make sure it was not them that caused the panic. NO one wants to exercise with you, or invite you over for a healthy meal. Actually some people may avoid you all together because they think you are crazy. Some of your friends, some of them, will tell you to just shake it off and tell you "Thank God it was not a REAL issue."
I have had about a half dozen of full fledged panic attacks. None of them were NOT a real issue. My chest hurt. I could not breath. I was sweating and my vision narrowed. If I were to have a full blown panic attack while I was driving in my car, you would think it WAS a REAL issue if you were in the car in front of me.
The problem with a panic attack is that inside your head you know you are only having a panic attack. But also in your head, right next to the part that is acknowledging it is a panic attack, is the part of the brain that doubts it all. It is the part of the brain where anxiety hangs out. That part of the brain is telling the reasonable part of your brain it is full of shit and that you are actually going to die of a heart attack or stroke or something. Which then makes the reasonable part of the brain start to doubt whether it is reasonable or not. Then that reasonable part of your brain starts to have it's own mini panic attack. Once the reasonable part of your brain has the mini panic attack your whole body goes into a fight or flight mode. The body responds by increasing blood pressure and adrenaline which adds to the feeling of panic.
All of the panic symptoms happen and you know you may end up wasting your afternoon at the ER because you just want to make sure you are not having a heart attack, Then while you are in the ER you start to worry about what if it is not a heart attack and it is just panic. Then you worry you will have to explain to friends and family why you were in the hospital. While the nurse checks your enzymes you secretly hope that you actually did have a heart attack so you do not have to feel embarrassed about suffering a mental disorder.
And if you really had a heart attack your friends will invite you to exercise and have healthy meals.
And if you have your friends around exercising and eating food you would not be alone with your own thoughts and then you would not have a panic attack.