Panic Disorder Symptoms and Diagnosis The Differences Between Panic Disorder and PTSD By Katharina Star, PhD Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on April 02, 2024 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print SDI Productions / Getty Images Table of Contents View All Table of Contents Overview Panic Disorder vs. PTSD Symptoms Panic Attacks Avoidance Behaviors Treatments Trending Videos Close this video player Panic disorder and post-traumatic stress disorder (PTSD) are two types of mental disorders that can cause intense feelings of fear and anxiety. While they share some similar symptoms, there are important differences in terms of symptoms, causes, and treatments. Someone with PTSD may experience symptoms of panic, but that does not mean they have panic disorder. And a person with panic disorder may have intense feelings of fear, but such symptoms are not related to having experienced a traumatic event in the past. At a Glance Panic disorder and PTSD have some similarities, but they are different conditions. Both conditions cause intense feelings of fear and may lead to panic attacks. However, PTSD happens after a person experiences a traumatic event, while panic disorder is caused by a combination of genetic and environmental factors. Keep reading to learn more about what distinguishes panic disorder and PTSD and how these conditions can be treated with medication and therapy. Overview of Panic Disorder and PTSD Panic disorder is an anxiety disorder that causes people to have recuring panic attacks. To avoid having these panic attacks, people with panic disorder may begin avoid situations that trigger these episodes. In some cases, this can lead to agoraphobia in which people become unable to leave their home. Post-traumatic stress disorder (PTSD) is a condition that can occur after a person has experienced a traumatic event involving intense fear and threat of bodily injury or death. Examples include military combat, sexual assault, or natural disasters. The person may not have experienced the event firsthand. Witnessing a traumatic stressor, such as the accidental death of a person or an attack on someone, can bring about symptoms. PTSD can also occur when a person has heard about the details of another’s exposure to trauma, including learning about the tragic death of a friend or family member. PTSD and panic disorder can occur together at the same time. Research has also found that having panic disorder significantly increases a persons risk of developing PTSD and vice versa. Differences Between Panic Disorder and PTSD People with PTSD often struggle with co-occurring conditions like anxiety-related disorders, depression, and substance use. It is not uncommon for a person with PTSD to also be diagnosed with panic disorder. However, each condition has its own set of symptoms, diagnostic criteria, and treatment options. The differences between panic disorder and PTSD can be determined by considering several factors. Panic Disorder Trembling, shaking, and trouble breathing Sudden, spontaneous panic attacks Avoidance of panic attack triggers May develop agorophobia PTSD Intrusive thoughts and nightmares Hyperarousal and trouble concentrating Panic attacks brought on re-experiencing trauma Avoidance of trauma reminders Symptoms of Panic Disorder vs. PTSD Understanding the symptoms of the two conditions is important for telling them apart. Symptoms of Panic Disorder People with panic disorder experience many physical symptoms associated with panic attacks, such as trembling, shaking, sweating, difficulty breathing, and chest pain. These somatic feelings can become so severe that the person may believe they are losing control, going crazy, or having a serious medical issue such as a heart attack. For people with panic disorder, these panic attacks can happen again and often without warning, which can make the person live in fear due to the anticipation of their next attack. Symptoms of PTSD The symptoms of PTSD, on the other hand, can be divided into three categories: re-experiencing the event in some intrusive way, avoidance behaviors, and increased arousal: Re-experiencing symptoms include intrusive thoughts, nightmares, and flashbacks of the traumatic event. Avoidance behaviors involve steering clear of anything that reminds them of the trauma, including thoughts, places, and memories associated with what happened. Hyperarousal symptoms typically consist of becoming easily startled, a lack of concentration, and frequent irritability. Panic Attacks in Panic Disorder vs. PTSD To have a diagnosis of panic disorder, the person must experience recurrent and spontaneous panic attacks. Panic attacks are a feeling of intense fear without the presence of actual danger. Panic attacks are often experienced with physical sensations, such as dizziness, nausea, and trembling. A person with PTSD can also experience the physical sensations of panic attacks, such as heart palpitations, shortness of breath, and hot flashes. However, these attacks are brought on by the re-experiencing of the traumatic event through such experiences as dreams, thoughts, and flashbacks. Hyperarousal symptoms present in PTSD, such as becoming panicked after hearing a loud noise, can also cause panic attacks. How to Get Through a Panic Attack Avoidance Behaviors in Panic Disorder vs. PTSD Both panic disorder and PTSD can lead to avoidance behaviors. However, the underlying cause of such avoidance differs for each condition. Avoidance in Panic Disorder Having a panic attack can be a terrifying experience. People with panic disorder often become frightened just thinking about their next impending attack. This dread of future attacks can become so powerful that the person develops agoraphobia, a fear of having a panic attack from which it would be difficult or embarrassing to flee. The person will avoid places where they believe attacks will occur and create a safe zone, in which they limit their exposure to certain areas that they feel they will not have an attack. Avoidance in PTSD People with PTSD display many avoidance behaviors. They often avoid places, activities, thoughts, conversations, people, and other stimuli that remind them of the traumatic event. A person may even experience memory loss of the event. A person with PTSD may also become distant from others, limit activities, find it difficult to express a full range of feelings, and lose hope about their future. Avoidance Coping and Why It Creates Additional Stress Treatment for Panic Disorder and PTSD Fortunately, there are many treatment options for panic disorder, including medication and psychotherapy. These forms of treatment can also effectively treat PTSD. There are several classes of medications that might be used for symptom reduction. Medication Medications can help treat symptoms of panic disorder and PTSD. Such medications may include antidepressants and anxiolytics (anti-anxiety medications). Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants commonly prescribed to reduce anxiety, the intensity of panic attacks, and hyperarousal. Benzodiazepines are a type of anti-anxiety medication that is prescribed for its sedative effect. Psychotherapy Cognitive behavioral therapy (CBT) is a common form of psychotherapy that can help to lessen the symptoms of both panic disorder and PTSD. This approach focuses on changing the underlying negative thoughts that contribute to feelings of fear and anxiety. For example, systematic desensitization is a CBT technique that entails therapist-guided gradual exposure to anxiety-provoking situations. The person learns to manage their fear in these situations through relaxation techniques. By continually practicing gradual exposure and relaxation through therapy, certain stimuli that once triggered anxiety will eventually no longer cause extreme nervousness and fear in the person. Both panic disorder and PTSD have intense symptoms that can be successfully reduced through proper treatment. It is important to get treatment at the onset of either condition to decrease the odds that the disorder will get worse. For example, by treating the hyperarousal symptoms of PTSD, the development of panic attacks may be prevented. Additionally, the chances of developing agoraphobia can be lowered by receiving help for panic disorder and attacks early on. Keep in Mind If you think you have panic disorder or PTSD, it is important to talk to your doctor or a licensed mental health professional. They can evaluate your symptoms and provide a proper diagnosis. By learning more about your condition, you can then determine which treatment might be most helpful for you. If you or a loved one are struggling with panic disorder or PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Center for Substance Abuse Treatment (US). Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD. Trauma-Informed Care in Behavioral Health Services. NCBI Bookshelf. Berenz EC, York TP, Bing-Canar H, et al. 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Benzodiazepines: Uses, dangers, and clinical considerations. Neurol Int. 2021;13(4):594-607. doi:10.3390/neurolint13040059 Kredlow MA, Szuhany KL, Lo S, et al. Cognitive behavioral therapy for posttraumatic stress disorder in individuals with severe mental illness and borderline personality disorder. Psychiatry Res. 2017;249:86-93. doi:10.1016/j.psychres.2016.12.045 By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit