Differences Between Panic Disorder and GAD

Key Takeaways

• Panic disorder involves panic attacks with symptoms like a fast heartbeat and fear of losing control.
• Generalized anxiety disorder (GAD) involves constant worry about everyday life and has symptoms like trouble sleeping and tiredness.
• It is possible for someone to have both panic disorder and GAD at the same time.

Panic disorder and generalized anxiety disorder (GAD) share some symptoms, such as excessive worrying; however, they’re two separate, distinct mental health conditions. Learn about these two common mental health conditions and the differences between them.

Panic Disorder

• Recurring panic attacks

• Fear of going insane or losing control

• Feelings of unreality (derealization) or being detached from oneself (depersonalization)

• Excessive worry about future attack

• Chest pain, trembling, and shaking

• Accelerated heart rate, shortness of breath

GAD

• Excessive worry over everyday life events

• Worrisome thoughts that interfere with daily functioning

• Sleep troubles, fatigue, muscle tension

• Irritability

• Feelings of mind going blank, or impaired concentration

• Digestive issues

Characteristics of Panic Disorder

Panic disorder is characterized by recurring, unexpected panic attacks that occur without the presence of actual danger. The “Diagnostic and Statistical Manual for Mental Disorders” (DSM-5) defines a panic attack as a sudden onset of intense fear during which at least four of the following physical and psychological symptoms are present:

• Chest pain or discomfort
• Chills or hot flashes
• Excessive sweating
• Feelings of choking
• Fear of dying 
• Fear of losing control or “going crazy”
• Feeling dizzy, unsteady, light-headed, or faint
• Feelings of unreality (derealization) or being detached from oneself (depersonalization)
• Heart palpitations, pounding heart, or accelerated heart rate
• Nausea or abdominal distress
• Numbness and tingling sensations (paresthesias)
• Sensations of shortness of breath or smothering
• Trembling or shaking

The symptoms of a panic attack usually happen suddenly, peak within 10 minutes, and then subside. However, some attacks may last longer or may occur in succession, making it difficult to determine when one attack ends and another begins.

Panic disorder often causes excessive worry about having another panic attack, creating a vicious cycle.

It’s not unusual for a person with panic disorder to become so consumed with worry and fear that they develop behavioral changes, such as agoraphobia, to avoid environments or situations where they fear a panic attack may arise.

Characteristics of GAD

The main feature of GAD is excessive and pervasive worry about everyday life events. This worry is difficult to control, and the worrisome thoughts can become unmanageable.

In order to be diagnosed with GAD, worry and anxiety must persist for more than six months and interfere with daily functioning. For a person with GAD, their worry and anxiety may take over, making it difficult for them to complete job tasks, maintain healthy relationships, and take care of themselves. 

With GAD, a person may have physical symptoms, but they differ from those with panic disorder. Common examples of these physical symptoms include:

• Chronic headaches
• Digestive issues like diarrhea or stomach discomfort
• Fatigue
• Irritability
• Muscle tension
• Restlessness
• Sleep problems (difficulty falling or staying asleep)

The focus of worry in GAD generally surrounds usual life circumstances—finances, job issues, children, health—unlike in panic disorder, when worry occurs spontaneously and/or focuses on when the next panic attack will occur.

Coexistence of Conditions

It is possible to have both panic disorder and GAD. It’s also not uncommon for panic disorder and GAD to co-occur with mood disorders like major depressive disorder, other anxiety disorders like social anxiety disorder or a substance use disorder.

Further complicating the picture is that some medical conditions such as an overactive thyroid (hyperthyroidism), heart disease, lung disease, or neurological diseases like stroke can mimic the symptoms of a panic disorder or GAD. This is why it’s important to seek out care from a healthcare professional to ensure proper evaluation and diagnosis, and to begin a course of treatment.

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.

Additional Reading

• Locke AB, Kirst N, Shultz CG. Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015 May 1;91(9):617-24.

• Stein MB, Craske MG. Treating anxiety in 2017: Optimizing care to improve outcomes. JAMA. 2017 Jul 18;318(3):235-36. doi:10.1001/jama.2017.6996

• American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders, 5th ed.,” 2013 Washington, DC: Author.

By Sheryl Ankrom, MS, LCPC

Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. 

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