Anxiety involves a person feeling disproportionate and sustained distress, worry, or fear in response to an emotional trigger. Anxiety can have a wide range of causes. These can include environmental, genetic, and medical factors.

A variety of factors can increase the likelihood of feeling anxious. These factors may be internal, involving genetics, for example, or external, involving racial inequity or ecological concerns.

Feelings of anxiety and anxiety disorders are not the same. Anxiety is an emotion characterized by tension, worried thoughts, and physical characteristics, such as increased blood pressure. An anxiety disorder involves recurring, intrusive thoughts or concerns and other specific criteria that lead to a diagnosis.

This article explores several causes of anxiety.

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A 2020 review defines anxiety as “a future-oriented mood state that consists of a complex cognitive, affective, physiological, and behavioral response system associated with preparation for the anticipated events or circumstances perceived as threatening.”

A variety of environmental factors can increase the likelihood of anxiety. For example, a person’s family composition, their cultural and religious upbringing, and many other childhood experiences can influence anxiety levels, according to a 2018 review.

Other studies have confirmed links between childhood traumas and an increased likelihood of having anxiety symptoms later in life.

People may feel anxiety as a result of various life stressors. These are not universal and can affect different people in different ways.

Social situations

Social situations may cause anxiety if a person believes that they might act in a way that could be negatively perceived.

A person might experience anxiety when required to perform publicly or in any situation where there is a real or perceived threat of scrutiny.

The effects of this anxiety can vary. For example, a 2014 review suggested that feelings of social anxiety may exacerbate stuttering and lead to a disabling experience for adults who stutter. However, fully understanding the relationship between between social anxiety and stuttering, especially among children and adolescents, will require further research, the study’s authors concluded.

Learn more about how COVID-19 affects people with social anxiety.

Anxiety, gender, and sexuality

Concerns relating to gender and sexual identities and stigmatization can cause anxiety for many people.

A survey-based 2016 study found that non-heterosexual respondents were more likely to report feelings of anxiety than heterosexual respondents.

In addition, bisexual people may experience anxiety at a higher rate than gay and lesbian people, according to a 2015 survey of students in the northeastern United States. The researchers suggested that exclusion from heterosexual and homosexual social groups may be the underlying cause.

For transgender people, gender dysphoria can be a cause of anxiety — as can systemic stigma and marginalization.

An online sample survey in the U.S., for example, found disproportionately high rates of anxiety, depression, and overall psychological distress in transgender respondents, compared with heterosexual respondents.

Anxiety and race

Systemic racism leads to psychological distress. The American Psychological Association (APA) lists socioeconomic deprivation and racial discrimination as two major components of this.

A 2014 study investigated the effects of aggressive policing on the mental health of young men in New York City and found an association between increased police contact and higher levels of anxiety. The respondents were aged 18–26 years, and 80% were non-white. On average, they had been stopped by police more than eight times in their lives. Respondents who had been stopped more than five times reported sharp increases in anxiety.

A 2015 review of studies concerning mental health and race found consistent associations between exposure to discrimination and anxiety, as well as a wide range of other mental health conditions.

Learn about racism in mental healthcare here.


Worry about the state of the environment can also cause anxiety, and this is sometimes called “eco-anxiety.” The APA describes eco-anxiety as “a chronic fear of environmental doom.”

Eco-anxiety is not yet a diagnosable condition. While its prevalence is still unknown, a survey-based 2018 study found that 70% of respondents in the U.S. are worried about climate change, and around 51% feel “helpless” about the current situation.

Learn more about eco-anxiety.

A range of genetic factors may influence a person’s tendency to feel anxious. These may vary among age groups, demographics, and genders.

However, a 2020 analysis found that general feelings of anxiety are more likely to be caused by environmental than genetic factors.

Many things related to health can cause anxiety. For example, anxiety may stem from an underlying medical condition or a side effect of a medication.

These factors may not directly cause the changes that characterize specific anxiety disorders, but they can cause situations or require lifestyle adjustments that trigger feelings of anxiety.

Recreational drug use can cause feelings of anxiety. However, the relationship between drug use and anxiety is complex.

For example, a 2018 study found links between cocaine self-administration and anxiety-like behavior in rats. Staying with the example of cocaine use, other studies have found that anxiety can be both a cause and a consequence of it.

A person who has persistent, severe anxiety may receive a diagnosis of an anxiety disorder. First, a medical professional does a physical assessment.

The World Health Organization (WHO) estimates that 3.6% of the global population had an anxiety disorder in 2015. This percentage is typically higher among women. In the Americas, as many as 7.7% of women have an anxiety disorder, compared with 3.6% of men, the WHO reports.

There are several anxiety disorders, including general anxiety disorder and social anxiety disorder. These differ from general feelings of anxiety in their frequency, severity, and impact on the quality of life.

An anxiety disorder can be difficult to distinguish from other mental health conditions. Before making a diagnosis, a mental health professional reviews a person’s history and performs a detailed assessment. They may also recommend or provide treatment.

Also, a physician may perform a physical exam and order lab tests. This is to rule out other conditions that might be causing the symptoms.

Anxiety is a natural, necessary emotion, and it has many causes, such as stress, fear of negative responses in social situations, environmental concerns, and systemic marginalization.

Anxiety and anxiety disorders are not the same. A mental health professional will take into account the frequency and severity of anxiety and the results of various detailed assessments before diagnosing an anxiety disorder.