Can You Have Both Panic Disorder and Generalized Anxiety Disorder?

Yes. It's very common for someone to experience both Panic Disorder and Generalized Anxiety Disorder (GAD) at the same time. This is called comorbidity, meaning two or more mental health conditions occur together. Both conditions involve heightened anxiety, but they show up differently and affect daily life in unique ways.

What Is Panic Disorder?

Panic Disorder is characterized by:

• Recurrent, unexpected panic attacks: Sudden surges of intense fear or discomfort that reach a peak within minutes.

• Physical symptoms during an attack, such as a racing heart, shortness of breath, chest pain, dizziness, sweating, or feelings of choking.

• Persistent worry about having more attacks or changing behaviors to avoid triggering panic (e.g., avoiding crowded places, travel, or exercise).

Panic attacks can feel overwhelming and frightening, often leading individuals to worry about losing control, fainting, or having a serious medical emergency.

What Is Generalized Anxiety Disorder (GAD)?

Generalized Anxiety Disorder (GAD) involves:

• Excessive, persistent worry about a wide range of topics (health, work, finances, relationships, safety).

• Difficulty controlling worry, even when there’s no immediate threat.

• Physical symptoms like muscle tension, restlessness, fatigue, difficulty concentrating, and sleep disturbances.

Unlike panic attacks, which are intense but brief, GAD involves a constant undercurrent of anxiety that can last for months or even years if left untreated.

How Common Is It to Have Both Panic Disorder and GAD?

It’s very common to experience both disorders at the same time.
Research from the National Comorbidity Survey Replication found that:

• Up to 55% of individuals with Panic Disorder also meet criteria for Generalized Anxiety Disorder at some point (Kessler et al., 2006).

Having both conditions can make anxiety symptoms more complex. For example:

• Someone might experience daily, persistent worry (GAD) while also fearing sudden panic attacks (Panic Disorder).

• Avoidance behaviors (like avoiding driving or public spaces) can reinforce both disorders over time.

The good news is that even when GAD and Panic Disorder occur together, they are highly treatable with evidence-based therapy.

How GAD and Panic Disorder Interact

When Generalized Anxiety Disorder (GAD) and Panic Disorder occur together, they can form a powerful and exhausting cycle. Though both are rooted in anxiety, they show up in different ways—and when combined, they often intensify one another.

People with GAD experience persistent, excessive worry that spans across many areas of life—work, health, relationships, and daily responsibilities. This worry tends to be ongoing and difficult to manage, often leaving individuals feeling “on edge” all the time.

Panic Disorder, by contrast, involves sudden and intense episodes of fear—panic attacks—that can include a racing heart, shortness of breath, dizziness, or a sense of losing control. The fear often becomes centered on the attacks themselves: When will the next one happen? What if I panic in public or can’t escape?

When someone lives with both GAD and Panic Disorder, the chronic worry of GAD can heighten sensitivity to physical sensations, which in turn can trigger panic attacks. At the same time, the fear of having another panic attack feeds back into the cycle of constant worry. Many individuals end up fearing the possibility of anxiety itself—afraid not just of what might happen, but of how their body might react.

This combination is exhausting. It can lead people to avoid certain places or situations, limit their daily activities, or withdraw from things they once enjoyed. Over time, life can start to feel smaller and more restricted—not because of external threats, but because of the overwhelming anticipation of fear.

Understanding the differences between GAD and Panic Disorder can be a helpful step toward regaining a sense of control. With the right support and evidence-based strategies like CBT, it’s possible to break this cycle and begin living with more confidence and calm.

How Are GAD and Panic Disorder Treated Together?

When both conditions occur together, therapy often addresses:

• Panic symptoms (managing physical sensations and fear of panic attacks)

• Chronic worry and intolerance of uncertainty (key features of GAD)

• Avoidance behaviors that maintain and strengthen anxiety over time

Effective treatment approaches include:

1. Cognitive-Behavioral Therapy (CBT)

CBT is the gold standard for both GAD and Panic Disorder. It helps individuals:

• Identify and challenge unhelpful thought patterns ("What if I have a panic attack at work?")

• Learn more balanced, calming ways of thinking

• Build coping strategies for both daily worry and panic symptoms

• Reduce avoidance by gradually facing feared situations

2. Exposure Therapy

Exposure therapy helps individuals face the situations or sensations they fear in a gradual, structured way.
For Panic Disorder, exposure might involve:

• Intentionally bringing on mild symptoms (like increased heart rate) in a safe setting to build tolerance

• Practicing facing feared places or activities

For GAD, exposure might focus on tolerating uncertainty—learning that it’s possible to live meaningfully without knowing exactly how things will turn out.

3. Mindfulness and Relaxation Techniques

Mindfulness practices can help manage chronic worry and panic responses by teaching individuals to:

• Stay present during moments of anxiety

• Respond to anxious thoughts and sensations without judgment

• Cultivate a calmer, more accepting relationship with anxiety

Simple techniques like paced breathing, body scans, or grounding exercises are often part of therapy.

4. Medication

In some cases, medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) are recommended.
These medications can help regulate brain chemistry linked to anxiety, making therapy even more effective.

Decisions about medication are personal and best made in collaboration with a psychiatrist or prescribing medical provider.

A Real-Life Example

Imagine someone named Maya.

• For years, Maya struggled with constant worry about her family’s health, her job performance, and daily decisions—classic signs of GAD.

• Then, during a stressful period, she began having sudden panic attacks while shopping or driving.

• She started avoiding errands altogether, afraid another attack would happen.

Through therapy, Maya learned how her persistent worries were fueling her general anxiety—and how her fear of panic was reinforcing avoidance.
Step-by-step, she practiced calming techniques, challenged catastrophic thoughts, and slowly re-entered activities she once enjoyed. Over time, her anxiety lessened and her world expanded again.

This kind of progress is possible—and common—with the right support.

A Compassionate Closing Thought

Experiencing both Panic Disorder and Generalized Anxiety Disorder can feel overwhelming at times—but with the right support, recovery is absolutely possible.
Evidence-based treatments like CBT, exposure therapy, mindfulness, and, when needed, medication, offer real, lasting help.

You are not alone in this. Many people living with intense worry and panic go on to build calmer, fuller lives with the right tools and support. If you're experiencing persistent worry, panic attacks, or both, know that help is available—and healing is within reach.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

National Institute of Mental Health. (2022). Generalized Anxiety Disorder .https://www.nimh.nih.gov/health/topics/generalized-anxiety-disorder-gad

Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2006). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617