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  • Natasha J. Thomas, MD

The Anxiety and Panic Series: What Causes Anxiety?

Today, in Part Three of our series, we briefly delve into the reasons for anxiety and panic. There are several theories about the cause of this mysterious emotional and mental state, explored by psychologists and psychiatrists for decades. Because knowledge is power, it's important to try to understand what is causing anxiety in you, or your loved ones.

While we may not be able to get to the root cause every time, knowing what's happening in your body and mind will guide us toward the most effective ways to be free of disruptive, intrusive and debilitating anxiety and panic. Anxiety is extremely treatable in most people and responds well to interventions like counseling, skills training and medication use.

Now that we know what anxiety is and all the different manifestations it may take, let's look at the psychological and biological theories behind it. We have one type of anxiety whose cause doesn't need any exploration, and that is anxiety that is caused by medications, illicit drugs or medical conditions. Remember, those are called Substance-Induced Anxiety and Anxiety Due to a Medical Condition.

But what about the others? Let's take a look at what researchers and theorists have had to say:


The Freud Factor

You may have heard of Sigmund Freud, a physician who developed a type of therapy called psychoanalysis. When you think of a psychiatrist, you think of a couch, right? That's because of his therapy style. He is sometimes considered to be the father of psychology, though he was actually a neurologist. Freud had several theories about anxiety over the course of his career. His first theory was that anxiety came from repressed or held-in desires. Later, he thought anxiety could be coming from a) helplessness felt in traumatic situations, or b) worry about a repeat of a traumatic situation. What do you think? If you've experienced something traumatic in life, do you think it is causing you anxiety today? Review the anxiety types by clicking here.


Many of our anxiety disorders are due, at least in part, to a problem estimating how harmful a particular situation will be. People who struggle with high anxiety in social settings overestimate both how harmful talking to other people will be, and what negative consequences will develop afterward. They anticipate being judged, and later disgraced or thought of in a negative light. They also underestimate their own power. They feel they don't bring enough to the table and whatever they say or do will just make them look "stupid." Though other phobias are not focused on social interactions, they do share the overestimating/underestimating problem. Remember the video of Marvin from last week's post? He clearly overestimated the power of the puppy and underestimated his ability to keep himself safe in that instance. Worriers, like in Generalized Anxiety Disorder, also overestimate the power of "what if" something goes wrong and underestimate their own ability to handle the things life brings their way.

Is it in the Genes?

Of course we have to take a look at family history, too, when we try to figure out where anxiety and panic originate. If you have family members that struggle with these issues, it's possible that you can be impacted as well. This may be due to the way your body responds to stress (which can be genetic). However, the environment your family members create and how they respond to your experiences can also be major factors in how anxiety impacts you. If you have family members that seem to minimize your experiences, you can feel isolated and silenced, left to struggle through difficult times alone. That can bring on anxiety. However, so can having family members that overreact to issues that arise in your life. It's both scary and annoying to have your family tell you that things are going to go horribly for you. It is no surprise that people with families like this also are isolated and silenced. No one is going to share concerns with someone they think is going to completely meltdown, or worse, is going to take the situation and turn the focus to themselves. Instead, people struggling with anxiety are often looking for a supportive sounding board.

Special Note

Even though we know Substance-Induced Anxiety and Anxiety Due to a General Medical Condition are the results of chemicals in our bodies, all types of anxiety can be made worse by certain things we ingest and certain medical conditions. For instance alcohol, caffeine, and high amounts of sugar can drive anxiety. So can thyroid disease, true heart palpitations or valvular disease, and respiratory issues.

My Thoughts

Over the past 8 years in my work as a psychiatrist, I have become very familiar with anxiety in the people I'm fortunate enough to call my patients. Because they have allowed me to participate in their care, I have developed some theories of my own. While I definitely think trauma, miscalculating threats, and genetics and environment are important contributors to anxiety, I have also seen other common threads between all anxiety disorders:

- Unresolved feelings

- Difficulty putting feelings into words

- Having a lack of coping strategies for stress

- The tendency to suppress emotions

And these are just a few. There are many, many theories about anxiety!

All in all, it's encouraging to see just how "treatable" anxiety can be, and fortunately, I've seen my patients flourish once some or all of the issues in this article have been addressed.

I also have seen that living in America causes a unique "flavor" of anxiety. I believe that the causes of anxiety listed in this article also cause a general societal anxiety, too - impacting the American people as a whole.

Next week, we will take a magnifying glass to America's brand of anxiety, panic and fear. But for this week, I'm going to give you a challenge: look at the causes of anxiety in this article and see how many of them apply to you. Keep track for when we discuss anxiety solutions (I'll give you a hint, I listed 8 causes here today).

Thank you for reading, I'll see you next time!

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