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Panic Disorder and Social Anxiety Disorder

How Do These Two Anxiety Disorders Differ?

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Updated July 19, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Social anxiety disorder is a mental health condition in which a person is consumed with fear of being negatively judged and evaluated by others. The person may become so afraid of being embarrassed or humiliated in front of other people that they avoid most social situations. Like panic disorder, social anxiety disorder can negatively impact a person’s quality of life.

Panic disorder and social anxiety disorder are marked with similar qualities, such as persistent fear, nervousness, and physical sensations, including trembling and shaking. However, each of these disorders has a specific set of diagnostic criteria that make them unique and distinct conditions. To understand each diagnosis more clearly, these disorders are compared by several factors:

1. Fear and Avoidance

  • Panic disorder can occur with or without agoraphobia, or the fear of experiencing panic attack symptoms in a situation that feels either physically difficult or emotionally embarrassing to escape from. A person with panic disorder often fears the physical symptoms of panic attacks, believing that they may have a medical issue causing their discomfort. Over time, the person may feel more secure from these attacks by remaining within certain areas or a self-determined safe zone, typically close to home. Agoraphobia develops when the person can no longer leave this safe zone without experiencing intense fear
  • Social anxiety disorder involves a fear of being the center of attention, criticized, or somehow behaving in a way that would cause embarrassment in front of others. This fear of public humiliation and general discomfort in social settings can become so great that the person may avoid most public and social interactions. Such avoidance differs from agoraphobia, as the person is concerned with the scrutiny of others and not about having a panic attack.

2. Symptoms

  • Panic disorder is characterized by recurrent panic attacks that often take hold without warning. Many of the physical symptoms of panic disorder, such as shaking, difficulty breathing, and heart palpitations can make the person feel that they are in danger. The person may also believe that they are at risk of losing control or going insane.
  • Social anxiety disorder often involves some of the physical symptoms similar to panic attacks, including excessive sweating and trembling. However, these symptoms would only be brought on when faced with or when thinking about public and social interactions. Other common symptoms of social anxiety disorder include blushing, muscle tension, low self-esteem, and avoidance of social contact.

3. Social Interactions

  • People with panic disorder often feel embarrassed about letting others see them have a panic attack. A trusted friend or family member can help support a loved with panic disorder.  People with panic disorder typically enjoy social interactions and can benefit greatly from social support. However, many experience loneliness due to trying to keep their panic a secret.   
  • Social anxiety disorder sufferers also experience high degrees of loneliness. Such people may want to interact with others, but find the anxiety it causes to be too overwhelming. Friends and family will need to be patient in helping a loved one with social anxiety disorder.

4. Treatment

  • People with panic disorder frequently seek medical attention for their physical symptoms, which can include frightening feelings, such as constricted breathing and racing heart. It is not uncommon for a person with panic disorder to go to the emergency room due to the intensity of their physical sensations. A doctor can determine if the symptoms are due to panic disorder or a general medical condition.
  • Considering that their symptoms are usually not as extreme as panic disorder, people with social anxiety disorder usually do not seek out medical help for their condition. Many people with social anxiety disorder do not realize they have a mental health condition. They may instead believe that they are overly shy or have a personality flaw. Due to the social isolation and lack of knowledge about the disorder, many people with social anxiety disorder remain undiagnosed

Both panic disorder and social anxiety disorder can be effectively treated through medications, such as SSRIs. Medications can help control symptoms and greatly improve daily functioning. Psychotherapy can also be an extremely helpful treatment for both of these disorders.

One form of psychotherapy called cognitive-behavioral therapy can assist with changing one’s thinking patterns and negative behaviors associated with their condition. For example, people with panic disorder can learn how to think of their physical symptoms as feelings of anxiety, rather than a life-threatening medical condition. Over time and with practice, these new thoughts can help the person feel more in control when panic attacks occur. People with social anxiety disorder can develop new ways of thinking about themselves and others that will allow them to feel more confident in social situations.

Although not typical, it is possible to be diagnosed with both of these disorders. Panic disorder and social anxiety disorder are often accompanied by another mood or anxiety disorder, such as obsessive-compulsive behavior, depression, or post-traumatic stress disorder. People with either panic disorder or social anxiety disorder are also prone to developing a substance abuse issue.  

To be certain that you receive the right diagnosis, it is important to seek out help from professionals that can treat panic disorder or other anxiety disorders. Talk to your medical doctor about diagnosis and treatment options. Seek out professional help in a timely manner, as treatment can greatly reduce the symptoms of anxiety disorders.  

Source:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.

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