PTSD and anxiety: Can you have both?

Post-traumatic stress disorder (PTSD) and anxiety disorders, such as generalized anxiety disorder and panic disorder, are mental health conditions that greatly impact your life. If you have them, your symptoms are typically pervasive, affecting many aspects of life and getting in the way of your day-to-day functioning. Luckily, effective, evidence-based treatments for PTSD and anxiety can help.

Read on to learn about the similarities and differences between PTSD and anxiety, as well as how both disorders are treated.  

Is PTSD the same thing as anxiety?

PTSD is not the same thing as anxiety. PTSD is a mental health condition that comes on after experiencing a very traumatic event (or events) such as physical or sexual assault, combat, a life-threatening accident, or a natural disaster. PTSD is a more specific manifestation of anxiety in the context of the history of trauma, whereas GAD consists of more generalized anxiety-based symptoms.

So, you can think of anxiety disorders and PTSD as separate entities, although there’s certainly overlap, and it’s common to have them both at the same time. Around 80% of people with PTSD also have another mental health condition, and anxiety is a common one.

PTSD overview

The majority of people experience some kind of trauma in their life, but only around 5.6% develop PTSD. Genetics may play a role in this. You might be more likely to develop PTSD if a family member also has PTSD or even another mental health condition.  

There are four main categories of PTSD symptoms:

• Re-experiencing: Flashbacks a trademark of PTSD and during one you may feel like the traumatic event is happening to you again in the present moment. This also includes intrusive memories and nightmares of the trauma.

• Avoidance: It’s common for trauma survivors to avoid anything that triggers them, reminding them of their trauma. This involves memories or any scenario that serves as a reminder. However, this avoidance ultimately fuels PTSD symptoms.  

• Changes in cognition and mood: PTSD can change your outlook on the world. You may have trouble experiencing positive emotions and have distorted thoughts about yourself and the world around you. You might also feel guilt, shame, and hopelessness.  

• Changes in arousal and reactivity: Hypervigilance becomes the new norm for those with PTSD, always feeling on guard and easily startled. There’s also common irritability, angry outbursts, and even self-destructive or reckless behavior.  

In some cases of PTSD, but not all, there are dissociative symptoms, too. You can see dissociation as a way the brain is trying to protect you from trauma. There’s derealization, where you may feel like your surroundings aren’t real, or depersonalization, which can feel like an out-of-body experience.  

Additionally, there’s a subtype of PTSD known as complex PTSD or C-PTSD. It may be a result of long-term recurring trauma, often in childhood, such as ongoing emotional or physical abuse.  

Types of anxiety disorders

Anxiety disorders are common mental health conditions linked to excessive worry, panic, and fear. Three common types of anxiety disorders include:

• Generalized anxiety disorder (GAD): GAD results in chronic, excessive, hard-to-control worry. The anxiety is typically out of proportion to the actual stressors. You might imagine worst-case scenarios, have trouble dealing with uncertainty, and uncomfortable physical symptoms.  

• Panic disorder (PD): PD results in sudden, often very scary-feeling panic attacks. People with PD often live in fear of another panic attack happening due to how distressing they are. Panic attacks can cause symptoms like feelings of impending doom, fear of losing control or dying, and physical symptoms like shortness of breath, racing heart, and chest pain.

• Social anxiety disorder (SAD): Sometimes called social phobia, SAD is characterized by excessive anxiety surrounding social situations, including a fear of being judged or embarrassed. You may feel self-conscious in various social settings and experience physical symptoms like sweating or a racing heart.  

What are the differences between PTSD and anxiety?  

Here are some of the key differentiating factors and similarities between anxiety and PTSD.

How do you know which one you have?

The only way to know for sure whether you have PTSD, an anxiety disorder, or both is to get a comprehensive evaluation from a mental health professional, such as a psychiatrist.

Each condition has specific diagnostic criteria outlined in the DSM-5. Through these criteria, your psychiatrist can determine whether you meet the diagnosis.

Some key defining factors of PTSD are:

• Trauma exposure

• The symptoms mentioned above are in the categories of re-experiencing, avoidance, alterations in cognition/mood, and alterations to arousal/reactivity.  

• Symptoms lasting for over one month.

• Symptoms interfering with functioning and quality of life  

Some key defining factors of an anxiety disorder such as GAD are:

• Excessive rumination and worry

• Somatic manifestations-headaches, abdominal discomfort, body tension

• Cognitive manifestations-issues with focus and irritability  

If you’re looking for a psychiatrist to diagnose you with PTSD or an anxiety disorder and provide a treatment plan, consider Talkiatry. We’re a national psychiatry practice that treats a wide variety of mental health conditions. We provide virtual, in-network services so you can get the care you need from home. To get started, complete our free online assessment to get matched with a psychiatrist.

Anxiety treatment vs. PTSD treatment  

Although these disorders are different, there is some overlap in treatment. The main approaches for both are talk therapy and psychiatric medication when appropriate. Antidepressants, such as SSRIs (AKA selective serotonin reuptake inhibitors), are a common first-line option for both.

When it comes to talk therapy modalities, there are some differences.

Anxiety therapy

The following types of therapy  can be extremely helpful for different types of anxiety disorders.

• Cognitive-behavioral therapy (CBT): With CBT, a mental health professional helps you understand the link between your thoughts, feelings, and behaviors. You’ll learn to identify and change negative thoughts and beliefs that contribute to your anxiety. You’ll also learn valuable coping strategies and self-care tips to manage heightened anxiety symptoms.  

• Acceptance and commitment therapy (ACT): ACT is a newer therapy that takes a mindfulness-based approach. It teaches acceptance rather than fighting your anxious thoughts, which can help reduce them. Additionally, ACT has a strong focus on living life in line with your values and goals.  

• Exposure therapy: For certain anxiety disorders, like phobias, social anxiety, or panic disorder, exposure therapy can help. Your therapist will help you expose yourself to your fears in a gradual manner that can help desensitize you to your fears.  

PTSD therapy

While standard CBT can be a part of treatment, there are also unique therapies specifically used for PTSD, including:

• Trauma-focused CBT (TF-CBT): In this type of talk therapy for PTSD, patients learn to identify and challenge negative thoughts related to their trauma, often through writing about their experiences. Research shows that CBT effectively reduces PTSD symptoms and enhances emotional well-being—and that therapy via video calls is just as effective as in-person sessions.

• Eye movement desensitization and reprocessing (EMDR): This unique therapy, designed specifically for PTSD treatment, helps to change the way traumatic memories are stored in your brain. EMDR helps you feel less distress and overall fewer symptoms related to your trauma. It typically utilizes back-and-forth eye movements while remembering the trauma.

In cases of comorbid or co-occurring PTSD and anxiety (or another mental health condition), a mix of treatment modalities may be necessary.

With the help of a mental health professional and an effective treatment plan, recovery from PTSD and anxiety disorders is possible.

FAQs  

Is anxiety after trauma always post-traumatic stress disorder?

No, not all anxiety after trauma is PTSD. It’s common and normal to feel anxious after a traumatic event, but PTSD is diagnosed based on specific diagnostic criteria, including the type and intensity of symptoms and duration of these symptoms.  

What are the symptoms of PTSD?

Common PTSD symptoms are:

• Flashbacks of the trauma

• Nightmares about trauma

• Avoidance of trauma triggers or traumatic memories

• Hyperarousal/hypervigilance

• Trouble experiencing positive emotions

• Irritability  

What’s the difference between PTSD and OCD?

PTSD is always linked to trauma, while obsessive-compulsive disorder (OCD) is not. OCD is characterized by constant distressing, intrusive thoughts and obsessions. Then, to neutralize or ease anxiety associated with these obsessions, an individual engages in compulsions or repetitive behaviors, which ultimately fuels the OCD cycle. PTSD can also result in intrusive thoughts, but these are linked to the traumatic event.

Related article:  OCD vs anxiety

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.