What causes anxiety disorder?

There isn’t a single cause of anxiety disorders. They usually arise from a mix of biological, psychological and environmental factors that interact differently in each person. Key contributors include:

- Genetics and family history
- Anxiety disorders run in families; genes increase vulnerability but don’t determine outcome alone.

- Brain structure and chemistry
- Differences in brain circuits that regulate fear and threat (amygdala, prefrontal cortex, hippocampus).
- Imbalances or dysregulation of neurotransmitters (GABA, serotonin, norepinephrine) can increase anxiety.

- Temperament and early development
- Children who are behaviorally inhibited or highly sensitive are at higher risk.
- Early-life stress, neglect, or attachment problems can predispose to chronic anxiety.

- Learning and cognitive factors
- Anxiety can be learned (classical conditioning for specific phobias) and maintained by avoidance.
- Negative thinking patterns and catastrophic interpretations fuel and sustain anxiety.

- Stressful life events and trauma
- Major stressors (abuse, loss, accidents, chronic stress) often trigger or worsen anxiety disorders.

- Medical conditions and substances
- Some medical problems can produce anxiety symptoms (hyperthyroidism, cardiac arrhythmias, respiratory disease).
- Medications and substances can cause or worsen anxiety — stimulants, caffeine, thyroid medications, some asthma drugs, corticosteroids — and withdrawal from alcohol or benzodiazepines can provoke anxiety.

- Other mental health conditions
- Depression, PTSD, and some neurodevelopmental disorders commonly coexist with and influence anxiety.

Bottom line: anxiety disorders are usually multifactorial and treatable — they’re not a personal failing. If you want, I can explain causes for a specific anxiety disorder (GAD, panic disorder, social anxiety) or outline how treatments target these causes.