What Causes an Anxiety Disorder to Develop?

The factors that contribute to the development of an anxiety disorder are just as unique as the 40 million individuals in the US who experience them each year. While it’s easy to pinpoint the cause of a physical illness or virus, it’s not so cut and dry when it comes to pinpointing the exact cause of an anxiety disorder. A virus will begin to present symptoms within hours to days of contamination from causes that are easy to track and determine, however, the symptoms of an anxiety disorder can take years to develop as a result of various life experiences and coping mechanisms. 

In addition to the experiences we have and the ways that we cope with stress, there are also factors such as our biochemical makeup, genetics, medical conditions, substance use, and overall resilience that come into play—making a person more or less susceptible to developing an anxiety disorder. 

With that being said, let’s dive into the various causes of anxiety that have been accounted for, researched, and treated by the medical and mental health community at large. 

Trauma and Abuse

Trauma and abuse, including major losses, are some of the most common causes of anxiety disorders. Trauma is often the result of any event or situation that causes a person or their loved ones to experience a threat to their overall safety and wellbeing. This includes the death of a loved one, abuse (mental, physical, emotional, and sexual), near-death experiences, car accidents, abandonment (physical and emotional), divorce, extreme illness, etc. 

When we experience extreme shame, this can also cause trauma which results in shame-based anxiety over the fear of facing such embarrassment again in the future. This form of anxiety commonly forms in childhood, or after years of repressed feelings of shame. These symptoms oftentimes manifest later on in life as social phobia, or codependent behaviors that include controlling behavior, people-pleasing tendencies, fear of abandonment, perfectionistic ways, obsessive or addictive behaviors, such as eating disorders and OCD (obsessive-compulsive disorder) symptoms. 

Shame anxiety typically manifests in men over fears related to the loss of a job or finances, while women are most likely to feel this type of anxiety over fears surrounding relationships and personal appearance. 

It is important to note that not every person who experiences a traumatic event will develop symptoms of trauma, anxiety, or depression. These are the most common mental health reactions to trauma that have been measured and researched over the years, however factors including resilience, genetics, coping skills, etc. do come into play here and can influence the likelihood of such symptoms manifesting as a result. 

In addition to the aforementioned factors that contribute to a person’s likelihood of developing an anxiety disorder after a traumatic experience, the way each person reacts to the trauma also has an impact on the direction a person’s mental health can develop. While everyone reacts to trauma differently, those who are able to process the event, including their feelings and emotions surrounding it, will be better equipped than those who simply externalize and react to the traumatic event by acting out toward others, or those who internalize it by ruminating, engaging in self-defeating thoughts, or repressing it. When trauma is internalized, it’s more likely to result in symptoms of PTSD, depression, and anxiety disorders.

woman massaging head

Coping Skills

The ways we learn to manage and cope with stress by the time we are teenagers hold influence over our likelihood of developing a mental health disorder such as anxiety into adulthood. Coping mechanisms that include unhealthy habits such as drinking alcohol, using drugs, shopping, gambling, sex, and engaging in other risky behaviors can contribute to even greater feelings of anxiety. 

Eight percent of all children and teens in the US have an anxiety disorder, and most cases develop symptoms before the age of 21. When it comes to teens age 13-18, 25.1% in the US have an anxiety disorder. Worldwide, 1 in 13 people suffer from an anxiety disorder, according to the World Health Organization—making anxiety the most common mental health disorder, not only in the US, but on a global scale. 

Part of this could be due to the societal norms among adults and teens that pertain to the ways we deal with stress, as well as environmental factors that make life more stressful today than it was for past generations. External factors in the environment that can contribute to anxiety include:

  • Stress from work and/or school
  • Stress from interpersonal relationships
  • Emotional trauma
  • Stress from medical conditions
  • Side-effects of medications
  • Symptoms of illicit drugs, alcohol, and caffeine
  • Symptoms of a medical condition 
  • Lack of oxygen from high altitudes and various medical conditions
  • Stress from social and political threats such as war, terrorist attacks, school shootings, etc. 

Medical, Genetic, Neurochemical Factors and More

Various medical conditions can present with symptoms of anxiety, as can the side-effects of certain medications. It’s also more common for anxiety to develop in those who have a family history of anxiety or other mental disorders. There’s a complex set of risk factors that contribute to the genetic likelihood of facing such disorders, including brain chemistry, personality, and exposure to traumatic life events at an early age.

Hand drawing formula

From a biochemical perspective, those with anxiety have imbalanced levels of serotonin, norepinephrine, and GABA. These are key neurotransmitters that help regulate mood and feelings of calm. Research has also discovered different brain activity in those who have anxiety vs. those who do not. It’s difficult, however, to determine if this is the cause or the result of the condition. There have also been studies that show an abnormal blood flow and brain metabolism in those who have an anxiety disorder, as well as structural differences in other regions of the brain. The good news is that with treatment, these changes in the brain are only temporary. With treatment, the brain can return to a normal, healthy state of homeostasis. Unfortunately, nearly 2/3 of people with an anxiety disorder do not seek treatment. 

Genetic components that have been linked to anxiety include impaired carbon dioxide receptors, as well as chromosomal irregularities. A specific gene mutation has yet to be pinpointed to account for anxiety disorders, however, a gene mutation linked with panic disorders has been found. Other factors that have been linked to anxiety include an imbalance in cortisol (the stress hormone), and psychological factors. 

Psychological Theories Surrounding the Causes of Anxiety Disorders

Many psychologists have presented theories over the years pertaining to the cause of anxiety disorders. Some believe that anxiety is the result of repressed interpersonal conflict that must be resolved in order to treat the anxiety. Others believe that anxiety develops over time like a behavioral, conditioned response—resulting from a series of consequences delivered from one’s environment. From this lens, behavioral therapy could help a person to condition new responses over time. Still, others believe that anxiety develops as a result of dysfunctional thought patterns (a common belief among cognitive-behavioral psychologists), and that these thoughts exaggerate the potential for danger in any given situation. By challenging these negative thought patterns and developing new core belief systems, CBT (cognitive-behavioral therapy) is able to address such notions and help those with anxiety create a new, positive, internal dialogue. 

The Takeaway

While each case of anxiety is unique and the direct cause or causes can sometimes be difficult to pinpoint, treatment is available to help address any symptoms and challenge the irrational fears and worries that plague the mind of a person who suffers from an anxiety disorder. If you or someone you love is struggling with anxiety, it’s important to know that no one should have to suffer in silence. Help is available, and research has shown it to work for many who believe in and subscribe to a treatment plan. 

Resources

Anxiety and Depression Association of America
https://adaa.org/about-adaa/press-room/facts-statistics

American Psychiatric Association. (2013). Anxiety Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
https://doi.org/10.1176/appi.books.9780890425596.dsm05

Gilbert, P. (2000). The relationship of shame, social anxiety and depression: the role of the evaluation of social rank. Clin. Psychol. Psychother., 7: 174-189. doi:10.1002/1099-0879(200007)7:3<174::AID-CPP236>3.0.CO;2-U

Levinson, C., Byrne, M., Rodebaugh, T. (2016). Shame and guilt as shared vulnerability factors: Shame, but not guilt, prospectively predicts both social anxiety and bulimic symptoms.
Eating Behaviors. 22:188-193. ISSN 1471-0153. https://doi.org/10.1016/j.eatbeh.2016.06.016.

Medical News Today
https://www.medicalnewstoday.com/articles/323456#causes

Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

McAfee, Erin L.. Shame: The Emotional Basis of Library Anxiety. College and Research Libraries, 79, no. 2 (2018) Association of College and Research Libraries: https://doi.org/10.5860/crl.79.2.237

Morris-Rosendahl D. J. (2002). Are there anxious genes?. Dialogues in clinical neuroscience, 4(3), 251–260. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181683/

National Alliance on Mental Illness
https://www.nami.org/learn-more/mental-health-conditions/anxiety-disorders

National Institute of Mental Health
https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

Na, H. R., Kang, E. H., Lee, J. H., & Yu, B. H. (2011). The genetic basis of panic disorder. Journal of Korean medical science, 26(6), 701–710. https://doi.org/10.3346/jkms.2011.26.6.701

Weingarden, H., Renshaw, K. D., Wilhelm, S., Tangney, J. P., & DiMauro, J. (2016). Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder. The Journal of nervous and mental disease. 204(11), 832–839. https://doi.org/10.1097/NMD.0000000000000498

Wilson, J. P., Droždek, B., & Turkovic, S. (2006). Posttraumatic Shame and Guilt. Trauma, Violence, & Abuse, 7(2), 122–141. https://doi.org/10.1177/1524838005285914

World Health Organization
https://www.who.int/mental_health/advocacy/en/#Factsheets

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