Generalized Anxiety Disorder vs PTSD: What These Two Conditions Share, And What They Don't

Generalized anxiety disorder and post-traumatic stress disorder are markedly different diagnoses, but they do share more in common than first appearances may suggest. Let's take a deeper look. 

What do you need to know about generalized anxiety disorder (GAD)?

Generalized anxiety disorder shares its chapter in the DSM-5 — the fifth edition of the diagnostic and statistical manual, used to define the diagnostic criteria for (almost) countless mental conditions in the US — with diagnoses like panic disorder, separation anxiety, social anxiety disorder, and specific phobias. That chapter is, predictably, called "anxiety disorders". 

Generalized anxiety disorder is characterized by excessive fear or worry (yes, anxiety) about everyday experiences and events. People diagnosed with it will suffer from this broad, looming, anxiety more often than not, for at least six months, and find it nearly impossible to keep under control.

As a result, they may deal with frequent feelings of restlessness or being "on edge", fatigue, irritability, tense muscles, a hard time concentrating, and dysfunctional sleep. While adults will have at least three of these symptoms, children may have only one and still get the label of GAD.

The anxiety someone with GAD goes through has a serious negative impact on their quality of life and daily functioning, and can't be better explained by other causes — if the anxiety only strikes in certain circumstances or has a specific trigger, like, say, spiders or social gatherings, another anxiety-related diagnosis will be made. Typical things someone with GAD may worry about would include a messy house, the possibility they may be late for a doctor's appointment, job loss, financial issues, or the possibility that one's partner may leave. 

What do you need to know about post-traumatic stress disorder?

Post-traumatic stress disorder — which can develop in people who have experienced or witnessed a trauma, or sometimes in people who were exposed to a horrific event in some other way — used to be classified as an anxiety disorder in the previous version of the DSM. Now in the DSM-5, it's included in a whole new chapter, "trauma and stressor-related disorders". 

That is because, although PTSD does feature anxiety, it is more than an anxiety disorder. It results directly from a trauma or series of traumas, and the PTSD-related anxiety people with the disorder experience may be related to distressing memories or reminders of the trauma, a sense of threat upon meeting an environmental stimulus that the traumatized brain deems dangerous, or feelings that it's impossible to be safe, happy, or even alive in the future (a so-called "sense of foreshortened future). The enormous effort many people with PTSD put into avoiding reminders of the trauma also seems to promote anxiety, research shows.

That is, anxiety that occurs in a PTSD context is related to the trauma. 

Not all symptoms of PTSD are anxiety-related. Memory gaps surrounding the trauma, irritable or angry outbursts, sleep dysfunction, an inability to concentrate or experience positive emotions, and a feeling of alienation from the rest of the world can, for instance, have an anxious component without actually being anxiety as such. 

What do PTSD and generalized anxiety have in common, and how are they different?

While anyone can develop generalized anxiety disorder, PTSD develops only in people who have suffered traumatic experiences. While the anxiety people with GAD experience is, well, generalized, anxiety that's part of PTSD is anxiety with trauma at its root.

On the surface, for starters, PTSD and GAD have some of the same symptoms, starting, of course, with excessive fear and worry. The restlessness or being "on edge" seen in generalized anxiety disorder can look a lot like the hypervigilance or being "on guard" seen in post-traumatic stress disorder. Dysfunctional sleep, irritability, and trouble concentrating are included in the diagnostic criteria for both. Like people with GAD, folks who have PTSD may be quick to fatigue and suffer from tense muscles. 

Because many mental disorders, particularly depression and anxiety disorders, do have a lot of symptoms that overlap with PTSD, someone who in fact has post-traumatic stress disorder may also be misdiagnosed with generalized anxiety disorder or another anxiety disorder. This is especially true if they approach a doctor with some of their symptoms, without mentioning that they experienced a trauma — and thus also without talking about intrusive memories, flashbacks, and avoidance of reminders of the trauma. 

Treatment approaches for GAD and PTSD are different, given the fact that trauma that still needs to processed lies at the root of post-traumatic stress disorder. This is why it's important to give a physician or mental health professional as much information as you can, to help ensure a correct diagnosis.