Understanding Anticipatory Anxiety and Panic Disorder

What Is Anticipatory Anxiety?

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If you have panic disorder, you may find yourself anticipating many life events. Driving to work, going into a store, attending a social gathering, and many 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.

This is often called “anticipatory anxiety.”

Normal vs. Problem 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 completion of a major task or life event. You might feel anticipatory anxiety before a first date, final exam, job interview, moving to a new home, or before a major trip.

If you have panic disorder, anticipatory anxiety may go beyond the limits of new or major life events. This is because the anticipation, or visualization of 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 one’s own home.

How Your Thoughts Contribute to Anticipatory Anxiety

Anticipatory anxiety is closely associated with the way we are thinking.

With panic disorder, 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 yours are similar to these:

  1. What if I have a panic attack and drive my car into a ditch?
  2. What if I start to panic in the store and embarrass myself with some bizarre behavior?
  3. What if, while eating at a restaurant, I can’t swallow and start choking on my food?
  4. 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

1. 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:

2. Get professional help if you can’t get your anxiety under control.
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.


  • Sadock, B. J., Sadock, V. A., & Ruiz, P. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th ed, 2015 Philadelphia, PA: Wolters Kluwer