Panic Disorder Symptoms Anticipatory Anxiety and Panic Disorder By Sheryl Ankrom, MS, LCPC Sheryl Ankrom, MS, LCPC LinkedIn Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. Learn about our editorial process Updated on December 06, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Amy Morin, LCSW, Editor-in-Chief Medically reviewed by Amy Morin, LCSW, Editor-in-Chief Facebook LinkedIn Twitter Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a psychotherapist, the author of the bestselling book "13 Things Mentally Strong People Don't Do," and the host of The Verywell Mind Podcast. Learn about our Medical Review Board Print Gianni Diliberto / Getty Images Anticipatory anxiety happens when people experience increased anxiety and stress when they think about an event that will happen in the future. While this is not a distinct mental condition, anticipatory anxiety is a common symptom of other conditions including panic disorder and generalized anxiety disorder (GAD). Anticipatory anxiety may occur in response to large events such as giving a presentation at work. But it can also precede minor, everyday activities such as driving to work, parking your car, or having conversations with co-workers. If you have panic disorder, you may find yourself anticipating many life events. Going into a store, attending a social gathering, and other activities may be a daily focus of your anticipation. Before you had panic attacks, you probably didn’t give much thought to any of these common events. But now anticipation may cause you to feel anxious and interfere with your ability to fully function in your everyday life. People often feel anticipatory anxiety because they fear that they will have a panic attack when they are in these situations. Normal vs. Problematic Anticipatory Anxiety An infinite number of human experiences cause normal anticipatory anxiety. Many times, we experience anxiety in anticipation of doing something new or before we complete a major task or go through an upcoming life event. You might feel anticipatory anxiety before a first date, a final exam, a job interview, moving to a new home, or before a major trip. This type of anticipatory anxiety is normal. If you have panic disorder, however, anticipatory anxiety likely goes beyond the limits of what people normally experience with new or major life events, leading to problematic anticipatory anxiety. This is because the anticipation, or the way you visualize a future event, is focused on having a panic attack in certain situations. The fear of having a panic attack can be associated with any life situation or event, big or small. In some cases, anticipatory anxiety surrounds any activity that involves leaving the safety of your own home. How Your Thoughts Contribute to Anticipatory Anxiety Anticipatory anxiety is closely associated with the way you think. With panic disorder, your thoughts are generally focused on worrying about having a panic attack in a situation that will result in embarrassment, extreme discomfort, a heart attack, or even worse. If you have panic disorder, you are probably very familiar with “what if” worries. Perhaps your worries are similar to these: What if I have a panic attack and drive my car into a ditch?What if I start to panic in the store and embarrass myself with some bizarre behavior?What if, while eating at a restaurant, I can’t swallow and start choking on my food?What if I take a walk around the block and start to panic and can’t get back home? This kind of thinking causes a lot of anticipatory anxiety that can lead to avoiding certain activities. The anxiety may be so intense that it causes a condition called agoraphobia. How to Cope With Anticipatory Anxiety Here are some ways to cope with anticipatory anxiety. Learn and Practice Relaxation Techniques By learning and practicing relaxation techniques, you will be able to reduce your level of anticipatory anxiety. You may even be able to defuse a panic attack in the making. Some techniques that may be helpful include: Deep breathing: Deep breathing exercises can often be an effective way to decrease feelings of panic and nervousness. Because feelings of panic are often accompanied by rapid, shallow breathing, learning to take slower, deeper breaths can help calm your body. Guided imagery: This process involves closing your eyes and visualizing imagery that helps you feel calm and relaxed. You can use this type of imagery to imagine yourself succeeding in different situations or simply to help return your body to a calmer state. Journal writing: Writing about your feelings may help you better notice patterns in how your thoughts and emotions contribute to anticipatory anxiety. Mindfulness meditation: This type of meditation can be helpful in easing anticipatory anxiety because it encourages you to focus on the present rather than worrying about the future. Progressive muscle relaxation (PMR): Panic often causes people to tense up, but practicing progressively tightening and then relaxing the muscles of your body can help you learn to better control this tension. After learning this technique, you will be able to release the tension in your muscles, which can have a relieving and calming effect. Try Self-Help Strategies When you find yourself experiencing anticipatory anxiety, there are some things that you can do that may make it easier to cope: Challenge anxious thoughts. When you get nervous about something you have to do in the future, ask yourself if you are being realistic. In many cases, you might find that you are catastrophizing or thinking of worst-case scenarios. Challenging these thoughts with more realistic ones can help calm your feelings of anxiety.Refocus your thoughts. When negative or anxious thoughts begin, intentionally interrupt your train of thought. Force yourself to consciously focus on good things that may happen rather than running through anxiety-provoking scenarios.Take action. Anticipatory anxiety often leads people to put off tasks rather than face them, which can then lead to even more anxiety. If you are dreading something and find yourself getting nervous about it, take control of the situation first. Remind yourself that if you get it over with now, you won't have to spend all of your time feeling anxious about it. Get Professional Help If you can’t get your anxiety under control on your own, it is important to talk to your doctor or mental health professional in person or online. A variety of professionals can help you with problem anticipatory anxiety. Some of the treatments they may be able to provide include: Cognitive behavioral therapy (CBT) to help you identify and change damaging behaviors and thought processes that are contributing to your anxiety. Panic-focused psychodynamic psychotherapy to help you become aware of unconscious conflicts and defense mechanisms that reinforce your anxiety. Medications, such as the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and anti-anxiety drugs known as benzodiazepines, to relieve some of your anxiety and panic symptoms. If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. The 7 Best Online Anxiety Support Groups 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Helbig-Lang S, Lang T, Petermann F, Hoyer J. Anticipatory anxiety as a function of panic attacks and panic-related self-efficacy: An ambulatory assessment study in panic disorder. Behav Cogn Psychother. 2012;40(5):590-604. doi:10.1017/S1352465812000057 Grupe DW, Nitschke JB. Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective. Nat Rev Neurosci. 2013;14(7):488–501. doi:10.1038/nrn3524 Jerath R, Crawford MW, Barnes VA, Harden K. Self-regulation of breathing as a primary treatment for anxiety. Appl Psychophysiol Biofeedback. 2015;40(2):107-15. doi:10.1007/s10484-015-9279-8 Hoge EA, Bui E, Marques L, et al. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. J Clin Psychiatry. 2013;74(8):786–792. doi:10.4088/JCP.12m08083 Additional Reading Roy-Byrne PP. Panic disorder in adults: epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis. UpToDate. Updated January 25, 2018. Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 11th ed. Philadelphia, PA: Wolters Kluwer; 2014. By Sheryl Ankrom, MS, LCPC Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.