Panic Disorder

Anticipatory Anxiety

After the first attack, most patients develop the fear that another attack may occur. During the intervals between the attacks, therefore, the level of non-panic (diffuse) anxiety increases. Anticipatory anxiety has many of the characteristics of generalized anxiety: increase of attention, apprehension, and hyperactivity. This condition can be intrusive enough to cancel the difference between panic attacks and generalized anxiety. It is speculated that such a higher level of diffuse anxiety may lower the threshold for panic, thus increasing the risk of new attacks. The anticipatory anxiety leads to avoidance behavior, so that agoraphobia ensues.

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