Lots of people can relate to being anxious, and wonder if they have anxiety or PTSD.
Sometimes the feelings are mild: slightly elevated heart rate or blood pressure, some discomfort in social settings, or too many thoughts to get back to sleep easily. Other times, experiences of anxiety are really debilitating: panic attacks that make the heart race and leave a person feeling like they are having a heart attack, or physical symptoms resulting from obsessive worry about all the “what ifs” involved with an upcoming event.
There are many types of anxiety. Social anxiety, generalized anxiety, acute stress disorder, and phobias all fall under the “anxiety disorder” umbrella, among others. But, up until 2013, so did Posttraumatic Stress Disorder (PTSD). And, with quite a lot of overlap in symptoms whether it’s anxiety or PTSD, it can be hard to distinguish the variety of anxiety disorders from PTSD, which the newest edition of the Diagnostic and Statistical Manual of Mental Disorders now calls a “trauma and stressor-related disorder.”
So, what is trauma?
It would be so much simpler if we could just identify which stressful experiences are “traumas,” and which aren’t. The trouble is that trauma isn’t in the event itself. It’s in each person’s experience of the event—even an event that happened to someone else, but was witnessed—and how his or her brain and nervous system perceive and process the threat.
You might not necessarily tie a traumatic event to your anxious thoughts and feelings, or even realize you experienced “trauma.” You might think you just feel bad. You might want help for your persistent nervousness or tools to manage the unexplained panic that comes “out of nowhere.” You may be frustrated by how out of control you feel when you’re stressed.
There is some complex neurobiology at work in a brain that perceives an event as traumatic. But, when most people think about anxiety and trauma, they think about their experiences. Let’s look at those.
How Do Anxiety and PTSD Compare?
There are clear symptomatic similarities. Anxiety and PTSD affect sleep and energy. They both impact disposition and mood. They both fuel a need to be alert and exhaustingly on guard. Both conditions generate fear and worry surrounding non-imminent threats.
For the most part, typical anxiety is often generated without an actual precipitating situation. Thoughts present in anxiety disorders do not necessarily relate to past events, and no real circumstance needs to drive the upset. The worry and fear are real, but the cause is often based on unsupported assumptions.
On the other hand, PTSD’s symptoms are driven by a significantly different force than other anxiety types. Suffering occurs because frightful circumstances are not imagined. Something frightful actually happened, and in fact, a person with PTSD experiences the symptoms as if the event was happening again and again.
While anxiety symptoms and PTSD symptoms can overlap, PTSD is always related to traumatic and stressful past events.
You might ask, “Isn’t social anxiety sometimes linked to stressful past social situations, for example?” Sometimes, but it’s much more usual that anxieties are not specifically related to a certain past event. For example, the stressful thoughts suffered by someone with Obsessive-Compulsive Disorder are not usually provoked by past experiences.
But, PTSD is always related to specific past events. It might be a one-time event in adulthood, like a horrific car accident. It could be a series of events over a period of time like many combat veterans experience. Or, it might be the ongoing developmental or complex traumatic stress experienced in childhood or later developmental years. Whatever the event(s), traumatic stress disorders have their roots in past events, and they can produce many symptoms in a sufferer’s current life.
PTSD is much more than fear and worry related to the frightening circumstance.
Enduring something so frightening or terrible that our very existence is threatened—or perceived to have been threatened— has the power to change not only perceptions, but the nervous system itself.
In fact, trauma survivors are distinctly and uniquely affected as the nervous system adapts to what it perceives as a more dangerous world in the aftermath of trauma. It is an inability to release oneself from the emotional, mental, and bodily sensations that accompanied that experience. It’s like the traumatic event or events are still happening. The brain and nervous system find ways to compensate for the perception of danger, and distinct symptoms result.
Let’s compare common symptoms of anxiety unrelated to trauma and common PTSD symptoms.
- Fatigue and restlessness
- Excessive, persistent worry
- Intrusive, fearful thoughts
- Difficulty with sleeping, digestion, and tension
- Reduced concentration
- Racing heart, sense of doom
Although many of these are also associated with PTSD, Traumatic Stress Symptoms Fall into Four Categories, and Include:
- Re-experiencing symptoms, such as nightmares and dissociative flashbacks, or intense distress related to triggers some parts of the event, and/or having bodily sensations specifically associated with the traumatic event.
- Avoidance symptoms, such as avoiding any people, places, actions, words or objects related to the event, and feeling detached, “spaced out,” or emotionally numb.
- Negative thoughts and mood, including difficulty remembering important parts of the event(s), ongoing negative moods and trouble having positive experiences.
- Arousal symptoms such as irritability, angry outbursts, recklessness, self-destructive actions, watchfulness or edginess, feeling easily startled, poor concentration, sleep problems.
While some anxiety symptoms and PTSD symptoms clearly overlap, the difference is that with anxiety, the intrusive thoughts, persistent worry, and other difficulties are generally not tied to a specific or past event, whereas in PTSD, they are.
PTSD impairs your ability to recover from overwhelming events, or to establish healthy thought patterns and relationships. It deserves to be set apart from standard anxiety disorders for good reason. To recover is possible, but the care of a well-trained therapist using safe, effective, research-based methods can be crucial.
How about you? Are you anxious and unsure why?
Do you need help distinguishing the way you feel now from what you endured in the past? Or, are you unsure if your current symptoms are related to anxiety or PTSD? Getting answers to these questions and gently working it out with a compassionate, skilled trauma therapist can make all the difference.