- Do I Have PTSD or Anxiety?
- What Is Posttraumatic Stress Disorder?
- How Is General Anxiety Different from PTSD?
- Help with PTSD and Anxiety
- Panic and Anxiety
- Difference Between Generalized Anxiety Disorder & PTSD
- Symptoms of Generalized Anxiety Disorder
- Symptoms of Post-Traumatic Stress Disorder (PTSD)
- The Key Differences
- Help for GAD or PTSD
- Phobias, panic attacks and post-traumatic stress in children
- Panic attacks in children
- Post-traumatic stress in children
- Professional help for children with phobias, panic attacks and post-traumatic stress
- Financial support for children with anxiety
- Generalized Anxiety Disorder vs. PTSD
- Signs and Diagnosis of Generalized Anxiety Disorder
- Post-Traumatic Stress Disorder Symptoms
- Telling GAD and PTSD Apart
- Search Our Site
- Posttraumatic Stress Disorder (PTSD)
- Relationships, Trauma, and PTSD
- PTSD Facts
- Additional Resources
- Fear of memories: the nature of panic in posttraumatic stress disorder
- What’s the Difference Between a Panic Attack and an Anxiety Attack?
- Lifestyle changes
Do I Have PTSD or Anxiety?
Do you experience feelings of panic, nightmares, chronic worries or nervousness? If so, you may be suffering from anxiety. Anxiety is a common but very serious problem that can affect every aspect of your life. Posttraumatic stress disorder (PTSD) is a type of anxiety problem that can lead to even greater levels of anxiety and problems over time.
What Is Posttraumatic Stress Disorder?
A person may be diagnosed with PTSD after experiencing a life-threatening or traumatic event. Usually, PTSD begins after a person believes that his life is in danger.
The event that causes PTSD symptoms does not actually have to be life-threatening, but if you felt threatened or in danger at the time, then PTSD may occur.
PTSD usually follows war or battle experiences, but it can also follow violence, abuse, assault, rape, loss of a loved one, natural disaster, or other catastrophic event. Some symptoms of PTSD include the following:
- Recurrent and intrusive memories or thoughts about the incident
- Feelings of panic or guilt about the event
- Difficulty recalling the event
- Problems connecting with others or feeling close to other people
- Feelings of irritability and anger that almost feel uncontrollable at times
- Efforts to avoid the unpleasant memories or experiences, sometimes at extreme costs
- Difficulty concentrating
- Feeling easily startled, or being constantly on guard
Post-traumatic stress disorder can overwhelm its victims. Symptoms can become worse over time without some type of intervention.
How Is General Anxiety Different from PTSD?
PTSD is a type of anxiety problem. However, you can have anxiety without having PTSD. Anxiety can be just as serious as PTSD, and it can manifest in ways such as the following:
- Generalized anxiety disorder: GAD is an anxiety issue that causes excessive worry and constant feelings of stress and concern over a number of different issues.
- Social anxiety: People with social anxiety feel panicked in social situations. Fear of public speaking is a very common social anxiety issue. Problematic social anxiety can cause individuals to live in isolation, struggle with employment and relations with others.
- Panic disorder: Panic disorder causes sudden and terrifying panic attacks that can seem unrelated to any real fear. Over time, panic attacks usually become worse as the suffering person begins to fear and anticipate future panic attacks.
- Specific phobia: A specific phobia is a fear of a specific object or experience. Some specific phobias include blood phobia, spider phobia, fear of heights, or a fear of dogs.
- Obsessive compulsive disorder: OCD is an anxiety disorder that causes people to obsess over repetitive thoughts and then try to ease those anxious thoughts through a compulsive behavior such as counting, hand washing or checking. OCD becomes progressively worse over time, many other anxiety issues.
Remember that an anxiety issue can occur alongside other anxiety problems. In fact, many people who suffer from generalized anxiety disorder also suffer from PTSD or other phobias or anxiety concerns.
Help with PTSD and Anxiety
Call us now and speak with an experienced and understanding counselor who can help. Our 24 hour, toll-free helpline can put you in touch with the best PTSD and anxiety professionals available. We work with a wide network of treatment providers, and we would be happy to help you find relief from the panic, anxiety and stress that has taken over your life.
Panic and Anxiety
Panic attacks are intense periods of fear or feelings of doom developing over a very short time frame — up to 10 minutes — and associated with at least four of the following:
- Sudden overwhelming fear
- Shortness of breath
- Sense of choking
- Chest pain
- A feeling of being detached from the world (de-realization)
- Fear of dying
- Numbness or tingling in the limbs or entire body
- Chills or hot flushes
Panic attacks and panic disorder are not the same thing. Panic disorder involves recurrent panic attacks along with constant fears about having future attacks and, often, avoiding situations that may trigger or remind someone of previous attacks. Not all panic attacks are caused by panic disorder; other conditions may trigger a panic attack. They might include:
Generalized anxiety disorder is excessive and unrealistic worry over a period of at least six months. It is associated with at least three of the following symptoms:
- Difficulty concentrating
- Irritability or explosive anger
- Muscle tension
- Sleep disturbances
- Personality changes, such as becoming less social
Phobic disorders are intense, persistent, and recurrent fear of certain objects (such as snakes, spiders, blood) or situations (such as heights, speaking in front of a group, public places). These exposures may trigger a panic attack. Social phobia and agoraphobia are examples of phobic disorders.
Post-traumatic stress disorder — or PTSD — was considered to be a type of anxiety disorder in earlier versions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. But in 2013, PTSD was reclassified as its own condition.
It describes a range of emotional reactions caused by exposure to either death or near-death circumstances (such as fires, floods, earthquakes, shootings, assault, automobile accidents, or wars) or to events that threaten one's own or another person's physical well-being.
The traumatic event is re-experienced with fear of feelings of helplessness or horror and may appear in thoughts and dreams. Common behaviors include the following:
- Avoiding activities, places, or people associated with the triggering event
- Difficulty concentrating
- Difficulty sleeping
- Being hypervigilant (you closely watch your surroundings)
- Feeling a general sense of doom and gloom with diminished emotions (such as loving feelings or aspirations for the future)
Symptoms such as chest pain, shortness of breath, palpitations, dizziness, fainting, and weakness should not be automatically attributed to anxiety and require evaluation by a doctor.
National Institute of Mental Health.
© 2018 WebMD, LLC. All rights reserved. What Does a Panic Attack Feel ?
Difference Between Generalized Anxiety Disorder & PTSD
If you have experienced something traumatic in your life, you may be confused about whether your response is normal and “to be expected” or if it could be something else.
Understanding the difference between General Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD) is essential to identifying the best course of treatment for your needs.
Symptoms of Generalized Anxiety Disorder
People with Generalized Anxiety Disorder report significant, persistent and uncontrollable anxiety and worry about a wide range of situations and things in life. People with GAD are often identified by their family members and friends as “anxious people” or “worriers.”
Also, people with GAD may experience physical symptoms of anxiety such as muscle tensions or headaches, difficulty sleeping and concentrating, and irritability. Sometimes a person’s response towards whatever is making him or her anxious can appear irrational or proportion.
GAD is differentiated from other anxiety disorders in that the symptoms of GAD must be present for at least six months before a diagnosis of the disorder can be made.
Symptoms of Post-Traumatic Stress Disorder (PTSD)
Post-traumatic Stress Disorder (PTSD) is an anxiety disorder that sometimes occurs after individual witnesses a traumatic event that involves actual or threatened death or serious injury to self or others.
In response to the event, the person feels scared, hopeless, or horrified, and re-experiences the trauma for at least one month following the event.
Individuals suffering from PTSD might re-experience the trauma in the following three ways:
- Re-experiencing: Symptoms include flashbacks, physiological responses similar to those experienced during the trauma, and feelings of distress when reminded of the event
- Avoidance: Symptoms include avoiding discussions or thoughts about the event, difficulty remember details of the event, and feeling distant from others
- Hyperarousal: Symptoms include difficulty with sleep, bursts of anger, and feeling on edge
Those suffering from PTSD may avoid places, activities, and people that remind them of the trauma. They lose interest in things they once cared about and often remain detached from others with blunted emotions.
The Key Differences
The key difference between GAD and PTSD is in how the disorder comes about. People with GAD often have a long and consistent history of anxiety across a wide variety of circumstances and situations.
People with PTSD, on the other hand, often find an intense experience of anxiety and related symptoms in response to a major life event.
Although there can be some generalizing to other situations, the experience with PTSD is often limited to the event.
It is possible for a person to have both Generalized Anxiety Disorder as well as PTSD. A traumatic event can make the anxiety associated with GAD more severe, so it's important to visit a professional for an official diagnosis so the right treatment can begin.
Help for GAD or PTSD
While each disorder can severely impact your life, it's important to know that they can both be treated with therapy or medication, or a combination of both. If you or a loved one are experiencing symptoms of either GAD or PTSD, we can help, Contact Crosswinds.
Phobias, panic attacks and post-traumatic stress in children
Specific phobias are fears of particular things or situations. These fears are quite common in children. Some common childhood phobias include the dark, storms, dogs, spiders, costumed characters clowns, heights, blood and injections.
Say a child is scared of the dark or of dogs, and he happens to be in a darkened room or facing a barking dog. The child might become very anxious and distressed. As with other anxieties, children with specific phobias will try to avoid the situation they’re afraid of. Or they might be extremely distressed if they have to go through it.
Although these anxieties are common, it’s a good idea to seek some professional help if your child’s fear:
- is really interfering with your child’s daily life
- is something you feel your child should have grown
- goes on for longer than six months.
Panic attacks in children
Panic attacks are a sudden rush of fear accompanied by physical feelings a racing heart, breathlessness, tightness in the throat or chest, sweating, light-headedness and/or tingling. During a panic attack, children might believe that they’re dying or that something terrible is happening to them.
These kinds of episodes are quite rare in young children and become more common in teenagers.
The fear of or anxiety about having panic attacks is known as panic disorder. For children with panic disorder, the fear is of the panic attack itself rather than of the situation. This means that children are afraid of their panic symptoms, rather than of the things that cause anxiety, people laughing at them, dogs biting them or getting lost.
Panic disorder is very uncommon in young children and younger teenagers. It happens more often in older teenagers and young adults.
If children start avoiding situations because of their panic attacks, this is called panic disorder with agoraphobia. If this happens, it’s worthwhile seeking professional help.
Post-traumatic stress in children
Post-traumatic stress is a reaction to a severe traumatic event in which a child was hurt or felt extremely scared or threatened. Events that might trigger these reactions include:
- natural disasters
- personal attacks
- car accidents
- sexual, physical and emotional abuse.
Children who have been affected by a traumatic event usually show some anxiety for a few weeks afterwards. The anxiety then gradually disappears.
Post-traumatic stress disorder (PTSD)
In some cases, children suffer anxiety for many months and years after a traumatic event. This can interfere with their daily lives. This might be post-traumatic stress disorder (PTSD).
Children with PTSD might keep remembering the traumatic event or have bad dreams about it, perhaps even including the trauma in their play.
They might suddenly act or feel as if the event is happening again and get very upset. They often try hard to avoid situations that remind them of the trauma and might become emotionally distant.
They might be jumpy or irritable and have sleep difficulties.
After a traumatic event, you or your child might need support, and children suffering PTSD usually need professional help. You can read more about first response to trauma and supporting children in the weeks after trauma.
Professional help for children with phobias, panic attacks and post-traumatic stress
You know your child best. If you’re worried about your child’s behaviour or anxieties, consider seeking professional help. Here are some places to start:
- your child’s teacher at preschool or school, or a school counsellor
- your child’s GP or paediatrician, who will be able to refer you to an appropriate mental health practitioner
- your local children’s health or community health centre
- a specialist anxiety clinic (present in most states)
- your local mental health service.
If your child is aged 5-8 years, he can talk with a Kids Helpline counsellor by calling 1800 551 800, or using the Kids Helpline email counselling service or the Kids Helpline web counselling service.
Financial support for children with anxiety
Your child might be able to get Medicare rebates for up to 10 mental health service sessions from psychologists, social workers and occupational therapists each calendar year.
To get these rebates, your child will need a mental health care plan from a GP (this covers what services your child needs and the goals of the treatment), or a referral from a psychiatrist or paediatrician. It doesn’t matter how old your child is.
Generalized Anxiety Disorder vs. PTSD
HomeGeneralized Anxiety DisorderGeneralized Anxiety Disorder vs. PTSD
Determining the difference between post-traumatic stress disorder (PTSD) and other trauma disorders can be a challenge. Confusing this issue is the fact that PTSD and other anxiety disorders, such as generalized anxiety disorder (GAD), often co-occur. Learn the difference between the two so you can learn how to begin the healing process.
Signs and Diagnosis of Generalized Anxiety Disorder
GAD is characterized by excessive worry and anxiety. While most people experience some worry or anxiety in their lifetime, someone suffering from GAD feels worry and anxiety more often than not.
He or she may also experience the following:
- Feeling restless or on edge
- Feeling easily tired
- Trouble concentrating
- Muscle Tension
- Sleep pattern disruptions
GAD is differentiated from other anxiety disorders in that symptoms of GAD must be present for at least six months before a diagnosis of the disorder can be made. The Anxiety and Depression Association of American shares that “GAD affects 6.8 million adults, or 3.1% of the U.S. population, in any given year.”1 If you struggle with GAD symptoms, you do not struggle alone.
>>> READ THIS NEXT: Treating Mental Health and Addiction Issues Together
Post-Traumatic Stress Disorder Symptoms
PTSD is an anxiety disorder that can develop after an individual experiences or witnesses a traumatic event. You may feel scared, hopeless or helpless. PTSD symptoms may start to interfere with your everyday life. These symptoms may include the following:
- Sleep pattern disturbances
- Angry outbursts
- Difficulty concentrating
- Feeling jumpy or easily startled
Additionally, you may begin to re-experience the trauma. Individuals struggling with PTSD may re-experience trauma in the following ways:
- Bad dreams
- Psychological or physiological distress
These can stem from mental images, thoughts and feelings. They can be triggered by real events, places or objects. Those struggling with PTSD may try to avoid re-experiencing symptoms by avoiding stimuli associated with the trauma.
This avoidance can look the following:
- You or a loved one may not want to talk about, think about or feel anything related to the trauma.
- You may avoid places, activities and people that remind you of the trauma.
- You may be unable to recall specifics about the event or events.
- You may lose interest in things you once cared about.
- You may feel detached from others.
- Your emotions may feel or seem blunted.
- You may have trouble imagining a normal future, life or lifespan.
PTSD symptoms can feel overwhelming, but they don’t have to control your life. You can learn how to manage your PTSD. The National Institute on Mental Health explains that professional treatment, medication and talk therapy offer real symptom relief.2
Telling GAD and PTSD Apart
Many GAD and PTSD symptoms overlap. For example, GAD is characterized by significant anxiety and worry. These are also issues that may surface when an individual struggles with PTSD. With either mental health issue, individuals may avoid places, activities and people in response to anxiety and worry.
Additionally, the two mental health concerns can co-occur. Co-occurrence may arise due to features of one disorder serving as risk factors for the development of the other.
An individual who struggles with GAD and then experiences a traumatic event may be more ly to experience symptoms of PTSD.
He or she has a pre-existing tendency towards excessive worry and anxiety that can be magnified by witnessing a traumatic event.
You don’t have to diagnose yourself or a loved one before you can get help. Mental health issues require professional diagnosis and treatment. So, if you are struggling with worry and anxiety symptoms, let us help you get an assessment, find recovery solutions and begin a healthy, balanced life. Call 615-490-9376 now.
1 “Generalized Anxiety Disorder.” The Anxiety and Depression Association of America. Accessed 7 Jun. 2018.
2 “Post-Traumatic Stress Disorder.” National Institute on Mental Health. Feb. 2016.
Search Our Site
Posttraumatic Stress Disorder (PTSD)
It’s not unusual for people who have experienced traumatic events to have flashbacks, nightmares, or intrusive memories when something terrible happens — the 9/11 terrorist attacks and those in cities around the world (Orlando and Paris, for example) or the bombings at the 2013 Boston Marathon, or active combat.
Be tolerant of your nervous system: It’s having a normal reaction. Try not to get hooked to news reports, which may seem particularly compelling. Spend time with loved ones in favorite activities or outside in nature, and avoid alcohol.
Learn more below, including how to help children.
Posttraumatic stress disorder, or PTSD, is a serious potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events.There are currently about 8 million people in the United States living with PTSD. Research has recently shown that PTSD among military personnel may be a physical brain injury, specifically of damaged tissue, caused by blasts during combat. (Research Traces Link Between Combat Blasts and PTSD)
Most people who experience such events recover from them, but people with PTSD continue to be severely depressed and anxious for months or even years following the event. Learn about PTSD symptoms.
Women are twice as ly to develop posttraumatic stress disorder as men, and children can also develop it. PTSD often occurs with depression, substance abuse, or other anxiety disorders.
- Help Your Child Manage Traumatic Events
Relationships, Trauma, and PTSD
Trauma survivors who have PTSD may have trouble with their close family relationships or friendships.
Their symptoms can cause problems with trust, closeness, communication, and problem solving, which may affect the way the survivor acts with others. In turn, the way a loved one responds to him or her affects the trauma survivor.
A circular pattern may develop that could harm relationships. Read more from the National Center for PTSD.
- More than 8 million Americans between the age of 18 and older have PTSD.
- 3.6% of the US Adult population experienced post-traumatic stress disorder (PTSD) in the past year.* (National Institute of Mental Health)
- 67 percent of people exposed to mass violence have been shown to develop PTSD, a higher rate than those exposed to natural disasters or other types of traumatic events.
- People who have experienced previous traumatic events run a higher risk of developing PTSD.
- PTSD can also affect children and members of the military: Watch a video about Staff Sgt. Stacy Pearsall, a combat photographer who experienced PTSD. See how she got help.
Screen yourself or a loved one for PTSD.
National Center for PTSD
Understanding PTSD and PTSD Treatment
PTSD Stories on The Mighty
Give an Hour — for veterans and their families
Real Warriors (U.S. Department of Defense) — for veterans and their families
The Gift From Within
Fear of memories: the nature of panic in posttraumatic stress disorder
Although there is increasing evidence that panic attacks are common in posttraumatic stress disorder (PTSD), little is known if posttraumatic panic is comparable to panic attacks observed in panic disorder (PD).
This study examined the cognitive responses to panic attacks in participants with PD and PTSD.
Participants with PD (n=22) and PTSD (n=18) were assessed on the Anxiety Disorder Interview Schedule for DSM-IV and subsequently administered the Agoraphobic Cognitions Questionnaire and a measure of fears related to trauma memories.
Although participants did not differ in terms of catastrophic appraisals about somatic sensations, PTSD participants were more ly to experience fears about trauma memories and being harmed by trauma again during their panic attacks than PD participants.
These findings suggest that although PTSD participants fear somatic outcomes during panic attacks, their panic attacks are distinguished by a marked fear of trauma memories.
There is increasing evidence that panic attacks are common in people with posttraumatic stress disorder (PTSD). An analysis of the US National Comorbidity Survey found that 35% of people with PTSD had panic attacks in the past year, and this was linked to greater disability and comorbidity (Cougle, Feldner, Keough, Hawkins & Fitch, 2010).
Many trauma survivors report experiencing panic attacks during the traumatic event; 90% of rape victims (Resnick, Falsetti, Kilpatrick & Foy, 1994) and 53% of motor vehicle and non-sexual assault survivors (Bryant & Panasetis, 2001) report at least four panic symptoms during the trauma.
People with acute stress disorder (ASD) are more ly to experience panic attacks at the time of the trauma than those without ASD (Bryant & Panasetis, 2001). Furthermore, people with ASD also report more posttraumatic panic when compared to trauma survivors without ASD (Nixon & Bryant, 2003).
Falsetti and Resnick (1997) found that 69% of treatment-seeking trauma survivors had experienced at least one panic attack in the 2 weeks prior to presenting for treatment.
The importance of panic in the trajectory of PTSD responses is also highlighted by findings that initial dissociation mediates the relationship between peritraumatic panic and subsequent PTSD (Bryant et al., 2011), and peritraumatic panic predicts long-term mental health outcomes (Boscarino & Adams, 2009). Despite the relevance of panic attacks in PTSD, little is known about the nature of posttraumatic panic.
The intersection between PTSD and panic disorder (PD) is highlighted in recent years by fear circuitry models, which posit common etiologies and mechanisms across fear-based anxiety conditions, including PTSD and PD (Andrews, 2009).
It is proposed that fear circuitry disorders share fear-conditioning processes at their point of origin such that otherwise benign stimuli are paired with an aversive experience; subsequent exposure to the conditioned stimuli signals threat and results in anxiety (Lanius, Frewen, Vermetten & Yehuda, 2010; Milad, Rauch, Pitman & Quirk, 2006). In the context of PTSD, this would involve reminders of the threat, whereas in the context of PD, it would require reminders of physical fears, such as choking, having a heart attack, or dying. This accords with models that posit that the arousal and panic experienced at the time of a traumatic experience become part of the conditioned stimuli, and thereafter somatic cues can trigger re-experiencing symptoms (Hinton, Hofmann, Pitman, Pollack & Barlow, 2008). Consistent with animal and human fear-conditioning research (Rauch & Drevets, 2009), fear circuitry disorders are characterized by excessive amygdala reactivity and impaired regulation of that response by the medial prefrontal cortex (Shin & Liberzon, 2010).
The major cognitive model of PD postulates that people catastrophically misinterpret somatic sensations to the extent that they fear that benign sensations are perceived as signals of impending death or severe illness (Clark, 1986, 1996).
For example, sensations such as mild chest pain and dizziness may be viewed as being indicative of an impending heart attack. Supporting this model is the evidence that PD patients are more ly to interpret situations containing ambiguous internal stimuli as threatening (Clark et al.
, 1988; McNally & Foa, 1987; for a review, see McNally, 1994).
Models of posttraumatic panic posit that panic that occurs at the time of trauma contributes to strong fear conditioning, and the somatic cues associated with the panic become associated with many other cues related to the traumatic experience (Falsetti, Resnick, Dansky, Lydiard & Kilpatrick, 1995; Jones & Barlow, 1990).
These models propose that subsequent internal (e.g., emotions, physiological arousal, and cognitions) and external (e.g., places, objects, and smells) triggers elicit subsequent panic attacks, which in turn trigger trauma-related associations. This proposal is supported by evidence that 84% of a sample of trauma patients experiencing panic attacks reported that trauma reminders cued their panic attacks (Falsetti & Resnick, 1997).
Cognitive models are capable of explaining both PTSD and PD.
The emphasis on cognitive responses in models of PD converges with cognitive PTSD models, which also propose that traumatic experiences can lead to catastrophic interpretations about the experience, the potential of future harm, and how one manages the effects of the traumatic experience (Ehlers & Clark, 2000).
This is supported by evidence that maladaptive appraisals after trauma are predictive of subsequent PTSD (Dunmore, Clark & Ehlers, 1999; Ehlers, Mayou & Bryant, 1998; Warda & Bryant, 1998).
Fear network models posit that mental representations of the feared content are highly connected and readily activated by cues that are related to the feared event; when activated, these representations can involve catastrophic appraisals about the feared event, thereby exacerbating the fear (Foa & Kozak, 1986).
These representations can apply to traumatic or somatic representations, thereby being able to explain the cognitive responses of both PTSD and PD. It has been suggested that PTSD is characterized by a more widely activated fear network than other anxiety disorders as a result of the severity of the threat (Foa, Steketee & Rothbaum, 1989). Consistent with this proposal, trauma survivors display catastrophic appraisals about traumatic, somatic, and social events (Smith & Bryant, 2000).
An outstanding issue concerns the cognitive responses to posttraumatic panic attacks. Although PD models posit that the major mechanism underpinning the disorder is fear of aversive consequences of somatic events, it is possible that different fears underpin panic attacks in PTSD.
Specifically, PTSD models emphasize that panic attacks cue conditioned responses that developed at the time of the traumatic experience and these attacks should accordingly trigger trauma memories.
This hypothesis has indirect support from evidence indicating that inducing arousal in trauma survivors elicits trauma memories, as well as more flashback phenomena, in trauma victims with PTSD or ASD (Bremmer et al., 1997; Nixon & Bryant, 2005).
On the basis of this hypothesis, we predicted that whereas panic attacks in the context of PD would be predominantly associated with fear of aversive outcomes from somatic perceptions, we expected that panic attacks in the context of PTSD would be associated with fear of trauma memories.
The PD sample comprised 22 consecutively assessed participants (9 male and 13 female) of mean age 39.55 years (SD=13.08), who were seeking treatment at the Anxiety Treatment and Research Unit at Cumberland Hospital, Sydney; 21 participants met criteria for PD with agoraphobia and 1 had PD without agoraphobia.
The PTSD sample comprised 18 consecutively assessed participants (8 male and 10 female) of mean age 42.22 years (SD=10.24), who were seeking treatment at the Traumatic Stress Clinic at Westmead Hospital, Sydney. Participants presented after motor vehicle accidents (n=11) or non-sexual assault (n=7).
Inclusion criteria were (1) met criteria for PD or PTSD, (2) proficiency in English, (3) aged between 16 and 65 years, and (4) no diagnosis of organic mental disorder or psychosis.
Patients in the PTSD group met DSM-IV diagnostic criteria for PTSD, did not meet criteria for PD, and had experienced at least one panic attack following their trauma. Patients in the PD group met DSM-IV criteria for either PD, with or without agoraphobia, but failed to meet criteria for a PTSD diagnosis.
In terms of comorbidity of the PTSD participants, six participants had major depressive disorder and four had substance abuse.
In terms of comorbidity of the PD participants, six participants were diagnosed with generalized anxiety disorder, five with major depressive disorder, two with obsessive–compulsive disorder, and one with social phobia. Four PD participants also reported past trauma, with two experiencing childhood abuse and two involved in a motor vehicle accident, but none reported PTSD symptoms related to these events.
Diagnosis of PD and PTSD was ascertained using the Anxiety Disorder Interview Schedule for DSM-IV (ADIS-IV; Brown, Di Nardo & Barlow, 1994), which is a clinician-administered structured diagnostic interview following DSM-IV criteria. This schedule was also used to determine the presence of any comorbid anxiety disorders.
The test–retest reliability of the ADIS-R (the predecessor of the ADIS-IV) ranges from 0.57 to 0.82 (di Nardo, Moras, Barlow, Rapee & Brown, 1993). PTSD severity was measured using the Clinician-Administered PTSD Scale (CAPS; Blake et al., 1995).
The CAPS is a structured clinical interview that indexes the 17 symptoms described by the DSM-IV PTSD criteria.
Participants in both groups were also administered two questionnaires to index their panic-related cognitions. The Agoraphobic Cognitions Questionnaire (ACQ; Chambless, Caputo, Bright & Gallagher, 1984) consists of 14 cognitive statements that represent cognitive misappraisals of somatic symptoms.
To assess trauma-related panic cognitions, a 12-item Traumatic Panic Cognitions Scale (TPCS) was developed. Items for this measure were proposals from experienced PTSD clinicians concerning the common fears that PTSD patients report during their panic attacks.
This questionnaire comprised items that index the extent to which respondents may worry about traumatic memories or traumatic events occurring during a panic attack, such as, “Memories of the past are hurting me”, “I am reliving a terrible event”, and “I will never escape my memories”. The TPCS showed strong internal consistency, with a Cronbach's-α of 0.94.
Both these questionnaires specifically indexed cognitions that occur during a panic attack and each utilized a five-point rt scale (1=never, 2=hardly ever, 3=sometimes, 4=often, 5=always).
Following informed written consent, participants were administered the ADIS-IV by clinical psychologists. Two weeks after the clinical interview, participants were administered the ACQ and TPCS in a random order of presentation.
An independent sample t-test indicated no difference between the PTSD and PD groups in terms of their age (t(38)=−0.708, ns). There was also no difference in time since the onset of panic attacks between the PTSD (M=68.50 months, SD=49.56) and PD (M=60.41 months, SD=56.56) groups (t(38)=0.33, ns).
The mean rating of each ACQ item is presented in Table 2. The PD (M=36.34, SD=11.83) and PTSD (M=32.50, SD=8.38) groups did not differ in terms of total ACQ scores, t(38)=1.25, ns. Multiple comparisons that adopted a Bonferroni-adjusted α of p
What’s the Difference Between a Panic Attack and an Anxiety Attack?
- Risk factors
- Home remedies
- Other treatments
You might hear people talking about panic attacks and anxiety attacks they’re the same thing. They’re different conditions though.
Panic attacks come on suddenly and involve intense and often overwhelming fear. They’re accompanied by frightening physical symptoms, such as a racing heartbeat, shortness of breath, or nausea.
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes panic attacks, and categorizes them as unexpected or expected.
Unexpected panic attacks occur without an obvious cause. Expected panic attacks are cued by external stressors, such as phobias. Panic attacks can happen to anyone, but having more than one may be a sign of panic disorder.
Anxiety attacks aren’t recognized in the DSM-5. The DSM-5 does, however, define anxiety as a feature of a number of common psychiatric disorders.
Symptoms of anxiety include worry, distress, and fear. Anxiety is usually related to the anticipation of a stressful situation, experience, or event. It may come on gradually.
The lack of diagnostic recognition of anxiety attacks means that the signs and symptoms are open to interpretation.
That is, a person may describe having an “anxiety attack” and have symptoms that another has never experienced despite indicating that they too have had an “anxiety attack.”
Read on to find out more about the differences between panic attacks and anxiety.
Panic and anxiety attacks may feel similar, and they share a lot of emotional and physical symptoms.
You can experience both an anxiety and a panic attack at the same time.
For instance, you might experience anxiety while worrying about a potentially stressful situation, such as an important presentation at work. When the situation arrives, anxiety may culminate in a panic attack.
It may be difficult to know whether what you’re experiencing is anxiety or a panic attack. Keep in mind the following:
- Anxiety is typically related to something that’s perceived as stressful or threatening. Panic attacks aren’t always cued by stressors. They most often occur the blue.
- Anxiety can be mild, moderate, or severe. For example, anxiety may be happening in the back of your mind as you go about your day-to-day activities. Panic attacks, on the other hand, mostly involve severe, disruptive symptoms.
- During a panic attack, the body’s autonomous fight-or-flight response takes over. Physical symptoms are often more intense than symptoms of anxiety.
- While anxiety can build gradually, panic attacks usually come on abruptly.
- Panic attacks typically trigger worries or fears related to having another attack. This may have an effect on your behavior, leading you to avoid places or situations where you think you might be at risk of a panic attack.
Unexpected panic attacks have no clear external triggers. Expected panic attacks and anxiety can be triggered by similar things. Some common triggers include:
Anxiety and panic attacks have similar risk factors. These include:
- experiencing trauma or witnessing traumatic events, either as a child or as an adult
- experiencing a stressful life event, such as the death of a loved one or a divorce
- experiencing ongoing stress and worries, such as work responsibilities, conflict in your family, or financial woes
- living with a chronic health condition or life-threatening illness
- having an anxious personality
- having another mental health disorder, such as depression
- having close family members who also have anxiety or panic disorders
- using drugs or alcohol
People who experience anxiety are at an increased risk of experiencing panic attacks. However, having anxiety doesn’t mean you will experience a panic attack.
Doctors can’t diagnose anxiety attacks, but they can diagnose:
- anxiety symptoms
- anxiety disorders
- panic attacks
- panic disorders
Your doctor will ask you about your symptoms and conduct tests to rule out other health conditions with similar symptoms, such as heart disease or thyroid problems.
To get a diagnosis, your doctor may conduct:
You should speak to your doctor or another mental health professional to find out what you can do to both prevent and treat anxiety- and panic-related symptoms. Having a treatment plan and sticking to it when an attack strikes can help you feel you’re in control.
If you feel an anxiety or panic attack coming on, try the following:
- Take slow deep breaths. When you feel your breath quickening, focus your attention on each inhale and exhale. Feel your stomach fill with air as you inhale. Count down from four as you exhale. Repeat until your breathing slows.
- Recognize and accept what you’re experiencing. If you’ve already experienced an anxiety or panic attack, you know that it can be incredibly frightening. Remind yourself that the symptoms will pass and you’ll be alright.
- Practice mindfulness. Mindfulness-based interventions are increasingly used to treat anxiety and panic disorders. Mindfulness is a technique that can help you ground your thoughts in the present. You can practice mindfulness by actively observing thoughts and sensations without reacting to them.
- Use relaxation techniques. Relaxation techniques include guided imagery, aromatherapy, and muscle relaxation. If you’re experiencing symptoms of anxiety or a panic attack, try doing things that you find relaxing. Close your eyes, take a bath, or use lavender, which has relaxing effects.
The following lifestyle changes can help you prevent anxiety and panic attacks, as well as reduce the severity of symptoms when an attack occurs:
- Reduce and manage sources of stress in your life.
- Learn how to identify and stop negative thoughts.
- Get regular, moderate exercise.
- Practice meditation or yoga.
- Eat a balanced diet.
- Join a support group for people with anxiety or panic attacks.
- Limit your consumption of alcohol, drugs, and caffeine.
Speak to your doctor about other treatments for anxiety and panic attacks. Some common treatments include psychotherapy or medication, including:
- antianxiety drugs
Oftentimes, your doctor will recommend a combination of treatments. You may also need to alter your treatment plan over time.
Panic attacks and anxiety attacks aren’t the same. Though these terms are often used interchangeably, only panic attacks are identified in the DSM-5.
Anxiety and panic attacks have similar symptoms, causes, and risk factors. However, panic attacks tend to be more intense and are often accompanied by more severe physical symptoms.
You should contact a doctor if anxiety- or panic-related symptoms are affecting your everyday life.