Anxiety disorders can wreak havoc on daily life. Generalized Anxiety Disorder (GAD) involves persistent worry about various aspects of life, while Panic Disorder is marked by sudden, intense panic attacks. Both can lead to physical symptoms, avoidance behaviors, and significant life disruptions.

The DSM-5 outlines specific criteria for diagnosing these disorders. GAD requires excessive worry for at least 6 months, while Panic Disorder involves recurrent panic attacks followed by persistent concern. Understanding these distinctions is crucial for proper diagnosis and treatment.

Generalized Anxiety Disorder (GAD) and Panic Disorder

Generalized anxiety vs panic disorder

• Generalized Anxiety Disorder (GAD)
  • Characterized by persistent and excessive worry about various aspects of life (work, health, finances) that is difficult to control
  • Anxiety is not focused on a specific object or situation but rather generalized across multiple domains
  • Accompanied by physical symptoms such as muscle tension, fatigue, and restlessness
• Panic Disorder
  • Marked by recurrent unexpected panic attacks that involve intense fear or discomfort peaking within minutes
  • Panic attacks are accompanied by physical symptoms (palpitations, sweating, trembling) and cognitive symptoms (fear of losing control or dying)
  • Concern about additional attacks or their consequences leads to significant maladaptive changes in behavior (avoidance of certain situations)

DSM-5 criteria for anxiety disorders

• GAD diagnostic criteria
  • Excessive anxiety and worry occurring more days than not for at least 6 months about a number of events or activities
  • Difficulty controlling worry that is associated with at least three of the following symptoms:
    1. Restlessness or feeling keyed up or on edge
    2. Being easily fatigued
    3. Difficulty concentrating or mind going blank
    4. Irritability
    5. Muscle tension
    6. Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
  • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
• Panic disorder diagnostic criteria
  • Recurrent unexpected panic attacks that involve abrupt feelings of intense fear or discomfort that peak within minutes
  • At least one attack followed by 1 month or more of:
    1. Persistent concern or worry about additional panic attacks or their consequences (losing control, having a heart attack)
    2. Significant maladaptive change in behavior related to the attacks (avoidance of unfamiliar situations)
  • Attacks not attributable to the physiological effects of a substance (caffeine) or another medical condition (hyperthyroidism)

Symptoms of anxiety disorders

• GAD symptoms
  • Physical: muscle tension, fatigue, restlessness, difficulty sleeping, stomachaches, headaches
  • Cognitive: excessive worry that is difficult to control, difficulty concentrating, mind going blank, indecisiveness
  • Behavioral: avoidance of anxiety-provoking situations, procrastination, seeking reassurance from others
• Panic disorder symptoms
  • Physical: palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, chills or heat sensations
  • Cognitive: fear of losing control or going crazy, fear of dying, derealization (feelings of unreality), depersonalization (feeling detached from oneself)
  • Behavioral: avoidance of situations that may trigger panic attacks (driving, crowded places), reliance on safety behaviors (always having an escape route or access to medication)

Impact of anxiety on daily life

• GAD impact
  • Decreased work performance and productivity due to difficulty concentrating and fatigue
  • Strained interpersonal relationships as a result of irritability and excessive reassurance-seeking
  • Reduced participation in social activities leading to isolation and loneliness
  • Increased healthcare utilization and costs due to frequent doctor visits for physical symptoms
  • Diminished overall quality of life and sense of well-being
• Panic disorder impact
  • Avoidance of places or situations where panic attacks have occurred (shopping malls, public transportation) resulting in restricted travel or social activities
  • Increased risk of unemployment or underemployment due to avoidance behaviors and decreased functioning
  • Impaired social and occupational functioning leading to strained relationships and decreased job performance
  • Decreased quality of life and increased disability, often accompanied by depression and other co-occurring disorders
  • Increased healthcare costs due to emergency room visits for panic attacks and frequent medical evaluations for physical symptoms