PTSD and Anxiety: How They're Connected and How to Manage Both
- North Star Psychology
- Feb 19
- 4 min read
Post-traumatic stress disorder (PTSD) and anxiety often go hand in hand, with overlapping symptoms that can make daily life overwhelming. While PTSD is a specific response to trauma, it frequently coexists with generalized anxiety, panic attacks, and other anxiety-related conditions. Understanding how PTSD and anxiety are connected can help people develop strategies to manage both more effectively.
This article explores the relationship between PTSD and anxiety, common symptoms, and evidence-based methods—Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE)—to treat PTSD while also addressing anxiety.
How Are PTSD and Anxiety Connected?
Anxiety is a natural response to perceived threats, activating the body’s fight-or-flight system. PTSD develops when a traumatic event causes this response to become dysregulated, leading to persistent fear, hypervigilance, and avoidance behaviors.
Anxiety disorders and PTSD share several common features, including:
Hyperarousal: Feeling constantly on edge, easily startled, or excessively alert to potential dangers.
Intrusive thoughts: Recurrent, distressing memories that disrupt daily life.
Avoidance behaviors: Avoiding people, places, or situations that trigger anxiety or trauma-related memories.
Negative thinking patterns: Persistent fear, excessive worry, and self-critical thoughts.
According to research, nearly 50% of people with PTSD also meet the criteria for an anxiety disorder (Gros et al., 2012). The two conditions reinforce each other, making treatment essential for long-term relief.
Symptoms of PTSD and Anxiety
While PTSD and anxiety disorders have distinct diagnostic criteria, they often share overlapping symptoms:
Symptom | PTSD | Anxiety |
Hypervigilance | Always scanning for danger | Excessive worrying about the future |
Panic Attacks | Triggered by trauma reminders | Triggered by general stress or uncertainty |
Avoidance | Avoiding trauma-related reminders | Avoiding anxiety-inducing situations or things |
Insomnia | Sometimes involve trauma-related nightmares or problems falling asleep | Restlessness, difficulty falling asleep |
Racing Thoughts | Replaying the traumatic event, worrying about it happening again | Persistent "what-if" worries about the future |
While anxiety can develop independently, PTSD-related anxiety is often tied to specific memories, triggers, or beliefs formed after trauma.
Effective Treatments for PTSD and Anxiety
CPT helps people identify and change unhelpful thought patterns related to trauma. Since PTSD often reinforces anxiety by creating rigid, negative beliefs, CPT focuses on restructuring these thoughts to reduce fear and self-blame.
How CPT Helps:
Challenges catastrophic or irrational beliefs.
Reduces self-blame and feelings of helplessness.
Helps reframe trauma in a way that lessens anxiety's hold.
CPT typically lasts 12 structured sessions and has been shown to significantly reduce PTSD and anxiety symptoms (Resick et al., 2017).
Avoidance is a key feature of both PTSD and anxiety disorders, which is why exposure therapy is one of the most effective treatments. PE helps people gradually face trauma-related memories and feared situations, retraining the brain’s fear response.
How PE Helps:
Teaches the brain that trauma-related memories are not dangerous.
Reduces avoidance behaviors that maintain PTSD and anxiety.
Desensitizes the body’s overactive fear response through gradual exposure.
PE is usually completed in 8-12 sessions and is highly effective for reducing both PTSD and generalized anxiety (Foa et al., 2018).
While therapy is the most effective treatment, self-management strategies can also help reduce PTSD and anxiety symptoms between sessions:
1. Practicing Grounding Techniques
Grounding exercises help bring attention to the present moment, preventing overwhelming anxiety and flashbacks.
5-4-3-2-1 Method: Identify five things you see, four things you hear, three things you can touch, two things you smell, and one thing you taste.
Deep breathing: Slow, controlled breathing can calm the nervous system.
Cold water exposure: Splashing cold water on your face activates the body’s calming response.
2. Engaging in Regular Exercise
Physical activity helps regulate stress hormones and improve mood. Studies show that regular aerobic exercise reduces PTSD and anxiety symptoms by decreasing hyperarousal and improving sleep (Rosenbaum et al., 2015).
3. Limiting Stimulants
Caffeine can worsen hypervigilance and panic attacks. Cutting back on stimulants can reduce excessive arousal and anxiety spikes.
4. Improving Sleep Hygiene
Sleep disturbances are common in both PTSD and anxiety. Strategies for better sleep include:
Sticking to a consistent sleep schedule.
Avoiding screens and stimulating activities before bed.
Using relaxation techniques such as meditation or deep breathing.
5. Identifying and Challenging Negative Thoughts
CPT principles can be applied at home by recognizing irrational fears and negative self-talk. When distressing thoughts arise:
Write them down.
Examine the evidence for and against the thought.
Replace it with a more balanced perspective.
6. Gradual Exposure to Anxiety Triggers
If avoidance is reinforcing anxiety, small, gradual exposures can help reduce fear over time. For example:
Facing a social situation that normally causes anxiety.
Listening to a difficult song associated with trauma.
Visiting a location that was previously avoided.
Final Thoughts
PTSD and anxiety are deeply connected, but they are treatable. Therapy—particularly Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE)—offers the most effective, research-backed approach. While at-home strategies can help manage symptoms, structured therapy provides the tools helpful for long-term recovery.
If you are struggling with PTSD and anxiety, North Star Psychology offers CPT and PE via telehealth services. Our therapists specialize in trauma-focused care, helping people regain control over their lives.
Call (205) 797-1897 or email us at info@NorthStarPsyc.com to schedule a free consultation.
Recovery is possible—take the first step today.
References
Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2018). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences. Oxford University Press.
Gros, D. F., Price, M., Magruder, K. M., Frueh, B. C., & Strachan, M. (2012). Symptom overlap in posttraumatic stress disorder and major depression. Psychiatry Research, 196(2-3), 267-270. https://doi.org/10.1016/j.psychres.2011.10.022
Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.
Rosenbaum, S., Vancampfort, D., Steel, Z., Newby, J., Ward, P. B., & Stubbs, B. (2015). Physical activity in the treatment of post-traumatic stress disorder: A systematic review and meta-analysis. Psychiatry Research, 230(2), 130-136. https://doi.org/10.1016/j.psychres.2015.10.017
