PTSD and Anxiety

For men and women with post-traumatic stress disorder (PTSD), anxiety becomes an unwelcome life companion. Sudden anxiety attacks and persistent anxiety both qualify as PTSD symptoms, and when a more serious condition called complex PTSD is present the intensity of the anxiety can be especially disabling. Treatment for PTSD must confront the anxiety problems the disorder causes, and if that process is continued the disorder can be overcome, although the journey to good health will take some time to complete.

Post-traumatic stress disorder (PTSD) is no longer classified as an anxiety disorder. It has now been recategorized as a trauma and stressor-related disorder, in recognition of the specific and unique circumstances that provoke the onset of the condition.

But anxiety is still synonymous with PTSD, and it remains a pervasive experience for those who have been diagnosed with this disorder. Much of the challenge of overcoming post-traumatic stress involves learning to cope with the anxiety symptoms and anxiety attacks that inevitably develop, and true healing will not be possible until this process is carried to a conclusion.

Pathways to Anxiety for People With PTSD


Anxiety can manifest in connection with PTSD in multiple ways. The potential pathways to anxiety for PTSD sufferers include:

Triggering Events

People with PTSD are prone to flashbacks, which are exceptionally realistic memories that share some characteristics with hallucinations. Triggers that somehow remind a person of past traumas will essentially bring those traumas back in full force, causing them to experience a cascade of emotions equivalent to what they experienced during the actual event.

During flashbacks, people with PTSD frequently suffer powerful anxiety attacks, which produce multiple physical, psychological, and emotional symptoms, and are similar to what would be experienced by a person with panic disorder. However, those who have PTSD are reacting to terrifying events that were entirely real, giving their anxiety attacks an extra fear factor that panic disorder cannot match.

Disturbing Memories

Even without flashbacks, memories associated with trauma tend to be vivid and evocative. They are more likely to occur at random, based on small reminders, conversations, or simply because the person is caught in an unguarded moment as their minds drift back to the past.

Anxiety symptoms will often be experienced in connection with such memories, causing a flood of unwanted feelings and unpleasant physical sensations. Anxiety is not likely to reach the panic stage, unless the person experienced long-term trauma, which can lead to the onset of complex PTSD (C-PTSD). With C-PTSD any memories of trauma can be highly jarring and horrifying, possibly leading to symptoms of intense and disabling anxiety.

Anticipatory Anxiety

One thing people with PTSD and those with anxiety disorders have in common is anticipatory anxiety. That is, a dread of entering any situations it is believed might trigger anxiety attacks or other troubling symptoms.

These feelings are as real and unwelcome as any other type of anxiety. As a strategy for self-protection, men and women with PTSD develop a variety of avoidance strategies, to prevent exposures to the wrong environments.

Chronic Anxiety

PTSD is associated with a sudden rush of fear or anxiety. However, those who have the disorder must often cope with vague, persistent feelings of anxiety that follow them everywhere.

There are some similarities between this type of chronic anxiety and that experienced by people diagnosed with generalized anxiety disorder (GAD). The latter condition also produces anxiety symptoms that appear disconnected from external threats. But for people with PTSD there is an extra sense of danger or risk that accompanies their anxiety; they are constantly on alert and on the lookout for any possible threat.

Other Anxiety Disorders

Studies show that about 80 percent of people with PTSD have other psychiatric disorders. Depression is the most common co-occurring condition, but many men and women with PTSD also have one or more anxiety disorders (social anxiety disorder, obsessive-compulsive disorder, specific phobia, panic disorder, and/or generalized anxiety disorder).

Multiple anxiety disorders often develop in those who have complex PTSD, the condition that results from exposure to long-term abuse or neglect. Those who experience such trauma in childhood are highly vulnerable to all types of psychiatric disorders, and the anxiety they experience as adults can be multidimensional and completely overwhelming.

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Getting Treatment for Anxiety and PTSD


PTSD symptoms are disabling and often frightening reminders of life-altering exposures to trauma. Traumatic memories can recur again and again, leaving a troubling legacy of suffering that can seem inescapable unless treatment is sought.

When PTSD is complicated by anxiety disorders, the suffering can be even more acute. But treatment plans can be customized to make sure multiple psychiatric disorders are addressed simultaneously and comprehensively, if the diagnosis requires it.

With or without co-occurring anxiety disorders, intense anxiety is one of PTSD’s defining core symptoms. When a person enters an inpatient or outpatient treatment program for PTSD, one of the primary goals of their therapists will be to help them come to terms with their past trauma, as they analyze its ongoing effect on their lives. Gaining perspective and self-understanding can help them reduce the anxiety they experience to a far more manageable level.

Practical techniques for managing anxiety may be introduced to patients as well. Their therapy regimen will almost certainly include instruction in cognitive behavioral therapy (CBT), which has been proven effective against anxiety symptoms by various studies. Holistic stress management practices, like meditation, biofeedback, yoga, massage therapy, acupuncture, and Tai Chi can promote long-term healing from anxiety troubles as well, and are frequently incorporated into mental health center treatment plans.

Anxiety from any source may respond positively to antidepressant medications. While anxiety and PTSD should never be treated exclusively with medication, as part of a comprehensive recovery program antidepressants can be beneficial for some individuals (and if depression has been diagnosed these medications are even more helpful).

Over time, and with a dedicated approach to recovery, people with PTSD and anxiety can regain their emotional equilibrium and bring much needed calm and contentment into their lives.

Serious anxiety is a sign of deep emotional and psychological disturbance, but with treatment the anxiety can be successfully managed and possibly even eliminated if the commitment to healing remains strong.