PTSD vs. Anxiety - What You Need to Know
Understanding mental health conditions can be complex, especially when discussing two closely related yet distinct disorders: PTSD and anxiety. Both can significantly impact your daily life, but recognising their unique characteristics can be helpful for seeking appropriate help.
Definition of PTSD
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can emerge after an individual experiences or witnesses a traumatic event. Such events could range from military combat to natural disasters, serious accidents, or personal experiences like sexual assault or childhood abuse.
Experiencing a traumatic event can alter your perception of safety and trigger a range of distressing symptoms, often persistent, that can disrupt everyday functioning. It is important to note, however, that not everyone who experiences trauma develops PTSD. Research shows that PTSD develops in around 1 in 3 people who experience severe trauma.
Here’s a quick overview of common PTSD triggers and characteristics:
Triggers:
Witnessing a traumatic event
Directly experiencing trauma
Learning about trauma experienced by a loved one
Characteristics:
Flashbacks and intrusive memories
Emotional numbness
Avoidance of reminders associated with the trauma
Definition of Anxiety
Anxiety is a broader category of mental health disorders characterised by feelings of unease, fear, and worry. While it’s perfectly normal to feel anxious during stressful situations, like a job interview or public speaking, anxiety becomes a problem when those feelings persist and start to interfere with daily activities. Symptoms of anxiety can vary widely, and they often manifest in various ways:
Common Symptoms:
Excessive worrying about potential problems
Restlessness and irritability
Physical symptoms, like a racing heart or sweating
While both conditions can lead to feelings of fear and tension, anxiety generally arises from concerns about future uncertainties rather than being tied to a specific, past traumatic event. This distinction is pivotal in understanding what you might be experiencing. Understanding these definitions allows for a clearer perspective on your thoughts and feelings, helping you take the first steps towards seeking help if necessary.
Common types of anxiety disorders:
Generalised Anxiety Disorder (GAD): GAD involves chronic, excessive worry about various aspects of life. The worry often feels difficult to control and interferes with day-to-day functioning.
Panic Disorder: Characterised by sudden, intense episodes of fear or discomfort known as panic attacks, which can include symptoms like heart palpitations, shortness of breath, and dizziness. These attacks often occur unexpectedly, leading to a fear of future attacks.
Social Anxiety Disorder (Social Phobia): This disorder involves intense fear of social or performance situations, driven by worries of being judged, embarrassed, or humiliated.
Specific Phobias: Marked by a strong, irrational fear of a specific object, situation, or activity, such as heights, flying, or spiders. The fear is often out of proportion to the actual threat and can interfere with everyday functioning.
Causes of PTSD
PTSD can develop after experiencing or witnessing a traumatic event, such as an accident, assault, natural disaster, or war. However, there is no single cause of PTSD, as its onset depends on a combination of factors, including the nature of the trauma, individual resilience, and genetic predispositions.
Traumatic Events
The primary catalyst for PTSD is exposure to traumatic events. A traumatic event is an experience that is deeply distressing or disturbing, often involving a real or perceived threat to life, safety, or physical or psychological well-being. When someone undergoes such an event, it may lead to an overwhelming sense of fear and helplessness. Some examples of traumatic events include:
Military Combat: Many veterans face intense situations in war zones, which can stay with them long after they return home.
Natural Disasters: Surviving hurricanes, earthquakes, or floods can lead to persistent traumatic and intrusive memories.
Accidents: Serious injuries from car accidents or workplace mishaps can instigate PTSD.
Assault: Experiences like sexual or physical assault can profoundly disrupt an individual’s sense of safety.
Childhood Experiences: Abuse or neglect during formative years can create lasting psychological impacts.
It's essential to recognise that trauma is subjective; what feels traumatic to one person may not have the same effect on another.
Genetics
While specific events trigger PTSD, genetics can play a significant role in an individual’s vulnerability to developing the disorder. Research suggests that specific genetic markers may influence how our bodies process stress and trauma. Factors that might contribute genetically include:
Family History: If you have a close family member who has been diagnosed with PTSD or other anxiety disorders, your likelihood of developing PTSD following a traumatic experience may be higher.
Biological Responses: Differences in neurotransmitter functioning, like serotonin and dopamine, can affect emotional regulation.
Coping Mechanisms: Genetic predispositions might influence how well you cope with stress and trauma. For instance, if both your parents struggled with anxiety or mood disorders, it may predispose you to a similar response to stressors.
Both traumatic events and genetic factors interact (among other factors, such as environmental influences or personal experiences) to determine the likelihood of developing PTSD. Acknowledging these causes can create a framework for a better understanding of a person’s experience and their recovery.
Causes of Anxiety
Similar to PTSD, anxiety is a multifaceted condition with no one specific cause.. Similar to PTSD, research suggests that anxiety can be caused by a combination of factors, including genetic predisposition, personality traits, and life experiences. Understanding what drives anxiety can help you make sense of your feelings and identify effective strategies for managing them.
Environmental Factors
Environmental influences can play a massive role in developing anxiety disorders. Your surroundings, experiences, and social contexts can all trigger anxiety responses. Think back to your life: perhaps those high-pressure moments before a big presentation or the stress of navigating a challenging relationship. Some common environmental factors include:
Stressful Life Events: Events like moving to a new city, changing jobs, or experiencing a breakup can trigger heavy feelings of anxiety.
Trauma: Exposure to traumatic incidents can lead to ongoing anxiety. For example, experiencing a severe car accident might cause someone to develop a fear of driving.
Chronic Stress: Continuous exposure to stress—whether from work, family, or financial pressures—can build up over time, leading to heightened feelings of anxiety.
Symptoms of PTSD
Understanding the symptoms of Post-Traumatic Stress Disorder (PTSD) can help you recognise how it manifests in individuals who have experienced trauma. While PTSD shares some symptoms with anxiety disorders, it also features distinct experiences that set it apart. Among these, flashbacks and hyperarousal are two prominent symptoms that severely affect those living with the condition.
Flashbacks
Flashbacks are involuntary memories that make the person feel like they are reliving the traumatic event. These can be triggered by things as simple as a sound, a smell, or a visual cue in the environment. Imagine sitting in a café, enjoying a cup of coffee, when suddenly the sound of a car backfiring transports you to a frightening experience you had during a traumatic incident.
It’s almost as if that moment is happening again—your heart races, you begin to sweat, and it feels like the event is playing out in real-time. This can be incredibly disorienting and frightening. Key points about flashbacks:
Types: Flashbacks can vary from intense, realistic re-experiencing of the event to more fragmented thoughts that seem out of control.
Common Triggers: These could include anniversaries of the event, specific places, or conversations that remind the individual of the trauma.
Hyperarousal
Hyperarousal is another significant symptom experienced by individuals with PTSD. This involves a heightened state of anxiety and sometimes an exaggerated startle response. People who experience hyperarousal often find it hard to relax, and they may feel constantly "on edge." Consider a friend who returned from military service.
Since then, loud noises cause them to jump or panic, and they often listen carefully for any sounds that might signal danger. This constant state of hyperarousal can lead to exhaustion, irritability, and difficulty focusing. Characteristics of hyperarousal might include:
Irritability and Anger: Frequent outbursts or mood swings that may surprise the individual and those around them.
Sleep Disturbances: Difficulties falling asleep or staying asleep, which can stem from nightmares or persistent anxiety about safety.
Easily Startled: Feeling jumpy or easily frightened by unexpected events.
Recognising these symptoms is helpful for understanding the profound impact PTSD can have on daily life. If you or someone you know is experiencing these symptoms, it may be an indication to seek professional help and begin healing. While PTSD can feel isolating, it’s important to remember that support is available.
Further down in this blog, we discuss further symptoms of PTSD and the diagnostic criteria.
Symptoms of Anxiety
Anxiety can manifest in various ways. Two common symptoms of anxiety are excessive worrying and panic attacks.
Excessive Worrying
One of the hallmark symptoms of anxiety, and more specifically Generalised Anxiety Disorder (GAD) is excessive worrying. This is more than just the usual concerns about daily life. Worry is a state of mental distress or unease about potential future events or outcomes, often involving repetitive, anxious thoughts focused on uncertainty, risk, or possible negative scenarios. For instance, you may find yourself preoccupied with thoughts like:
"What if I fail this exam?"
"What if I embarrass myself at the meeting?"
"What if something happens to my loved ones?"
Excessive worry can lead to heightened stress and impact mental well-being. These persistent thoughts can feel overwhelming, feeding into a sense of doom that can disrupt your daily activities. Characteristics of excessive worrying may include:
Physical Symptoms: This can manifest as muscle tension, fatigue, or sleep disturbances.
Avoidance Behavior: You might avoid situations that trigger your worries, leading to a narrowing of your experiences.
Impaired Functioning: Excessive worry can affect your performance at work or school and strain relationships with others.
Panic Attacks
Panic attacks can be another symptom of anxiety. A panic attack typically occurs suddenly, without warning, causing a surge of intense fear or discomfort. Common physical symptoms during a panic attack may include:
Increased Heart Rate: You may feel as if your heart is racing.
Shortness of Breath: You might struggle to catch your breath, leading to feelings of suffocation.
Chest Pain: This might feel like a heart attack, causing significant concern.
It's essential to recognise that while panic attacks and excessive worrying are common symptoms of anxiety, they can also significantly interfere with daily life and functioning. If you or someone you know experiences these symptoms, it may be beneficial to seek professional help.
Diagnosis of PTSD and Anxiety
Diagnosing anxiety, PTSD or other mental health difficulties is an essential first step toward understanding and managing symptoms. Diagnosing mental health difficulties such as anxiety and PTSD is usually a multi-step process that often can involve thorough criteria evaluation and psychological assessment.
Psychological Evaluation
Clinical Interview: A mental health professional will likely conduct an in-depth interview, discussing your history, symptoms, and, in the case of PTSD, the context of the traumatic event. Sometimes, this can feel like a deep conversation about your life, but it's integral to uncovering possible underlying issues or maintaining factors.During this aspect, the therapist will probably ask open-ended questions about your feelings, experiences, and symptoms. This is your opportunity to express the symptoms and situational triggers.
Standardised Assessments: Questionnaires, such as the PTSD Checklist for DSM-5 (PCL-5) and Generalized Anxiety Disorder 7-item scale (GAD-7), can help in corroborating symptoms and their intensity. These assessments may also provide an avenue for individuals to express their feelings more openly.
Coping Mechanism Exploration: The evaluation may also examine how you cope with stress and trauma. This exploration helps the professional understand your preferences for support and resilience.
Behavioural Observation: Therapists may observe your body language, tone of voice, and overall demeanour during the session. For example, fidgeting or avoidance of eye contact may indicate heightened anxiety.
This diagnostic process can be very revealing, helping individuals understand their feelings and foster a path to healing. Early diagnosis and intervention pave the way for discussion of effective treatment options that could significantly enhance one's quality of life. If you or someone you know is navigating difficult or concerning symptoms, seeking a professional evaluation is likely a good next step.
Diagnosis of Anxiety
Diagnostic Criteria for PTSD
DSM-5 Criteria
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines specific criteria to diagnose PTSD. Understanding these can give you more precise insights into what a mental health professional may look for during an assessment. Here are the critical criteria:
Exposure to a Traumatic Event: The individual must have been exposed to a traumatic event, either directly by witnessing it, learning that it happened to a close person, or through repeated exposure to distressing details of trauma (e.g., first responders). You must have experienced, witnessed, or been indirectly exposed to death, serious injury, or sexual violence. This makes it personal—PTSD isn't merely about hearing about someone else's trauma.
Intrusive Symptoms: These include recurrent, involuntary memories of the trauma, flashbacks, or distressing dreams related to the event. For example, an individual might have vivid recollections of an accident during the day or face nightmares at night.
Avoidance Symptoms: A person may actively avoid reminders of the trauma, including thoughts, feelings, or related conversations. They might also avoid certain places or people that trigger these memories.
Negative Alterations in Mood: This could involve feelings of detachment, apathy, or memory issues regarding the traumatic event. An individual might struggle to maintain positive emotions or feel excessively negative thoughts.
Arousal Symptoms: Symptoms in this category might manifest as irritability, hypervigilance (being extremely alert), and startle responses. For example, a loud noise might provoke an exaggerated jump reaction.
These symptoms must last for more than a month and significantly affect daily life to meet the full criteria for PTSD.
Treatment Options for PTSD
Navigating the path to recovery from Post-Traumatic Stress Disorder (PTSD) involves understanding the various treatment options available. The effective management of PTSD may include psychological therapy, medication or a combination of therapy and medication tailored to individual needs. Let’s explore these treatments in greater detail.
Therapy
Therapy plays a pivotal role in addressing the symptoms of PTSD. Several evidence-based therapeutic approaches have been shown to be effective in helping individuals process trauma and develop coping mechanisms. Here are a few common types:
Cognitive Processing Therapy (CPT): This therapy focuses on helping individuals modify distressing beliefs related to the trauma. The goal is to help you identify unhelpful thoughts and beliefs, challenge them, and replace them with healthier and more rational perspectives.
Prolonged Exposure Therapy (PE): PE involves safely facing trauma-related memories, thoughts, and situations to reduce fear. This may include recounting the traumatic event in a supportive environment to enable processing of the trauma.Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a therapy designed to process traumatic memories through guided eye movements.
Medication
In some cases, medications may be prescribed alongside therapeutic approaches to help effectively manage PTSD symptoms. While not everyone will require medication, they can benefit those experiencing severe symptoms. Commonly prescribed medications include selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Medication must be prescribed by a medical professional.
Treatment Options for Anxiety
When addressing anxiety, a variety of treatment options are available.Two approaches that have been shown to be effective are Cognitive Behavioral Therapy (CBT) and medication, or a combination of both. Let’s delve deeper into these options to understand how they might work for you.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is widely recognised as one of the most effective treatments for anxiety disorders. At its core, CBT focuses on the connection between thoughts, feelings, and behaviours. The key is to identify and challenge negative thought patterns that contribute to anxiety and address behaviours that serve to maintain difficulties with anxiety (such as avoidance). Here’s how CBT typically works:
Identifying Negative Thoughts: A therapist may help you recognise unhelpful beliefs and cognitive distortions, such as catastrophising situations. You might realise that you frequently expect the worst outcomes in everyday scenarios, like worrying excessively about a work presentation.
Reframing Thoughts: Once identified, you might work on replacing these negative thoughts with more balanced or rational ones. This can significantly reduce anxiety. Instead of thinking, "I will embarrass myself," you might consider, "I have prepared well and can manage this."
Behavioural Techniques: CBT also involves gradually facing your fears through exposure therapy, which can help reduce avoidance behaviours. For example, if you struggle with social anxiety, your therapist might encourage you to start by attending small gatherings to build your confidence gradually.
Medication
Medication can also play a role in managing anxiety, especially symptoms that are more severe. Not everyone who experiences an anxiety disorder will need to take medication. Discussing your symptoms with a medical professional, such as your GP or a psychiatrist, may be helpful if you want to explore medication options. Examples of types of medications include Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):
Ultimately, treatment for anxiety is not a one-size-fits-all approach. You may benefit from a combination of CBT and medication tailored to your needs. If you’re grappling with anxiety, reaching out to a mental health professional can set you on the path to recovery. They can help you create a plan that aligns with your goals and lifestyle. Remember, seeking help is a significant first step towards feeling better!
It’s important to note that psychologists cannot prescribe medication. If you are wanting to discuss medication, seeing your GP is a good place to start.
Coping Mechanisms for PTSD
Coping with Post-Traumatic Stress Disorder (PTSD) can be a challenging journey, but employing effective strategies can facilitate healing and improve overall well-being. Two valuable coping mechanisms include mindfulness techniques and support groups. Let’s dive into how these can be instrumental in managing PTSD symptoms.
Mindfulness Techniques
Mindfulness is a powerful practice that focuses on being present in the moment. It encourages individuals to observe their thoughts and feelings without judgment. This practice can be especially beneficial for those experiencing PTSD, as it helps ground them and reduce the intensity of intrusive memories or anxiety. Here are some mindfulness techniques that can be helpful:
Deep Breathing: Deep breathing exercises can help calm your nervous system. Inhale slowly through your nose, allowing your abdomen to expand, then exhale gently through your mouth. This can help ease the physical symptoms of anxiety.
Body Scan: This technique involves lying down comfortably and focusing attention on different parts of the body from head to toe. By progressively relaxing each muscle group, you can become more attuned to physical sensations and release tension.
Meditation: Mindfulness meditation encourages sitting quietly and paying attention to your thoughts without getting caught up. You might notice your thoughts drifting toward past traumas, but the key is gently bringing your focus back to the present moment.
Support Groups
Connecting with others with similar experiences can be a vital source of comfort and understanding. Support groups provide a safe space to express feelings and share coping strategies for dealing with PTSD. Consider the benefits of attending a support group:
Shared Experiences: Listening to others recount their stories can help you feel less isolated. Knowing you are not alone in your struggles can alleviate shame and fear.
Coping Strategies: Support groups often facilitate discussions on various coping mechanisms that have worked for other members. For instance, you may pick up relaxation techniques or learn how to express feelings positively through art or writing.
Emotional Support: Members often offer empathy and encouragement, creating a community that fosters healing. This social interaction can be especially vital in combating the loneliness that usually accompanies PTSD.
By integrating mindfulness techniques and engaging with support groups, individuals facing PTSD can take proactive steps on the road to recovery. Embrace these coping mechanisms, and remember that healing happens over time, often through connection and understanding. If you’re overwhelmed, consider contacting a mental health professional or joining a supportive community. You're not alone in this journey.
Coping Mechanisms for Anxiety
Managing anxiety effectively often requires a combination of approaches, including relaxation exercises and healthy lifestyle changes. While each person’s experience with anxiety is unique, these strategies can provide substantial relief and promote overall well-being.
Relaxation Exercises
Incorporating relaxation exercises into your routine can significantly lower anxiety levels and help you regain a sense of calm. These exercises focus on reducing muscle tension and promoting mental clarity. Here are a few techniques you can try:
Deep Breathing: One of the simplest yet effective relaxation techniques involves deep, diaphragmatic breathing. Inhale deeply through your nose, allowing your abdomen to rise, and then exhale slowly through your mouth. Repeat this for a few minutes to help alleviate stress and anxiety.
Progressive Muscle Relaxation: This technique involves systematically tensing and relaxing different muscle groups. Start at your toes, tense the muscles for a few seconds, then relax them, moving up through your legs, abdomen, arms, and face. This method helps to release built-up tension and encourages relaxation.
Visualisation: Find a quiet space and imagine a peaceful scene like a beach or forest. Use all your senses to create a vivid picture, focusing on that place's sounds, smells, and sensations. This mental escape can help divert your mind from anxious thoughts.
Healthy Lifestyle Changes
Making mindful changes to your daily routine can also be instrumental in coping with anxiety. Here are some healthy lifestyle changes to consider:
Regular Physical Activity: Exercise is a powerful anxiety reducer. Aim for at least 30 minutes of moderate-intensity exercise several days a week. Activities like walking, jogging, or yoga can release endorphins, which are natural mood lifters.
Sleep Hygiene: Prioritising good sleep habits is vital for managing anxiety. Ensure you maintain a consistent sleep schedule, create a calming bedtime routine, and create a comfortable sleep environment. Aim for 7-9 hours of quality sleep each night.
Incorporating relaxation exercises and healthy lifestyle changes into your daily routine may help manage anxiety and enhance overall mental health. If you find anxiety overwhelming, don't hesitate to seek professional support for additional strategies tailored to your needs.
Meet Your Clinical Psychologists In Newcastle
Dr Emma Doolan is a Clinical Psychologist based in Newcastle. With a collaborative and evidence-based approach, she helps clients overcome various challenges such as anxiety, depression, stress, and trauma.
Emma is experienced in cognitive behavioural therapy (CBT) and other modalities like schema therapy, acceptance and commitment therapy (ACT), and compassion-focused therapy. She holds a PhD in clinical psychology and has completed her registration as a clinical psychologist from AHPRA. Emma is a member of several professional associations, including ACPA, APS, AACBT, and APN.
Paige Cornell is a clinical psychologist in Newcastle who has experience in therapeutic modalities such as Motivational Interviewing, CBT, Schema Therapy, DBT, and ACT. She focuses on building a solid therapeutic relationship and tailoring treatment to each individual. Paige has experience in private practice, NGOs, and forensic settings.
She works with a diverse range of mental health issues, including anxiety, mood disorders, PTSD, relationship problems, substance abuse, and offending behaviours. Paige is particularly interested in helping LGBTQI+ individuals and those dealing with trauma and substance abuse. She is fully registered and endorsed as a clinical psychologist and a board-approved supervisor for psychologists. Paige is a member of ACPA and APS, holding a Master's in Clinical Psychology and a Bachelor's in Psychological Science (Honours).
Taylah Armstrong is a Clinical Psychologist in Newcastle. She focuses on developing solid therapeutic relationships to assist individuals in enhancing their well-being and achieving their goals. Taylah is skilled in treating various concerns such as anxiety, stress, mood disorders, trauma, and eating disorders.
She utilises evidence-based therapies like CBT, DBT, and ACT. Taylah has worked in public healthcare, primary care, and education sectors. She is fully registered and endorsed as a clinical psychologist by AHPRA and holds a Master's and Bachelor's degree in Psychology from the University of Newcastle.
Paige Whitfield is a clinical psychologist in Newcastle with experience in private and public health settings. She collaborates with health professionals, families, and schools to provide evidence-based treatments like CBT, Narrative Therapy, and ACT for various issues. Paige has a Bachelor's degree in Psychology (Honours) and a Master's in Clinical Psychology. She is fully registered and endorsed as a clinical psychologist and is a member of APS and ACPA.
Dr Kaitlin Fitzgerald is a clinical psychologist in Newcastle who takes a collaborative and client-centred approach to therapy. She creates a warm and relaxed environment for clients, aiming to make therapy sessions comfortable and even enjoyable. Kaitlin holds a Doctor of Philosophy in Clinical Psychology and a Bachelor of Psychology (Honours) from the University of Newcastle. In addition to her private practice at ELD Psychology, she also works in public mental health treating adults with various mental health issues.
Kaitlin has experience working with a wide range of concerns, such as anxiety, depression, and relationship difficulties. She is skilled in evidence-based therapies like CBT, Schema Therapy, DBT, and ACT. Kaitlin is fully registered as a clinical psychologist with AHPRA and is approved to supervise provisional and registered psychologists.
Eliza Newton is a person-centred Clinical Psychologist dedicated to helping clients explore their deeper selves. She tailors her approach to each client, using psychodynamic therapy for self-exploration or structured techniques like Acceptance and Commitment Therapy, Cognitive Behaviour Therapy, and Schema Therapy. Eliza focuses on individuals overcoming childhood trauma, including Complex PTSD, and helps those with ADHD develop organisational and emotional well-being strategies. With experience in private practice, inpatient settings, and psychiatric rehabilitation, she addresses challenges from anxiety and mood disorders to severe mental illness.
Eliza holds a Bachelor of Psychology (Honours) from the University of Newcastle and a Master of Clinical Psychology from Western Sydney University. She is registered as a Clinical Psychologist with AHPRA and is a member of AAPi and ACPA.
Disclaimer
The content provided on this blog is intended for Australian audiences and is for informational purposes only. It should not be considered as professional psychological advice, diagnosis, or treatment. The information shared here is based on general knowledge and experience in the field of psychology, but it may not be applicable to your specific situation.
Always seek the advice of your psychologist or other qualified mental health provider with any questions you may have regarding a psychological condition or treatment. Never disregard professional psychological advice or delay in seeking it because of something you have read on this blog.
If you are in crisis or you think you may have an emergency, call your doctor, or dial 000 immediately. This blog is not intended to be a substitute for professional advice, diagnosis, or treatment.
The opinions expressed in this blog are solely those of the author and do not necessarily reflect the views of any affiliated organisations or institutions.