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Severe anxiety and PTSD can qualify as disabilities, and therefore can have a service animal.
A service animal is trained to perform a specific task that allows a person with a disability to perform normal daily activities. For PTSD and anxiety this action can be (but isn't limited to) detecting the onset of a panic attack and providing direct physical stimulation/grounding.
An emotional support animal is one that isn't trained for a task and whose presence makes the person with a disabling condition better (e.g. someone with anxiety is generally less anxious with their cat around).
ESA's are not protected under the Americans with Disabilities Act (or equivalent in most other countries) while service animals are.
Also, a service animal can be any type of dog. Yes, even a pug can be a service animal if it is trained to do a task. No, training does not have to be done by an expensive service.