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What Causes Anxiety?

Anxiety can be caused by a variety of different things. For one individual, the cause may be from genetics – this is often the case among individuals with a family history of anxiety disorders. For another person, the cause of anxiety may be a demanding job or abusive relationship. In each individual scenario, it can be difficult to pinpoint the specific cause or multiple contributing factors to a person’s anxiety.

Due to the complexity of each individual, determining a specific cause is difficult. For some individuals simply not getting enough sleep at night may make them anxious. For others, using a medication such as a stimulant to help treat ADHD may lead to increased arousal and make them feel uncomfortable levels of anxiety. When determining what caused your specific anxiety, it is important to analyze your life and realize that there usually isn’t just one specific root cause, rather anxiety is a response to a culmination of symbiotic factors.

Causes of Anxiety: Comprehensive List of Possibilities

Below is a list of potential causes of anxiety. Realize that not everyone will have the same causes for their anxiety and that it is possible to have multiple “causes.”

1. Genetics

Most would agree that there is a significant influence of genetics on anxiety. Those with certain genes are more likely to become anxious than those without those genes. Some individuals are naturally more laid back, while others are more prone to anxiety given their genetic expression.

  • Ethnicity: In the same study of 20,000 individuals that identified females as having more anxiety disorders than men, it also was discovered that European American women and Hispanic women were more likely to have anxiety compared to other ethnic groups. Ethnicity doesn’t “cause” a person to feel anxious, but it is thought that various genetic components may be inherited by certain ethnicities.
  • PLXNA2 Gene: Some research has indicated that polymorphisms of the “PLXNA2” gene may play a major role in contributing to anxiety. Although this needs to be further explored, a major study of over 18,000 people (624 of which had anxiety or depression) were noted as having certain polymorphisms of this particular gene.

Source: http://www.sciencedirect.com/science/article/pii/S0018506X06001711

Source: http://www.ncbi.nlm.nih.gov/pubmed/17339520

2. Environmental factors

Nearly everyone has experienced anxiety from their environment at some point in their lives. Whether the anxiety is caused by getting into an accident, getting into a fight, running from a vicious dog, or getting stuck in an abusive relationship – environmental-induced anxiety is common. In some cases, a person is unable to cope with the anxiety caused by their environment and an environmental change is necessary to increase relaxation.

  • Abusive relationships: Being trapped in an abusive romantic and/or general relationship can cause significant anxiety. You may feel as if you are walking on eggshells around the individual that you are in the relationship with and/or may get treated poorly on a consistent basis. Anytime you are in a relationship that leaves you feeling depressed, drained, anxious, and/or poorly – it is best to leave. Unfortunately many people have a difficult time making the move to leave the relationship and this leads to significant increases in anxiety and the “fight-or-flight” response.
  • Break-up: Going through a break-up with a significant other can lead some people to become highly anxious. Although other feelings like depression may surface during a break-up, anxiety and panic are common experiences.
  • Bullying: Individuals who are bullied are more likely to experience anxiety than those who aren’t. Victims of bullying often get stressed out and may come to fear what the bully will do to them next. This may result in fear of going certain places, fear of getting taken advantage of, or fear of getting physically abused. Repeatedly getting bullied can leave emotional scars of anxiety long after the actual bullying stops.
  • Danger: The most common source of anxiety is environmental danger. For example, if we are charged by a wild animal and believe that we could die, we immediately either run from it or fight. Anxiety is an evolutionary response to danger that helped humans survive when faced with predators, scarce resources, or competition.
  • Grief: Nearly everyone deals with the loss of a loved one in their lifetime. Whether it’s the loss of a pet, family member, or close friend – grief can be one of the most difficult emotions to cope with. It makes us feel extremely depressed, and can induce a significant amount of fear. We may come to fear our own existence and may fear that we will not be able to carry on or face the world without the person we lost.
  • School problems: Something as simple as struggling with a class or getting bad grades can make some students feel anxious. In other cases school-related activities such as presentations, speeches, test-taking, and failure to comprehend what is being taught can lead to anxiety. In some cases the anxiety from learning or performance issues at school can lead to a person dropping out or avoiding school functions.
  • Separation: You may have heard of “separation anxiety” – this can be described as increased anxiety as result of some sort of separation. The separation may be from a friend, a loved one, or from an environment that you grew to love. For example, if you lived in one country for your entire life, then moved to a new country, you may have anxiety over the separation from your old home.
  • Trauma: Traumatic experiences such as war, sexual abuse, violence, and accidents can result in overwhelming anxiety. So much anxiety is produced that a person becomes traumatized and experiences what is known as “PTSD.” Trauma can affect our memory and invade our entire consciousness – making it difficult to shift focus away from the trauma. Each time a person is reminded of the trauma, they may experience a significant degree of anxiety and become highly sensitized to stimuli.
  • Work problems: People who overwork themselves and/or experience a high degree of stress on the job are more likely to suffer from anxiety. Jobs that demand a person work long hours with high intensity can lead a person to “burn out” as a result of anxiety. Other individuals that are getting harassed at work, feel as if they may get fired, or feel threatened can also experience anxiety.

3. Brain chemistry

It is thought that certain individuals experience anxiety as a result of their brain chemistry. Alterations in brain structure, circuitry, activity, and neurotransmitters are all thought to contribute to anxiety. Certain people may really have a chemical imbalance that causes them to feel anxious.

  • Brain circuitry: Specifically the amygdala and the hippocampus are thought to contribute to anxiety. During anxious situations, it has been demonstrated the activity and bloodflow tend to significantly increase in the amygdala. It is believed that the increased activity within the amygdala is geared towards helping individuals avoid dangerous situations.
  • Brain injury: Certain parts of the brain are known to increase relaxation and reduce anxiety. When a person’s brain gets injured, there is no telling how a person will be affected. It is well-established that people with brain injuries are more likely to experience anxiety and other mood disorders.
  • Evolution: From an evolutionary perspective, anxiety is created as a survival mechanism to help cope with dangerous situations, predators, or threats. Anxiety increases our body’s energy through the “fight-or-flight” response or stimulation of the sympathetic nervous system. This increases our pain threshold, increases performance, and allows us to “fight” or “escape” dangerous situations. Among individuals with anxiety disorders, it is believed that their “fight-or-flight” system may stay active even in non-threatening situations.
  • Low serotonin: The hypothesis that low levels of serotonin is linked to anxiety has some merit. SSRIs or selective-serotonin reuptake inhibitors tend to increase the amount of serotonin between synapses in the brain – which tends to significantly reduce anxiety in some people. Those with low levels of serotonin are thought to be prone to both depression and anxiety compared to those with sufficient levels.
  • Nucleus accumbens: This region of the brain is thought to be increasingly sensitive among those with anxiety compared to others. The nucleus accumbens influences whether an individual should take action based on the reward that they receive. In anxious individuals, this region becomes more inhibited, which can lead to further anxiety. It should be noted that this is the same region associated with “reward deficiency syndrome.”

4. Physiological factors

Anxiety is inherently self-perpetuating in that exposure to one anxiety-provoking stimulus can result in increased adrenaline, faster brain waves, hormonal changes, etc. These physiological changes that occur can further perpetuate the initial anxiety and must be mentioned.

  • Adrenaline: Although this is a “symptom” of anxiety and fear, it is also a cause. When we become anxious, our adrenaline levels increase (epinephrine and norepinephrine). These neurotransmitters are secreted by the medulla of the adrenal glands and stimulate the nervous system. This increased stimulation makes it difficult for the parasympathetic nervous system to produce a relaxation response and we feel trapped in anxiety.
  • Brain waves: In most individuals, when we become anxious our beta waves increase and alpha waves decrease. As we become more anxious, our cortical arousal increases, and high-frequency, low amplitude brain waves increase. Our fast-paced brain waves can contribute to the severity of our anxiety. Those with lower levels of anxiety tend to have more alpha waves.
  • Hormones: Some have suggested that hormones could play a role in influencing anxiety. In particular, it is hypothesized that since females are more likely to experience anxiety than men, that hormones like estrogen may play a role in influencing the severity of anxiety and/or fear. Additionally once cortisol levels increase as a result of stress, it makes us more prone to future anxiety.
  • Sex: Most evidence suggests that anxiety is more common among women than men. In one study which took into account over 20,000 adults, it was noted that the ratio of men to women suffering from anxiety disorders is approximately 1 to 1.7 – this is pretty significant. Women were more likely to have all types of anxiety except social anxiety – which affected both groups equally.
  • Sympathetic nervous system: Those who experience physical symptoms of anxiety and/or a nervous breakdown tend to have issues reducing activity in the sympathetic nervous system. The sympathetic nervous system is responsible for increasing heart rate, physical stimulation, pupil dilation, muscle tension, and all physical responses to anxiety. If we aren’t able to reduce activity in the sympathetic nervous system, we will continue to experience anxiety.
  • Traits: Research has shown that those with apprehensive, vigilant, and fearful temperaments are at greater risk of experiencing anxiety. Additionally it is thought that introverts are more likely to have anxiety than extroverts. Both introverts and extroverts can have anxiety disorders, but anxious predisposition is more likely to be found among introverts.

Source: http://www.ncbi.nlm.nih.gov/pubmed/21439576

5. Lifestyle

It is important to consider the fact that personal factors can play a significant role in influencing the severity of anxiety. In some cases, personal habits can serve to be the root cause of anxiety among various individuals. Those who eat poor diets or abuse drugs may be sabotaging their natural ability to relax.

  • Diet: Eating diets high in sugars and carbohydrates may lead some individuals to feel increasing anxiety. The ideal diet for optimal mental health consists of a balance between: vegetables, fruits, whole grains, fish, and meats. Eating processed foods with high sugar contents may lead some individuals to experience anxiety.
  • Drugs: It’s common sense that stimulant drugs will increase anxiety after they are taken. For example, someone taking cocaine may notice that their heart rate increases, paranoia, and inner feelings of generalized anxiety. The anxiety may take a different form long after the effects have worn off as well. Additionally drugs like alcohol and marijuana may temporarily alleviate anxiety, but are thought to increase it with consistent long-term usage.
  • Early life experiences: Experiences early in our lives can contribute to significant anxiety later in life. Various factors such as cold parenting, lack of affection, drug abuse, and other forms of child abuse can contribute to anxiety. As a child, it may be difficult to cope with experiences that provoke significant anxiety and it is difficult to get help. A child may isolate him or herself as a way to cope with whatever made them feel anxious. This changes the wiring and functioning of the brain and can lead to permanent anxiety later in life.
  • Financial problems: If you are barely scraping by financially and are in debt or at risk for bankruptcy, this can cause a significant amount of anxiety. Money is the primary tool people use for survival purposes – we exchange it for food, shelter, and other services to help make our life easier. When we are struggling with finances, we may feel “knots” in our stomach and become highly anxious because we don’t know how we will get food and/or provide for ourselves and family.
  • Lack of exercise: Those who don’t get enough exercise can experience anxiety as a result of pent-up energy. Although not everyone feels anxiety if they don’t exercise, there is evidence that exercising can help reduce anxiety levels in certain individuals. By not exercising, some people experience a build-up of anxiety throughout the body. (Read: Psychological benefits of exercise).
  • Lack of oxygen: In some cases, people experience significant anxiety as a result of low oxygen levels. This can happen in high altitudes and among other individuals with various lung problems. Medically it is known as “hypoxia” and at low amounts,
  • Lack of sleep: Not getting enough sleep can lead to changes in brain activity and increases in stress hormones like cortisol. These interfere with our ability to focus, experience positive mood, and relaxation. Many people who are anxious and/or stressed would benefit from getting more sleep.
  • Medical diagnosis: Individuals facing a serious health problem such as heart disease, cancer, schizophrenia, or any serious illness may experience an increase in anxiety. Let’s face it, those who get diagnosed with a potentially life-threatening or permanently life-altering illness typically take awhile to accept that they have the disease. Getting a diagnosed with something severe can lead to rumination, negative feelings such as depression, and significant anxiety.
  • Medications: Taking certain medications can lead people to feel more anxious than usual. This is most common when people take certain psychotropic drugs, but can also be experienced on other classes of drugs as well.
  • Pessimistic outlook: Those with pessimistic outlooks on life tend to have more anxiety than those who are optimistic. Whether pessimism itself is caused by the anxiety or vice versa is up for debate. It is thought that anxiety and pessimism may be comorbid in certain individuals.
  • Phobias: These are specific things or situations that a person is afraid of. Someone with arachnophobia is said to be afraid of spiders. In some cases these are the result of early childhood experiences that caused a person to “learn” or associate certain things with fear. If left unaddressed, certain phobias can cause a significant degree of anxiety.
  • Relaxation: It’s counterintuitive that some individuals would feel more anxious when they are “relaxed” but it can be the case. Although relaxation-induced anxiety is rare, it is usually common among those who are used to functioning at greater levels of arousal. When their arousal level drops and they become relaxed, this relaxation makes them feel highly uncomfortable and anxious. Although their sympathetic nervous system may not be highly active, they still feel anxious.
  • Stimulants: Various stimulants such as caffeine and psychostimulants (e.g. Adderall) can contribute to a person’s anxiety. Stimulants are known to increase heart rate, change brain activity, and activate the sympathetic nervous system. This leads to increases in focus and concentration for some individuals, but can also lead others to feel extremely anxious.
  • Withdrawal: Withdrawing from various medications including both illicit and pharmaceutical drugs can lead to anxiety. A variety of people experience anxiety during drug withdrawal because their entire physiology changed while they were on the drug. When a person withdraws from a substance, their body and brain need time to adjust back to homeostatic functioning. During the adjustment phase, brain activity and neurotransmission is temporarily altered – levels of certain neurotransmitters may be abnormally low.

Determining the cause of your anxiety

Both controllable and uncontrollable factors can contribute to a person’s anxiety. Additionally factors that are both internal and external can determine someone’s level of anxiety. Someone with a genetic predisposition to anxiety would be considered to have an internal, uncontrollable factor for causing their anxiety. On the other hand, someone who is anxious from overworking and stress on the job would be said to have an externally-based, controllable form of anxiety.

  • Controllable vs. Uncontrollable: First take the time to understand whether your anxiety is within your control or out of your control. Meaning, would making lifestyle changes such as: finding a different job, practicing daily relaxation, getting more exercise, and/or eating healthier help? Only after you’ve made many changes in your life will you know whether your anxiety is within your control or out of your control. If it is out of your control, you will need to seek some sort of external help such as: psychotherapy and/or pharmaceutical medication.
  • Internal vs. External: Most external factors that cause anxiety can be controlled or avoided. For example, if a person is causing you significant anxiety, you can simply avoid them and hang out with someone else. On the other hand, internal causes of anxiety such as genetics cannot usually be controlled.
  • Combination: Understand that many cases of anxiety may be a result of controllable and uncontrollable variables as well as internal and external causes. There tends to be a symbiotic relationship of internal and external causes. Meaning, if a person is naturally anxious, they may be more prone to getting bullied, which will further increase their anxiety. In cases where anxiety is caused by both internal and external factors, making lifestyle changes may help significantly, but not entirely. In this case, a person may need a little extra help from a medication and/or therapist to fully cope with it.

What type of anxiety do you have?

By understanding what causes your anxiety, you can target the root cause during treatment. If your anxiety is being caused by an abusive relationship, but you don’t get to the root of the cause, nothing will fix the problem. Taking an antidepressant medication may help reduce your anxiety in the short-term, but it will act more as a patch rather than a cure.

In another scenario of anxiety being caused by genetics, eating healthier, getting exercise, and daily meditation may only help to a certain extent; natural cures for anxiety are not always effective. At some point, you may need to accept the fact that pursuing a pharmaceutical medication may be your best hope to cope with your anxiety and function in society. Understanding the cause of your individual anxiety helps provide insight regarding the optimal course of treatment. (Read: Hierarchy of treatments for anxiety).

Finally, some cases of anxiety may be better addressed in therapy rather than with medications or lifestyle changes. Working with a therapist may help you realize that you need to simply change your perspective, learn a new way of thinking, and/or coping strategies for your anxiety. If you are having a difficult time determining what is causing your anxiety, do some self-reflection, take an honest look at your life, and consider working with a psychologist.

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