One might think they’re having a heart attack, which they might be.

When experiencing symptoms such as chest pain or tingling in the hands, especially for the first time, people might think they’re suffering from a congestive failure when they’re actually suffering from something far less dangerous: A panic attack.

“Oftentimes, after your first one [panic attack], you can tell the difference,” said Brithany Pawloski, a clinical psychiatrist for NorthWest Ohio Psychological Services. “A lot of times, there’s the shortness of breath, nausea, tingling in your hands. This is why a lot of people end up in the hospital, because they think they’re having a heart attack.”

Panic attacks are very short but overwhelming surges in anxiety that trigger unpleasant physical sensations such as a shortness in breath, nausea, physical trembling, abdominal discomfort, fainting, and dry mouth, among other symptoms, Ohio medical professionals said.

Panic attacks last around 10 minutes while anxiety attacks tend to be longer and less intense, she said.

Dr. Pawloski said she likes to think of panic attacks as a kettle of water burning on a stove, the pressure continuously building until whistles blow from the top of the kettle.

“The whistle blowing is the panic attack,” she said. “A lot of people turn to the last cubic meter of pressure as the reason that the ‘kettle’ blew but that’s not really true. It’s just the culmination of our nervous system that can't take it anymore.”

Carrie Baker, a pediatric mental health specialist, said most panic attacks are the result of underlying anxiety.

“I would say 99 percent of the time, you are not going to have panic attacks unless you have underlying anxiety,” she said.

What causes a panic attack?

Panic attacks can be caused many stressful situations in a person’s life, both past and present, experts say.

Stressors such as childhood trauma, divorce, or the death of a loved one are among the many contributing factors to anxiety, which can lead to a panic attack. 

“There’s no good evidence that one single thing causes panic attacks for people,” Dr. Pawloski said. “There are definitely things that can contribute to panic attacks. Things like genetics; if your parents have panic attacks, you’re more likely to have panic attacks. Things like substance abuse and certain medications can cause a panic attack.”

Panic attacks can also be triggered by social situations that are anxiety provoking such as going for a job interview, going into a crowded place that is unfamiliar, and public speaking, said Dr. Rajiv Parinja, a clinical psychiatrist at Mercy Health.

Dr. Parinja said the fear of having a panic attack can also provoke a panic attack. 

“The fact of having a panic attack then itself can trigger a panic attack because you worry about having a panic attack because it’s such an unpleasant experience,” Dr. Parinja said. “They don’t want to have it again and that anxiety can actually trigger a panic attack and then subsequent avoidant behavior because you don’t want to be in the situation where you have that panic attack.”

Dr. Peter Mezo, an associate professor and associate chair in the Department of Psychology at the University of Toledo, said some people could suffer from panic disorders, which can cause panic attacks that aren’t necessarily related to any stressors one could be experiencing. 

“A panic disorder is actually a specific area where you’ll have a panic attack that seems to come out of the blue,” Dr. Mezo said. “You’re just hanging out, you’re watching TV and then suddenly, you have this rush of symptoms and you don’t know where it came from. In those instances, it’s a panic disorder because the thing you’re actually fearful about are the internal sensations and what they mean.”

What to do in a panic attack 

There’s no true way to stop a panic attacks once it starts, Dr. Pawloski said. 

Though suffering from one is extremely uncomfortable, keeping yourself calm and remembering to breathe are some of the best ways to get through a panic attack, she said. 

“Trying to stop it from happening is just going to agitate you more,” she said. “We’re trying to calm the down the nervous system. That’s why people say, ‘Try to go outside, take some deep breaths, change your environment, cold compress on the face], those kinds of things.” 

Going to therapy as well as implementing what one has learned is also effective, Dr. Baker said. 

She said de-escalating the anxiety behind a panic attack will decrease the uncomfortable physical sensations while experiencing one. 

“The biggest thing is, especially if they’ve been to therapy, which is huge, is to implement the coping strategies that you’ve learned in counseling,” Dr. Baker said. “Some of those could be stepping back, taking a deep breath, blowing in a bag, regulating your respiration, trying to use some of those cognitive skills of talking yourself through what’s really going on and telling yourself some truth. Like, ‘It’s going to be OK. I’m not having a heart attack.’”

First Published October 1, 2023, 4:00 a.m.