Written by Hafsa Saleemi,
Medically reviewed by:
Mimi Winsberg, MD
Chief Medical Officer
Over 18% of people in the United States experience anxiety every year—that’s 40 million people. Anxiety disorders are the most common mental health condition, and they’re very treatable.
If you experience symptoms of anxiety, such as restlessness, near-constant worrying, or trouble controlling worry or panic, it’s a good idea to talk to a mental health provider. At Brightside Health, expert providers can put together a personalized treatment plan that includes therapy, medication, or both to help you get back to feeling like you again.
What causes anxiety?
If you experience symptoms of anxiety or know someone who does, you may be wondering about the cause of anxiety. Anxiety disorders are caused by many factors, including brain chemistry, personality, life events, and genetics.
While you may commonly hear the word anxiety, there are actually several types of anxiety disorders:
- Generalized anxiety disorder (GAD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Acute stress disorder
- Social anxiety
- Obsessive-compulsive disorder (OCD)
Anxiety symptoms can come in many forms and often, many overlap with depression. In fact, it’s estimated that 60% of people with anxiety also experience depression.
Depression symptoms & anxiety symptoms
What the research says: How anxiety works in the brain
Considering that brain chemistry is one of the factors that influence anxiety’s development, let’s take a look at research that studies both the brain and anxiety.
- Research published in the National Library of Medicine states that anxiety develops because of “brain circuits that regulate the emotional response to potentially threatening stimuli.” Just like our ancestors perceived a threatening animal and chose to fight or flee, our brains sometimes create the same response in our bodies even when threats aren’t there.
The review continues, “The expression of anxiety involves a coordinated activity of numerous brain pathways involving different neurotransmitters, all of which interact.” Examples of these neurotransmitters, the brain’s chemical messengers, include serotonin and GABA. Serotonin helps stabilize mood while GABA is involved in decreasing your nervous system’s activity.
- A Stanford University School of Medicine study found differences between the amygdala patterns in people with generalized anxiety disorder compared to those without the mental health condition. The amygdala is the brain’s center for emotions and motivation. They found that those with GAD had muddled lines of communication from their amygdala and less connection to the region of the brain responsible for determining the importance of things. They concluded, “This could mean that people with the disorder have a harder time discerning truly worrisome situations from mild annoyances.”
- One study involving fMRI brain scans of people who recently experienced a traumatic event found differences in brain activity related to mental health symptoms. Participants with brain activity categorized as reactive/disinhibited (high activity related to both a threat and reward) had more symptoms of both PTSD and anxiety over the six-month follow-up period compared to people with different brain activity.
While experts are still exploring exactly how the brain and anxiety are linked, the studies above emphasize the clear connection between the two. When talking about the cause of anxiety, it’s also important to discuss the other factors that influence anxiety, including personality, life events, and genetics.
Other anxiety factors
- Have you ever wondered how your personality affects your mental health? Studies have found that personality traits, such as NEM and behavioral inhibition, can affect our emotional responses and how we cope with stress. In particular, NEM, which relates to your likelihood to experience and express negative emotions, was correlated with emotional distress such as stress and anxiety.
- Two additional studies further discuss the implications of personality and anxiety in terms of behavioral inhibition—a personality characteristic in which one shows stress or nervousness in new situations or avoids them altogether. One study published in the Journal of the American Academy of Child and Adolescent Psychiatry found:
- Participants who continued to show behavioral inhibition in childhood were more likely to experience worry dysregulation in adolescence (age 15), which in turn predicted elevated anxiety during the early months of the COVID-19 pandemic when the participants were in young adulthood (around age 18).
- The second study also found that behavioral inhibition, this time in infants, predicted personality and was linked to mental health conditions years later in adulthood.
- Life events
- Events in your life, as well as your response to them, can impact your mental health. As noted in the brain and anxiety research mentioned above, trauma can impact one’s susceptibility to an anxiety disorder. Additionally, other stressful life events can too—one study measured adolescents’ responses to difficult events such as parents’ divorce, loss of a family member, hospitalization, and more.
- They found that stressful events can lead to repetitive thinking (called rumination) as well as increased attention to your body and mind’s signs of anxiety (called anxiety sensitivity). As the study says, “Both rumination and anxiety sensitivity are established risk factors for the development of anxiety. As such, it is likely that similar environmental events (i.e., stressors) may trigger the development of each of these types of self-focused thought.”
- Is anxiety hereditary? It can be. Generalized anxiety disorder is thought to be about 30% heritable and anxiety disorders as a whole have a 26% heredity lifetime rate. This means about a quarter of your risk for anxiety is genetic—however, your environment, personality, physical health, and life events are important factors too.
The bottom line: Treatment for anxiety
There are many factors that can cause anxiety—and often, it’s the combination of a few of them that leads to an anxiety disorder.
The good news is that anxiety responds well to treatment, which can include therapy, medication, self-care, and lifestyle changes. If you have symptoms of anxiety, it’s important to talk to a mental health provider so you can get the care you deserve to live your life fully.
At Brightside, therapists and psychiatric providers can diagnose you and recommend a personalized treatment plan so you can feel better sooner and stay that way longer. Within 12 weeks, 86% of Brightside members feel better and 71% achieve remission.