Anxiety vs PTSD | A Comprehensive Explanation By A Clinician
Written By Kobi Nathan, Pharm.D., M.Ed., CDP, BCGP, AGSF
Sleep Disorders
October 2, 2023

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There are many types of anxiety, and posttraumatic stress disorder (PTSD) is one of them.

To explain the differences between anxiety vs PTSD, we need to clearly understand the common types of anxiety, how they differ, and how they can be managed.

Anxiety vs PTSD

Generalized anxiety is characterized by persistent, chronic anxiety and dread about normal, everyday life, while a person experiencing PTSD will avoid re-experiencing, arousal, cognitive, and mood symptoms following a traumatic, terrifying event.  

Let’s explore in detail…

All of us experience occasional anxiety at some point in our lives.

Worrying about that upcoming exam, finances, personal and family problems, and health is a normal part of life. 

However, when anxiety starts taking over most aspects of our lives to the point where our daily activities, such as our relationships, schoolwork, and job performance, then we need to take a serious look at managing it. 

There are five major types of anxiety disorders, namely:

  • Generalized Anxiety Disorder (GAD)
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Social Anxiety Disorder (Social Phobia)

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by persistent feelings of anxiety. 

People living with GAD experience constant feelings of dread for months or even years. 

This type of anxiety greatly interferes with daily life, so the person living with it cannot function.

Symptoms of GAD are:

  • Becoming easily tired.
  • Trouble concentrating.
  • Easily irritable.
  • Difficulty controlling anxiety and constant worry.
  • Trouble sleeping (hard to fall and/or stay asleep).
  • Having headaches, stomach pain and upset (we tend to carry worry in our guts), muscle pain, and unexplained pains.
  • Constantly feeling restless, “on-edge, or “keyed-up.”

Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder or OCD is a chronic and long-lasting anxiety disorder characterized by:

  • Uncontrollable, recurring, unwanted thoughts, mental images, or urges (obsessions)


  • Repetitive behaviors (compulsions) that the individual feels they must do repeatedly in response to the obsessive thoughts.


Performing these activities only provides temporary reprieve from these compulsive thoughts, so the person keeps doing them in a never-ending cycle. 

Not doing these “rituals” only worsens their anxiety.

Common symptoms of obsessions

  • Needing to have objects in perfect order or symmetrical.
  • Fear of germs or contamination.
  • Unwanted, taboo thoughts that involve harm, sex, etc.

Symptoms of compulsions

  • Repeated, compulsive handwashing and/or cleaning.
  • Rearranging or reordering objects in a very specific, particular way.
  • Repeated counting.
  • Compulsively checking on things such as whether the fridge door is closed or locked, etc.
  • Some people with OCD also have physical symptoms, such as repeated eye blinking, sniffing, throat clearing, shoulder or head shrugging/jerking, etc.

Panic Disorder

Panic disorder is an anxiety disorder characterized by unexpected and frequent episodes of intense fear when there is no clear, immediate, and discernible danger.

These fears can be accompanied by physical symptoms such as:

  • Profuse sweating.
  • Chest pain (can be so intense that people think they are having a heart attack).
  • A feeling of impending doom and negative thoughts.
  • Pounding or racing heart rate (heart palpitations).
  • A feeling of not being in control.
  • Trembling.


What makes it worse is that people who experience feelings of panic become preoccupied with worry about when the next attack will happen and will in turn, actively avoid situations or places to prevent future episodes, further isolating themselves from society.

Panic attacks can be as frequent as several times a day or as rare as a few times a year.

Post Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a shocking, terrifying, or traumatic experience. 

Traumatic events that may trigger PTSD include violent physical, psychological, emotional/sexual assaults, natural or human-caused disasters, accidents, military combat, or other life-threatening events.


Signs and symptoms of PTSD:

PTSD symptoms usually occur early, within three months of the traumatic event.

However, late manifestation can also occur, sometimes years afterward.

Symptoms can last over a month and interfere with normal daily functioning, affecting personal relationships. 

Recovery from PTSD can also be varied – some people recover within a few months, while others can experience chronic symptoms lasting for years.

Diagnosis of PTSD

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), lists the diagnostic criteria for PTSD as follows:

To be diagnosed with PTSD and to differentiate it from other mental health disorders, the adult must have the following for at least one month:

  • One or more re-experiencing symptom
  • One or more avoidance symptom
  • Two or more arousal and reactivity symptoms
  • Two or more cognition and mood symptoms

Re-experiencing symptoms include:

  • Nightmares reliving the traumatic event, such as a sexual assault, serious accident, or combat event
  • Frightening thoughts
  • “Flashbacks” during the daytime – reliving the traumatic event repeatedly (can include physical symptoms such as racing heart or profuse sweating)

Avoidance symptoms include:

  • Avoiding feelings and thoughts that remind the person of the traumatic event
  • Avoiding events, places, or things that remind the person of the traumatic event

These things can trigger a PTSD episode and negatively affect their relationships, daily life, and ability to work productively.

Specific arousal and reactivity symptoms:

  • Difficulty sleeping.
  • Angry reactions to people.
  • Easily startled (such as from loud noises).
  • Being “on edge.”

Cognition and mood symptoms include:

  • Enjoyable activities are no longer of interest.
  • Feelings of guilt or shame.
  • Negative, intrusive memories and thoughts about oneself or others.
  • Not being able to recall specific parts of the traumatic event (usually the ones that caused the greatest trauma).


Social Phobia (or Social Anxiety Disorder)

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by an intense, persistent fear of being watched and judged by others. 

There is a great degree of irrational self-consciousness in everyday social situations. 

For people living with social anxiety, the fear of social situations may be so intense that it affects their relationships at work, school, or other necessary daily activities.

Social phobia can range from experiencing anxiety in only one type of situation, such as a fear of speaking in formal or informal situations (performance anxiety) to the most severe form, where the individual cannot be around other people in any situation.

Symptoms of social anxiety include:

  • Stomach pain.
  • Avoiding eye contact with people one does not know.
  • Racing heart.
  • Sweating, trembling, and/or blushing.
  • Self-conscious thoughts of being negatively judged by others.
  • Speaking very softly.

Professor Hutchison from the University of Colorado at Boulder clearly compares anxiety vs PTSD in the video below:

What is the most common cause of anxiety in the elderly?

According to the National Council on Aging, GAD is the most common anxiety disorder in older adults.

It is also more common in older women than older men.

This is particularly prevalent during life events such as divorce, separation, or the death of a spouse or partner. 

Living with multiple chronic medical problems (diabetes, heart failure, etc), the realization that advancing age may contribute to limited mobility, the loss of independence, sleep disturbances, medication side effects, diagnosis of dementia, the misuse or abuse of alcohol or prescription drugs, and trauma from childhood may all contribute to the development of an anxiety disorder in older adults.

How Do You Treat Anxiety?

Many treatment options exist for managing anxiety.

Anxiety is usually treated using talk therapy (also called counseling or psychotherapy), medication, or a combination of both.

Talk therapyCBT

These sessions are conducted one-on-one in a confidential setting with a therapist or counselor. 

One very effective way of treating anxiety is Cognitive Behavioral Therapy (CBT). 

A lot of research and science-based evidence validates the positive outcomes seen in people when they participate in this mode of therapy.

With the advent of secure online services, transportation and privacy concerns are a thing of the past. 

One excellent, reputable resource that provides a complete suite of private, secure talk therapy services staffed by licensed professional counselors and therapists is

You will get a 20% discount your first month for giving them a try! 

If you feel you need to talk to someone confidentially, I highly recommend them! 

Medication Therapy

In addition to talk therapy, your doctor may prescribe medications to treat your anxiety. 

These medications have good research and clinical evidence supporting their use in managing anxiety disorders. 

You will notice that one class of medications, the selective serotonin reuptake inhibitors (SSRIs), are also used to manage depression effectively. 

Interestingly, the co-occurrence of anxiety and major depressive disorder is highly prevalent in the general population.

Both disorders are twice as common in women than men.

The tables below list the various medications and the typical doses used to manage GAD and PTSD:


Medications Used To Manage Generalized Anxiety Disorder (GAD)

First-line therapies
Escitalopram (Lexapro) 10-20 mgVenlafaxine XR (Effexor) 75-225 mg​
Paroxetine (Paxil) 20-50 mgDuloxetine (Cymbalta) 60-120 mg
Sertraline (Zoloft) 50-150 mg
Second-line therapies
Benzodiazepines when patient has no history of dependency, may combine with antidepressants for first 2-4 weeks​
Pregabalin (Lyrica)150-600 mg; imipramine (Tofranil) 75-200 mg
Hydroxyzine (Vistaril) 37.5-75 mg – effective in trials for acute anxiety, but side effects limit use
Buspirone (Buspar) 15-60 mg – indicated for GAD, but efficacy results were inconsistent​
Source: Baldwin DS, Anderson IM, Nutt DJ, et al. J Psychopharmacol.​ 2014;28(5):403-39.​


Medications Used To Manage Post-Traumatic Stress Disorder (PTSD)

First-line therapies
Fluoxetine (Prozac) 20-40 mgVenlafaxine (Effexor) 75-300 mg​
Paroxetine (Paxil) 20-40 mgSertraline (Zoloft) 50-100 mg
- Prazosin may be more effective in combat-related PTSD
Second-line therapies
TCAs – amitriptyline, imipramine 75-200 mg
Mirtazapine 30-60 mg
Lamotrigine (study doses ranged from 50-500 mg/day)
Treatment resistance
Quetiapine + venlafaxineGabapentin + SSRI
Source: Baldwin DS, Anderson IM, Nutt DJ, et al. J Psychopharmacol.​ 2014;28(5):403-39.​


My in-depth, comprehensive article on depression and its management provides much more information on the SSRIs.

You can read it here

Benzodiazepines are generally not a good choice for older adults due to the risk of sedation, fall risk, and cognitive impairment.

And, not all benzodiazepines are the same!

Some can put older adults at significant risk due to how they are broken down and eliminated in the aging body.

Hydroxyzine also comes with risks, and its use must be carefully considered during talks with your doctor.

Does CBD help with Anxiety?

Emerging evidence suggests that cannabidiol (CBD) may help with anxiety symptoms

As always, please do extensive research on any particular CBD company you are reviewing for possible use. 

Information on where and how they source their CBD, third-party independent lab testing for purity and potency, and whether they use cGMP/FDA-certified manufacturing facilities must all be readily available on their website.

Always consult your doctor before starting CBD products, as they may interact with your current prescription medications. 

If you would like to try CBD products, I highly recommend Joy Organics.

They are a reputable, ethical seller; all information is available on their website.

You can order here. Use code GA20 for 20% off your order.



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