Anticipatory Anxiety and Panic Disorder

What Is Anticipatory Anxiety?

Anticipatory anxiety.
Anticipatory anxiety can make you feel nervous about future events. Photo © Microsoft

According to Merriam-Webster’s Online Dictionary, anticipation is a “visualization of a future event or state.” 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 panic, 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. Life offers us the experience of many anxiety-provoking “firsts” -- a first date, the first day of school or the first time away from home. All of these events may produce a certain amount of anticipatory anxiety. If you’re about to take a major exam, you may feel a sense of anxiety. Hopefully, this type of anticipatory anxiety will motivate you to study harder in preparing for the exam.

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 Our 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.

Tips 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:

    Deep Breathing
    Progressive Muscle Relaxation (PMR)
    Guided Imagery
    Mindfulness Meditation 
    Journal Writing 
  1. Get professional help if you can’t get your anxiety under control.

    A variety of professionals are able to help you with problem anticipatory anxiety. Some of the treatments they may be able to provide include:


    Anticipation. ”Merriam-Webster Online” 2016 Springfield, MA: Merriam-Webster, Inc. Accessed online on February 24, 2016.

    Carbonell, D. "Panic Attacks Workbook" 2004 Berkley, CA: Ulysses Press.

    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.

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