Panic Disorder vs. Social Anxiety Disorder

Anxiety can show up in many ways. Two common types are panic disorder and social anxiety disorder (SAD). Panic disorder impacts 2–3% of people each year and about 2.5% at some point in their lives. Social anxiety disorder is even more common, affecting about 13% of people during their lifetime.

In this article, you will learn the differences between panic disorder and social anxiety disorder, including their symptoms, causes, and treatments.

Differences in Symptoms

Here are the differences of panic disorder and social anxiety disorder in terms of how and why the symptoms occur, as well as the situations that trigger them.

Panic Disorder Symptoms

Panic disorder involves sudden and unexpected panic attacks that make you feel extremely scared. These attacks can happen anytime, often without a clear reason. During a panic attack, you might experience:

• A pounding or racing heart
• Sweating
• Chills
• Trembling
• Difficulty breathing
• Weakness or dizziness
• Chest or stomach pain
• Tingly or numb hands

These intense feelings can make you think something is seriously wrong, like having a heart attack. This fear can make you even more anxious, leading to more panic attacks. Panic attacks can happen many times a day or just a few times a year.

This unpredictability makes you worry about when the next attack will occur, causing you to avoid places or situations where you fear an attack might happen.

Social Anxiety Disorder Symptoms

Social anxiety disorder is all about fearing social interactions or situations where you might be judged. This fear can disrupt your daily life. You might worry about:

• Being judged negatively
• Embarrassing yourself
• Avoiding social interactions
• Having physical symptoms like blushing or trembling

You might fear doing things like eating in front of others, attending parties, starting conversations, or giving presentations. Even simple actions, like entering a room full of people, can make you feel very anxious. Physical symptoms can include:

• Blushing
• A fast heartbeat
• Trembling
• Sweating
• Nausea or an upset stomach

Unlike panic disorder, the anxiety in social anxiety disorder builds up as you anticipate a social event. This makes you want to avoid these situations, which can affect your work, school, and relationships.

Differences in Causes

The causes of panic disorder and social anxiety disorder both involve a mix of genetics, brain function, and life experiences.

Below are the differences of panic disorder and social anxiety disorder in terms of what triggers their development and how past experiences contribute to each condition.

Causes of Panic Disorder

Panic disorder is caused by a mix of genetics, biology, and life experiences. It often runs in families, as studies show that the lifetime rates of panic disorder in the general population range from 1.2% to 2.4%, but these rates are significantly higher—between 7.7% and 20.5%—among first-degree relatives of people with panic disorder. This suggests a strong genetic component.

Panic attacks may happen because the brain misfires its survival instincts, sending false alarms that make you feel like something terrible is happening when it’s not.

For instance, a racing heartbeat might make you think you’re having a heart attack, triggering more panic. Life stress, especially during major transitions like graduating, getting married, or having a child, also increases the risk of panic attacks.

Panic disorder often starts in the teen years or early adulthood, when these stresses are most common.

Causes of Social Anxiety Disorder

Social anxiety disorder has many causes, including:

• Genetics
• How your brain works
• Your life experiences

Anxiety disorders can run in families, which means you might be more likely to develop social anxiety disorder if your parents or siblings have it. Studies show that about 12% of the differences in social anxiety between people can be traced to genetic factors. Specific genetic markers, like ones on chromosomes 1 and 6, have been linked to social anxiety disorder, and these genes are also associated with traits like shyness or introversion.

Your experiences growing up also affect social anxiety disorder. If you were teased, bullied, rejected, or humiliated as a child, you might be more likely to develop social anxiety. Parenting styles matter too. If your parents were overprotective or too controlling, it could make you more fearful in social interactions. These experiences shape how you see and react to social situations, leading you to avoid them to reduce your anxiety.

Differences in Diagnosis

The diagnosis of panic disorder and social anxiety disorder both require evaluations by mental health professionals, but they focus on different symptoms.

Diagnosing Panic Disorder

Diagnosing panic disorder needs a careful evaluation by a mental health professional. The first step is getting a diagnosis from someone who understands mental health. A key sign is having unexpected panic attacks and worrying about more or changing your life to avoid them.

You might go to the doctor because the physical symptoms feel like a serious illness, such as a heart attack.

A diagnosis usually includes:

• Detailed symptom history: The doctor asks how often you have panic attacks, how strong they are, and what was happening when they occurred.
• Physical examinations: These check to make sure there aren’t any medical issues causing your symptoms.
• DSM-5 criteria: According to the DSM-5, panic disorder involves at least four panic attacks and ongoing worry about more attacks or their effects.

It's important to distinguish panic disorder from other conditions because a wrong diagnosis can lead to the wrong treatment. You might fear you have a medical disease because of the sudden and intense panic attack, so specialized evaluation is necessary.

Diagnosing Social Anxiety Disorder

Diagnosing social anxiety disorder also requires a thorough check by a trained professional. For social anxiety disorder to be diagnosed, your fear, anxiety, and avoidance must interfere with your relationships, daily life, work, school, or other activities. Unlike panic disorder, social anxiety disorder is about social or performance situations, not unexpected panic attacks.

Key steps in diagnosing social anxiety disorder include:

• Assessing symptoms: The doctor looks at your fear of being judged, avoiding social interactions, and physical signs like trembling or sweating in social settings.
• Functional impairment analysis: It’s not just being shy; your fear and anxiety must disrupt your life.
• DSM-5 criteria: According to the DSM-5, social anxiety disorder involves a strong and ongoing fear of social situations where you might be judged. Symptoms must last at least six months and cause significant distress or problems.

Some people with social anxiety find it hard to get a diagnosis because seeking help involves social interactions, like going to therapy, which can be challenging for them. This makes it harder to identify and treat social anxiety disorder.

Differences in Treatments

Here’s how therapy and medications are applied to address the specific challenges of each condition.

Treatment for Panic Disorder

Panic disorder is treated with both talk therapy and medication. The main type of therapy used is Cognitive Behavioral Therapy (CBT). CBT helps you change negative thoughts and behaviors. It teaches you new ways to think and act when you feel panic coming on.

A study on the effectiveness of Cognitive Behavioral Therapy (CBT) for panic disorder found that CBT significantly reduces symptoms. In a large trial, patients with panic disorder who received 11 weeks of CBT experienced a 40-74% reduction in symptom severity for "much improved" outcomes, while a 75-100% reduction indicated "very much improved." These findings suggest CBT is effective in treating panic disorder and achieving substantial symptom relief.

A part of CBT called exposure therapy helps you face your fears in a safe setting. This reduces how often and how strongly you panic. For example, CBT can help you understand that a racing heart is just part of anxiety, not a heart attack.

Medications also help manage panic disorder. These include:

• SSRIs and SNRIs: These antidepressants help control panic symptoms but might take a few weeks to work.
• Benzodiazepines: These can quickly reduce panic but might lead to dependency if used too long.
• Beta-blockers: These help manage physical symptoms like a fast heartbeat.

Your treatment plan will be personalized. You and your healthcare provider might adjust therapy or medications to find what works best for you.

Treatment for Social Anxiety Disorder

Social anxiety disorder is also treated with therapy and medication, but the focus is different from panic disorder. CBT is the most effective therapy for social anxiety disorder. It helps you change negative thoughts about yourself and build confidence in social settings.

Research found that many patients maintain these improvements long-term, even years after treatment. CBT works well in both individual and group formats, and online options are also effective.

CBT for social anxiety disorder includes exposure therapy, where you slowly face social situations you fear. For example, you might start by having small conversations and then work up to giving presentations. This helps you stop avoiding social interactions and builds your confidence.

Medications for social anxiety disorder include:

• SSRIs: These are the first choice for treating social anxiety and help reduce symptoms over time.
• Beta-blockers: These manage physical symptoms like trembling or a fast heartbeat during performances.
• Benzodiazepines: These are less common for social anxiety disorder because of the risk of dependency.

Additionally, group therapy and social skills training can help you practice interacting with others. Group therapy lets you learn and improve social skills in a supportive environment.

Final Words

Panic disorder and social anxiety disorder are different but treatable conditions. Panic disorder causes sudden panic attacks that seem to come out of nowhere, while social anxiety disorder involves a strong fear of social situations and being judged. Both conditions can improve with therapy, medications, and support from others.

FAQs on Panic Disorder vs Social Anxiety Disorder

How can I help a friend with social anxiety or panic disorder?

Be patient, listen without judgment, avoid pushing them into uncomfortable situations, and encourage professional support.

Can panic disorder go away on its own?

Without treatment, panic disorder can persist and worsen. Professional help is key to managing it effectively.

What should you do during a panic attack?

Focus on slow, deep breathing. Remind yourself it’s temporary and will pass. Grounding techniques like counting objects can also help.

Can panic disorder lead to other problems?

Yes, it can cause phobias, depression, substance abuse, or difficulty with work and relationships if untreated.