Anxiety disorders may be caused by environmental factors, medical factors, genetics, brain chemistry, substance abuse, or a combination of these. It is most commonly triggered by the stress in our lives.
Usually anxiety is a response to outside forces, but it is possible that we make ourselves anxious with "negative self-talk" - a habit of always telling ourselves the worst will happen.
Anxiety caused by environmental and external factors
Environmental factors that are known to cause several types of anxiety include:
- Trauma from events such as abuse, victimization, or the death of a loved one
- Stress in a personal relationship, marriage, friendship, and divorce
- Stress at work
- Stress from school
- Stress about finances and money
- Stress from a natural disaster
- Lack of oxygen in high altitude areas
Anxiety caused by medical factors
Anxiety is associated with medical factors such as anemia, asthma, infections, and several heart conditions. Some medically-related causes of anxiety include:
- Stress from a serious medical illness
- Side effects of medication
- Symptoms of a medical illness
- Lack of oxygen from emphysema, or pulmonary embolism (a blood clot in the lung)
Anxiety caused by substance use and abuse
It is estimated that about half of patients who utilize mental health services for anxiety disorders such as GAD, panic disorder, or social phobia are doing so because of alcohol or benzodiazepine dependence. More generally, anxiety is also know to result from:
- Intoxication from an illicit drug, such as cocaine or amphetamines
- Withdrawal from an illicit drug, such as heroin, or from prescription drugs like Vicodin, benzodiazepines, or barbiturates
Anxiety caused by genetics
It has been suggested by some researchers that a family history of anxiety increases the likelihood that a person will develop it. That is, some people may have a genetic predisposition that gives them a greater chance of suffering from anxiety disorders.
Anxiety caused by brain chemistry
Research has shown that people with abnormal levels of certain neurotransmitters in the brain are more likely to suffer from generalized anxiety disorder. When neurotransmitters are not working properly, the brain's internal communication network breaks down, and the brain may react in an inappropriate way in some situations. This can lead to anxiety.
How is anxiety diagnosed?
A psychiatrist, clinical psychologist, or other mental-health professional is usually enlisted to diagnose anxiety and identify the causes of it. The physician will take a careful medical and personal history, perform a physical examination, and order laboratory tests as needed. There is no one laboratory test that can be used to diagnose anxiety, but tests may provide useful information about a medical condition that may be causing physical illness or other anxiety symptoms.
To be diagnosed with generalized anxiety disorder (GAD), a person must:
- Excessively worry and be anxious about several different events or activities on more days than not for at least six months
- Find it difficult to control the worrying
- Have at least three of the following six symptoms associated with the anxiety on more days than not in the last six months: restlessness, fatigue, irritability, muscle tension, difficulty sleeping, difficulty concentrating
Generally, to be diagnosed with GAD, symptoms must be present more often than not for six months and they must interfere with daily living, causing the sufferer to miss work or school.
If the focus of the anxiety and worry is confined to a particular anxiety disorder, GAD will not be the diagnosis. For example, a physician may diagnose panic disorder if the anxiety is focused on worrying about having a panic attack, social phobia if worrying about being embarrassed in public, separation anxiety disorder if worrying about being away from home or relatives, anorexia nervosa if worrying about gaining weight, or hypochondriasis if worrying about having a serious illness.
Patients with anxiety disorder often present symptoms similar to clinical depression and vice-versa. It is rare for a patient to exhibit symptoms of only one of these.
On the next page we look at the common symptoms of anxiety.