Comparing Different Types of Anxiety

Author: IAFF Staff

February 9, 2018

Everyone experiences some degree of anxiety from time to time, but the stressful nature of the job can make fire fighters and paramedics susceptible to severe anxiety that can interfere with personal and professional life.

Despite recent improvements in education and advocacy, a stigma against mental health conditions — including anxiety — still exists in the fire service. Because of this, it’s vital that IAFF members and the people who love them learn more about the ways anxiety can manifest itself. Some of the most common types of anxiety include social anxiety disorder (SAD), panic disorder, generalized anxiety disorder (GAD), acute stress disorder (ASD) and post-traumatic stress disorder (PTSD).

Social Anxiety Disorder (SAD)

Some people are shyer and more naturally reserved than others, and everyone feels nervous in social situations from time to time. But for people with social anxiety disorder (SAD), everyday interactions cause a significant amount of fear, embarrassment and self-consciousness. Common social situations, like attending a social gathering, starting a conversation, making eye contact, interacting with strangers or returning items to a store can be sources of debilitating stress for those with SAD.

People with SAD exhibit a broad range of anxious behaviors before, during and after most social interactions, including:

  • Fear of judgement
  • Intense anxiety and fear
  • Preoccupation with covering up any signs of nervousness
  • Worrying about embarrassing or humiliating oneself
  • Blushing, sweating or trembling
  • Increased heart rate

According to the Anxiety and Depression Association of American (ADA), approximately 15 million American adults over the age of 18 have SAD. While working as a fire fighter or paramedic doesn’t necessarily make you more likely to develop SAD, it’s important to remember that this condition can affect people in all professions.

Panic Disorder

People with panic disorders experience recurring and unexpected panic attacks, or periods of sudden, intense and paralyzing fear. Panic attacks are usually accompanied by a variety of physical symptoms, including:

  • Racing thoughts
  • Increased heart rate
  • Heart palpitations
  • Sweating
  • Trembling or shaking
  • Shortness of breath, choking sensations or the feeling of being smothered

The physical and psychological intensity of panic attacks can be overwhelming. Because of this, many who experience them worry for weeks, months or even years about having another attack. While some never experience another panic attack, others endure additional episodes. These individuals often meet the criteria for panic disorder.

The exact cause of panic disorder is unknown, but genetics, temperament and stress levels are thought to play a role. Because firefighting and emergency response can involve a great deal of stress, IAFF members may be at an increased risk of panic attacks and panic disorder than the general population. Approximately 6 million American adults have panic disorder.

Generalized Anxiety Disorder

Occasional anxiety is perfectly normal, especially for fire fighters and paramedics who are exposed to stressful situations on a regular basis. However, anxiety that is ongoing and interferes with daily life, health and happiness may be a sign of generalized anxiety disorder (GAD).

Symptoms of GAD are usually persistent and long-lasting. They may include:

  • Overthinking
  • Difficulty dealing with uncertainty
  • Indecisiveness
  • Inability to let go of worry
  • Feeling restless, tightly wound, or on edge
  • Being easily fatigued
  • Trouble concentrating
  • Muscle tension
  • Sleep problems

What differentiates GAD from other anxiety disorders is the persistent nature of the condition, and the wide range of circumstances that can cause or trigger anxiety. Individuals who experience symptoms for at least six months may be diagnosed with GAD. Because the criteria for GAD is fairly broad, it tends to naturally overlap with other anxiety disorders like SAD, ASD and PTSD. GAD affects 6.8 million individuals over the age of 18 in the United States alone.

Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD)

As the two most common anxiety disorders affecting fire fighters and paramedics, acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) can develop after witnessing or experiencing a traumatic event.

ASD and PTSD share many of the same symptoms, including:

  • Hyperarousal that manifests in sleeping problems, irritability, outbursts of anger, jumpiness and trouble concentrating
  • Re-experiencing the traumatic event in the form of images, flashbacks or nightmares
  • Avoiding people, places and activities that trigger memories of the traumatic event or cause the individual to re-experience it

While these conditions are closely related, there are some key distinctions. An ASD diagnosis is confirmed when a person experiences the above symptoms for at least three days within the first month after a traumatic event. A PTSD diagnosis is made after these symptoms persist for more than a month. Unlike PTSD, an ASD diagnosis requires that the individual experience dissociative symptoms, like feeling outside of their body, not knowing where they are, or having trouble remembering key aspects of the traumatic event.

Despite their differences, it’s clear that ASD and PTSD are tightly linked. Between 6 and 33 percent of people who experience trauma exhibit ASD symptoms within a month of the traumatic event. Of these individuals, 80 percent meet the criteria for PTSD six months later. Both of these conditions take an enormous physical and mental toll, wreaking havoc on the individual’s personal and professional life. Tragically, people who spend their lives helping others — including fire fighters and paramedics — are often the most vulnerable to ASD and PTSD.

Anxiety disorders can be difficult to deal with alone . But if left unaddressed, they can lead to substance use disorder, depression and other behavioral health issues. If you recognize the symptoms of these anxiety disorders in yourself or others, it’s important to seek out professional help. With the right care, most anxiety disorders can be effectively managed.

The IAFF Center of Excellence understands your struggle. Designed with the needs of IAFF members in mind, our evidence-based treatment methods and expert staff can help you (or a loved one) heal. Reach out to one of our intake coordinators today for more information.

Medical Disclaimer: The IAFF Center of Excellence aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

We can help. Call 855-900-8437 or

Get Help Now