Panic Disorder vs. Generalized Anxiety Disorder (GAD)

Most of us will experience stress and at least some form of anxiety during our time on Mother Earth. It’s a normal and natural response that helps us prepare for situations where we are expected to perform. Think about that one big speech you had to give in high school, how well you prepared, how stressed and anxious you were. Normal levels of stress and usual bouts of anxiety help us navigate different life situations.

However, when anxiety becomes overwhelming and is no longer in line with a normal stress response, it can negatively impact our quality of life. The tricky thing here is that there are many similarities between anxiety and everyday stress. I am talking about “normal stress” in this post, not to diminish the effects it can still have on your life but to separate it from anxiety and related disorders. In other words, when stress becomes abnormal. Its necessary to emphasize this because there are many similarities between anxiety and stress, for example: A feeling of uneasiness, high blood pressure (does this ring a bell for you, hubby?), tense muscles, stress headaches, loss of sleep, and an upset tummy. However, the causes of the symptoms manifested by stress and those displayed due to an anxiety-related disorder are entirely different.

If you or someone you love suffers from an anxiety disorder, you know how debilitating it can be. To properly deal with your situation and get your life back to a healthy space, it’s necessary to understand what you are dealing with before addressing it. Please FIGGI Goddess, only use this post as an informative guideline. Speak to your healthcare professional to get the correct diagnosis for you.

Anxiety vs. Stress

The difference between stress and anxiety is that anxiety does not subside once a concern is resolved; you stay in a heightened state of awareness, with the waters constantly churning beneath the surface.

Generally, stress is a response to something “external to ourselves,” such as a tight deadline at work or a disagreement with a close friend. The stress gradually subsides once the situation has been resolved. Because stress results from external factors, symptoms are often alleviated by tackling the external source of stress head-on. If you are struggling with chronic or prolonged periods of stress, its essential to include lifestyle habits to help you navigate this phase. Examples of helpful practices are regular exercise, breathing exercises, adequate sleep, and taking digital breaks.

On the other hand, anxiety is stress on steroids (or at least that is what it feels like to me). The source and cause of anxiety are not related to external factors, although these can worsen anxiety. Its origins are internal; for example, some people have anxious personalities or are more prone to anxiety than others. Often times this may also lead from past events or trauma. Anxiety symptoms mimic stress symptoms but coexist with persistent dread or apprehension. This feeling remains even when dealing with situations that are not necessarily dangerous or stressful. It’s like your body remains in constantly high rev even when parked in neutral.

The difference between stress and anxiety is that anxiety does not subside once a concern is resolved; you stay in a heightened state of awareness, with the waters constantly churning beneath the surface. Anxiety manifests in many forms, with a few common anxiety-related disorders. These disorders are generalized anxiety disorder (GAD), panic disorder (my diagnosis), obsessive-compulsive disorder, phobias, social anxiety, and post-traumatic stress disorder. These serious mental health issues should be properly diagnosed by your mental health care professional. I urge you again, not to self-diagnose through this post FIGGI Goddess, but to refer to a medical professional for help and guidance.

Differences Between Panic Disorder and GAD.

I specifically want to address these two anxiety disorders because so many of their symptoms can overlap. It took years for my correct diagnosis as well although I believe these two disorders overlapped or co-existed for a period in my life. Although these two disorders are similar, with some common symptoms, they are entirely different psychological disorders. I am diagnosed with Panic Disorder, so let’s take a closer look at this strange bed fellow.

Panic Disorder

Someone (like me) with panic disorder suffers from recurring, unprovoked panic attacks without any actual danger being present. Unprovoked and recurring are the key words for me here. Many of my panic attacks will occur when I am at my most relaxed. While having these attacks, I often feel (or become convinced) that I am going insane or that I am losing control.

Depersonalization or derealization also causes me to feel detached from myself or feel like I am somehow disconnected from my body. People with panic disorder constantly run on an excessive fear of future attacks which impacts their daily routines and normal behaviors. This is true for me and I give you more details on this below.

So what does a panic attack feel like or look like? We experience chest pain, shaking, trembling, feelings of suffocation or choking, shortness of breath, or rapid heart rate. To put it in technical medical terms, I can refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It lists the following symptoms of a panic attack, of which at least 4 must be present for a diagnosis to be made:

  • Chest pains or discomfort.
  • Hot flashes or chills.
  • Sweating excessively.
  • Choking sensations.
  • The fear of dying.
  • A fear of going crazy or losing control.
  • Dizziness, feeling unsteady, lightheaded, or faint.
  • A state of feeling detached from oneself (depersonalization) or a feeling of unreality (derealization).
  • An accelerated heart rate, palpitations, or pounding heart.
  • Distress or nausea in the abdomen.
  • Tingling and numbness (paranesthesia).
  • Breathing problems or sensations of suffocation.
  • Shaking or trembling.

Panic attacks usually begin suddenly, peak within 10 minutes, and then subside. Some episodes, however, appear in succession or last longer than others, making it challenging to identify when they end and begin. Unfortunately, the excessive and constant worry about repeat attacks often leads to more panic attacks. We can easily develop agoraphobia because we actively work to avoid situations and environments that we think will bring on an attack. People with the panic disorder commonly become so consumed with worry and fear of a future attack that we develop behavioral changes.

To put this into more perspective, I will share my example of a panic attack. When I have panic attacks, it always comes on suddenly and without warning. Usually, when I am on holiday and at my most relaxed, or when I just enter the stages of deep sleep. It starts with a sudden rush of falling backward, followed by extreme heat and cold sensations shooting up and down my body. Uncontrollable shaking and trembling follow, often requiring me to subdue my shaking arm by holding it down. I become convinced I am going insane or losing control of my body.
Painful heart palpitation and pressure on my chest are next, and I often feel like I may lose control of my bladder or that I might vomit. My attacks are always accompanied by a weird sensation of floating, almost like I’m outside my body, removed from it somehow, looking in. This does not help the feelings of going insane or losing control.

The final stage is the absolute belief, with conviction and beyond any reasonable doubt, that death is imminent. I always experience feelings of choking and suffocation with my attacks, which is something I do not wish upon my worst enemy. After panic attacks, especially in the beginning, my behavior changes as I try to avoid further attacks. I become so fearful of a repeat attack that I reorganize my life to ensure it does not happen again. I usually have severe social anxiety after attacks and find it difficult to leave the house or places of safety. I do this because it feels like I am more prone to an attack if I cannot control my surroundings and am overwhelmed by too many sights, sounds, and people. I also have an immense fear of it happening when I am somewhere unknown, alone, and without help.

After my first panic attack, I stopped eating because I feared choking. I lost an overwhelming and highly unhealthy amount of weight. I also stopped exercising because every time my heart rate increased, I felt like I was experiencing heart palpitations which would set off an attack. I will sometimes also struggle to get back into a good sleeping routine as I fight sleep to the end, fearful of waking up in a state of panic again.

What causes Panic Disorder?

I have a long family history of other mental illnesses, so I was genetically predisposed to this. Its interesting though that no one in my family has panic disorder.

So now that we know what panic disorder is, it may be helpful to understand why it happens. Many mental health experts believe that panic disorder is caused by biological, environmental, and psychological factors. Your age and gender, for example are key contributing factors. Women are more prone to panic disorder and it usually develops between the ages of 18 and 35.

Your genetics also play a part. If you have a relative with this disorder or history of mental illness in your family, you are more prone to it. However, its worth noting that most sufferers of panic disorder are not related to anyone with this disorder.

Trauma and major life transitions also increase the risk of developing panic disorder. Losing a job, getting divorced, getting married, having a child, or going through a challenging life event for example.

In my case, I ticked almost all these boxes. I was 30 when my panic attacks started, although I had struggled with some form of anxiety since I was 19. I have a long family history of other mental illnesses, so I was genetically predisposed to this. Its interesting though that no one in my family has panic disorder. I was also sexually abused for a prolonged period during my childhood and as a young adult. I came from a divorced family with issues, struggles, and its own kind of psychological stressors. I also dealt with various other types of traumas during my younger years which I never identified and also did not address correctly. So basically I was like honey to a bee .

Why is diagnosing panic disorder tricky?

Many medical and psychological disorders can mimic and coexist with panic disorder, making a precise diagnosis essential. I was first diagnosed with GAD, and it took a few years to confirm the panic disorder diagnosis. However, I do feel like GAD co-existed with my panic disorder for a period.

It’s possible, for example, to misdiagnose panic disorder as cardiac arrhythmias (abnormal heart rhythms). Similarly, a patient can be misdiagnosed with an erratic heartbeat as a symptom of a heart problem when it’s a symptom of a panic attack. In the initial stages of my panic symptoms, this was also what doctors thought to be wrong with me, and I was placed on a heart monitor. I was sent from pillar to post by doctors. I completed every test known to man, and a couple of years later I would go through the same barrage of tests again only to be told everything is normal.

The symptoms of a panic attack are truly paralysing and horrifying. It therefore makes sense that doctors would want to be sure you are not suffering from any other biological ailment before making a proper diagnosis. Therefore, to diagnose panic disorder, all other possible causes must be excluded. Your healthcare team must also verify there is no direct physiological link between these attacks and other medications you may be taking, or other general medical conditions. The DSM-5 I described above is the key diagnostic tool used to make a final proper diagnosis.

Generalized Anxiety Disorder (GAD)

Why is GAD different from panic disorder and how do we best understand the difference? GAD is equally debilitating to your every day life but takes a different form from panic disorder. Its really important to understand that these two disorders can overlap or co-exist. Many times GAD can be the precursor or a trigger to the panic attacks. So, what is GAD?

Worrying excessively and pervasively about everyday events is the hallmark of GAD. This permanent state of worry can become so overwhelming and so impossible to control, it often interferes with the ability to perform regular daily routines. People with GAD constantly feel overwhelmed by their thoughts, which can hinder them from taking care of themselves, performing their work tasks, and maintaining healthy relationships.

The symptoms of GAD can differ slightly from those of panic disorder. However, a person can start to experience physical symptoms as a result of GAD. There are many examples of physical symptoms associated with this condition, some of which are:

  • Chronic headaches.
  • Diarrhea, stomach discomfort or other digestive issues.
  • Restlessness.
  • Muscle tension.
  • Fatigue.
  • Irritability.
  • Sleep problems (difficulty falling or staying asleep).

The main difference here is that with panic disorder worry occurs spontaneously and is focused on when the next panic attack will occur. With GAD, on the other hand, worry primarily revolves around usual life circumstances, such as finances, job issues, children, and health. It is persistent and near ever-present.

To diagnose GAD properly mental healthcare professionals usually look for the following common symptoms:

  1. An excessive level of anxiety and worry about anything and everything. This excessive worry needs to occur more frequently than not for an ongoing period of at least six months.
  2. Difficulties with controlling the worry, and often worrying about different topics at the same time. There are additional factors that need to be considered before diagnosing a child with GAD.

What causes GAD?

Gender seems to be a big risk factor with women being twice as likely to develop GAD as men. This is contributed to hormone fluctuation, cultural expectations and the overall greater willingness to visit doctors.

A family history, or genetics, also play a role. If you have a family history of GAD or mood disorders you are more prone to this. However, your risk can be increased by smoking, excessive alcohol use, drugs, and dealing with a chronic illness.

Life events can also cause GAD, such as traumatic events, socio-economic environments of the sufferer, neglect or abuse as a child, divorce, and death of loved ones.

The Takeaway

Dealing with the symptoms of an anxiety disorder can be overwhelming and debilitating. Not just for the person who suffers from it but for her loved ones that witness it. I always feel that the better I understand my own the disorder, the better equipped I am to deal with it. If I am well-equipped to deal with it then I am in a better position to educate my loved ones and support network on what to expect.

There is so much heartache, energy, and fear that goes into a disorder like this. Anything you can do to relieve it in some way, deal with it in a more effective way, or make space for it in your life, is a welcome addition to your routine.

I really struggled to understand the differences between these two disorders in the beginning. It confused me and this confusion causes me even more anxiety, which led to more attacks…you can see the vicious circle here. I hope I could shed some light on the differences for you and that post helped you in some way.

Love and light



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