Difference Between Panic Attack and Generalized Anxiety Disorder

There are many different types of anxiety disorders. Panic Disorder is only one, but we've given it its own Google Site because of how pervasive it seems on our campus. Let's look at the difference between panic attacks and generalized anxiety disorder, starting with the latter.

Generalized Anxiety Disorder (GAD)

GAD is characterized by a persistent sense of worry about people, places and things. Often focused on the worse possible outcome of a situation, the person with GAD may have constant thoughts that things will not work out as they wish, may be pre-occupied with planning for disaster, worrying about health, finances or family and friends. They may worry more than seems proportionate to a situation compared to someone without GAD. The non-GAD person may even think something is "not a big deal" but to the person with GAD, the "deal" may seem overwhelmingly huge.

Someone with GAD may experience frequent muscle tension and pain, rapid heartbeat, shallow breathing, frequent headaches or stomach aches (or other gastrointestinal issues), high blood pressure, persistent feeling of being "on edge", irritability, restlessness, and possibly sleep difficulties.

Often GAD clients find themselves at a loss in trying to control their worry and feel helpless. Often they put their attention on trying to control that which is not in their power to control. Some examples of things a person with GAD cannot completely control (but may try to anyway) are how other people perceive them, the extent to which they can control the future, other people's decisions or actions. Someone with severe GAD may avoid situations that they might otherwise enjoy or benefit from due to their anxiety such as travel, classes, job promotions, dating.

GAD is very treatable and there are several approaches to doing so. Most involve some form of talk therapy with a trained professional. Cognitive Behavior Therapy, Mindfulness Based therapies, and other behavior based therapies have been found to be helpful. Therapies that involve "in-vivo" exercises (which means "in real life") can be very effective. Essentially, in-vivo therapies involve the person with GAD doing those things that they fear the most until those activities no longer cause anxiety. Many people with GAD may supplement their talk therapy with prescription medication to help reduce symptoms of anxiety.

Panic Disorder

We do not completely understand how or why Panic Disorder develops in people. There is evidence that it can be both something people are genetically predisposed to as well as a behavior that is learned from those we have in our lives as we mature. Panic often comes "out of the blue" and some people even wake up in the middle of the night in a full panic attack but do not recall having any dreams that might have provoked such a response. Anxiety attacks are often provoked by anxious thoughts about a specific situation (see page about the difference between panic and anxiety attacks).

Someone with Panic Disorder may experience frequent worry that a panic attack will happen at any time because they can be unpredictable. And during a Panic attack may experience chills or flushes, dizziness and lightheadedness, a choking sensation, pounding heartbeat, sweating, weakness in the knees, and hyperventilation.

In the worse case scenarios, a person with severe Panic Disorder may develop agoraphobia (a fear of being in public or leaving home) which severely impairs their satisfaction of living. Someone with severe Panic Disorder may have difficulty staying enrolled in college or keeping a job afterwards. They may have difficulty making and keeping friends for fear that others will witness a symptom of panic that the sufferer will be embarrassed by.

Panic Disorder treatable and there are several approaches to doing so. Prescription medication is often used as it is relatively fast acting. In talk therapies, mental health professionals will work with clients to try to recognize early symptoms that an attack is coming on and teach skills to the client to interrupt the attack. One example of this is teaching a client to recognize when their breathing is becoming faster than it needs to be and interrupting the fast breathing by taking a deep breath and holding it as long as possible 2 or 3 times. When our breathing becomes fast under anxiety it is our brains trying to get oxygen into our muscles for a fight or flight response; taking a deep breath and holding it signals the brain and body that we are not in danger and do not need to prepare to flee or fight. Distraction exercises are also valuable tools in managing panic and anxiety attacks. See the "HELP!..." page for some of these exercises.