What causes anxiety disorders?

Anxiety disorders arise from an interplay of biological, psychological, and social factors. Genetic studies indicate a heritable component: first-degree relatives have increased risk, and research implicates specific gene variations affecting neurotransmitter systems such as serotonin, gamma-aminobutyric acid (GABA), and norepinephrine. Brain imaging and neurophysiology show altered function in circuits that regulate fear and emotion, notably the amygdala, prefrontal cortex, and hippocampus. Dysregulation of stress-response systems, including the hypothalamic-pituitary-adrenal axis, contributes to heightened arousal and sensitivity to perceived threats.

Psychological processes also play a central role. Cognitive patterns such as catastrophic thinking, attentional biases toward threat, and intolerance of uncertainty can maintain and amplify anxiety. Learned associations from traumatic or stressful experiences—classical conditioning of fear responses—often explain phobias and posttraumatic stress. Developmental factors matter: early attachment disruptions, chronic childhood stress, and adverse experiences increase vulnerability.

Social and environmental influences further shape risk. Chronic stressors like socioeconomic hardship, interpersonal conflict, and ongoing exposure to danger elevate physiological stress and reduce coping resources. Substance use, caffeine, and certain medications can provoke or worsen symptoms. Medical conditions such as thyroid disease, cardiac arrhythmias, and respiratory disorders may mimic or precipitate anxiety and should be evaluated by clinicians.

Diagnosis follows standard clinical guidelines that assess symptom pattern, duration, and functional impairment. Effective treatments include evidence-based psychotherapies—cognitive behavioral therapy, exposure therapy—and pharmacological options that target implicated neurotransmitter systems. Integrated care approaches that combine psychotherapy, medication when appropriate, lifestyle changes, and social support produce the best outcomes. Clinicians recommend individualized assessment to identify contributing factors and tailor interventions that restore adaptive emotion regulation and daily functioning.

Ongoing research by multidisciplinary teams refines understanding and improves treatments, and clinicians encourage early help-seeking, routine screening in primary care, and coordination with family supports to reduce disability and improve long-term recovery while ensuring culturally sensitive, evidence-informed care for diverse populations.