~ Physiological symptoms in PTSD are more severe than in PD.

~ Individuals with PD experience longer periods during which they have no symptoms compared to those with PTSD

Instability of anxiety symptoms characterize panic disorder (PD) and post-traumatic stress disorder (PTSD), as they are marked by frequent phases of intense anxiety associated with acute physiological responses (i.e., fast heart beats, shortness of breath, etc…). Typically, the focus of research has been on the severity of those symptoms, not their instability, but that method does not always yield accurate information.

For example, PD patients tend to exaggerate the severity and frequency of their panic attacks when asked retrospectively. Furthermore, patients don’t experience anxiety symptoms at the same degree. Indeed, research shows that some patients suffer from high but stable levels of anxiety symptoms, while others experience low but unstable anxiety symptoms marked by bursts of intense anxiety.

Tracking the occurrences of anxiety symptoms in PD and PTSD

Thus, for a more accurate clinical picture of PD and PTSD it is necessary to look at both severity and instability of the anxiety symptoms. Since the temporal component provides crucial information, the use of electronic diaries has been proposed as a suitable method of assessment (i.e., in a palm pilot)

Electronic diaries have the particularity of tracking the time for each entry such that it is possible to capture symptom (i.e., bodily symptoms of anxiety) fluctuations across various time points (i.e., throughout the day, the week, the month, etc…) and situations that are close to their occurrence.

Bodily symptoms of anxiety in PTSD and PD

In line with diagnostic criteria in PD and PTSD, patients’ electronic diaries show heightened instability of bodily symptoms. These results coincide with reports of recurrent panic attacks in PD and recurrent psychological reactions to cues associated with the trauma in PTSD. Furthermore, it was found that this instability is higher in PTSD compared to PD, which is likely attributed to the fact that patients with PTSD tend to re-experience the physiological symptoms related to a trauma.

Alternatively, the heightened instability of anxiety symptoms in PTSD could also implicate the perceived predictability and uncontrollability of symptoms. Notably, patients might feel that they are unable to predict and control when symptoms are occurring, which results in increased distress.

Another interesting difference between PD and PTSD is that patients with panic disorder experience longer episodes during which they have no bodily symptoms of anxiety compared to patients with post-traumatic stress disorder. Results indicate that in PD symptom-free episodes last about 18 h, while in PTSD they are only 8 h.

This finding suggests that patients with PTSD carry a heavier burden of somatic symptoms than those with PD.



Pfaltz MC, Michael T, Grossman P, Margraf J, Wilhelm FH. Instability of physical anxiety symptoms in daily life of patients with panic disorder and patients with posttraumatic stress disorder. J Anxiety Disord. 2010 Oct;24(7):792-8. doi: 10.1016/j.janxdis.2010.06.001. Epub 2010 Jun 10. PMID: 20580527.



 In this study, 10 bodily symptoms were assessed in a 3 h interval. You can go through the questionnaire to help you evaluate the frequency of those symptoms in yourself for information purposes.

 During the past 3 h (since waking up) I experienced the following symptoms:

(1) palpitations, pounding heart or accelerated heart rate

(2) sensations of shortness of breath or smothering

(3) feeling of choking

(4) feeling dizzy or light-headed

(5) trembling or shaking

(6)chills or hot flushes

(7) sweating

(8) nausea or abdominal distress,

(9) chest pain or discomfort

(10) tingling or numbness in parts of the body


Leave a Reply

Your email address will not be published. Required fields are marked *