Causes and Risk Factors of Generalized Anxiety Disorder

Causes and Risk Factors of Generalized Anxiety Disorder GAD Print Generalized Anxiety Disorder: Causes and Risk Factors By William Meek Medically reviewed by Medically reviewed by Steven Gans, MD on July 08, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on August 06, 2019 Generalized Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children In This Article Table of Contents Expand Genetics Brain Structure Life Experiences Societal Factors Lifestyle Factors View All There is no singular cause of generalized anxiety disorder (GAD) that has been identified. Evidence has shown that multiple factors are usually at play, influencing the development of GAD.?? Some of the common factors include things like genetic predisposition, brain chemistry, family background, social influence, and life experiences. Verywell / Cindy Chung Genetics Your genetics may play a role in determining whether or not you will develop GAD. As with many other mental and medical health conditions, we can be genetically predisposed for developing certain symptoms. This is the same with generalized anxiety disorder. Technological and methodological advances have allowed researchers to examine the role genes play in the development of GAD in more detail, but the research is still in preliminary stages. Despite this, it has significant implications for anyone who faces  anxiety disorders. We know, for example, that we can have a genetic vulnerability to developing GAD if certain genetic markers have been passed on to us. Vulnerability, in combination with certain environmental factors, can trigger the development of symptoms. Studies have shown that first degree relatives of someone with GAD are more likely to develop mood and anxiety disorders in general, with a specific increased risk for developing GAD. First degree relatives would include family members most closely related to you, such as a parent, sibling, or your child. Finally, women are more prone to anxiety disorders in general. In fact, statistics from the ADAA show that women are actually twice as likely to be impacted by a generalized anxiety disorder. Although the condition typically begins around 30 years old, many of those who are diagnosed are found to have been struggling with symptoms for years before seeing a professional and being properly diagnosed. GAD comes on gradually, with the greatest risk between childhood and middle age. Brain Structure The limbic system is a collection of brain structures that, among other functions, is involved in the regulation of many of our basic emotional reactions. Although it is generally under the control of the thinking part of our brain, it can respond to stimuli on its own as well. The Amygdala The amygdala, in particular, is the part of our limbic system involved in our automatic fear response, as well as in the integration of memory and emotion. Although a lot of research on amygdala function has been focused on anxiety disorders like post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD), there are some patterns of brain structure and function that have presented in research as consistent for patients with GAD. Understanding that the amygdala is an important player in our ability to discern and feel fear, it may not be a surprise that imaging studies of patients diagnosed with GAD show elevated amygdala activity during the processing of negative emotions. It is this heightened activity within the amygdala that researchers believe might influence the inaccurate interpretations of social behavior for patients with GAD. People with GAD may inaccurately perceive a social cue or interaction as threatening when it is not actually threatening. Gray Matter The volume of gray matter is another factor that has been researched in relation to GAD and other anxiety and mood disorders. An increased volume of gray matter at certain locations in the brain has been repeatedly found in GAD patients compared to controls. One area of the brain that consistently shows an increased volume of gray matter in patients with GAD is called the right putamen. Researchers found that a larger volume of gray matter in the right putamen was positively correlated with childhood maltreatment. In other words, the greater the report of childhood maltreatment, the greater the likelihood of increased volume of gray matter in that area of their brain. Life Experiences Although genetic and biologic factors clearly contribute to the development of GAD, a greater percentage of the risk for GAD lies in complex psychological, environmental, and social factors. Experiencing Trauma Mental health researchers have found that trauma in childhood can increase our risk of developing GAD.?? Difficult experiences such as physical and mental abuse, neglect, the death of a loved one, abandonment, divorce, or isolation can all be contributing factors. When we have gone through particularly hard experiences that leave us feeling uncertain, humiliated or apprehensive to trust others, it is understandable that we may become anxious in a variety of situations in the future. People with GAD have difficulty accurately interpreting threats. Experiences or interactions that may seem harmless to most could feel emotionally threatening, dangerous and anxiety-producing for someone with GAD. Interestingly, research has shown that life events that result in specific feelings of loss, humiliation, entrapment, and danger are reliable predictors of the development and onset of generalized anxiety disorder. It is important for medical and mental health practitioners to gather family and social history, information that can help lead to an accurate diagnosis. Learned Behavior Some behavioral scientists believe that anxiety is a learned behavior, suggesting that if we have a parent or caregiver who demonstrates anxious behavior, we may tend to mirror that same anxious behavior.?? We are learning from caregivers and other important people close to us how to handle challenging, stressful situations. When they model less effective methods of stressful management, we tend to do the same. These early social learning experiences can influence our development of long-lasting anxiety. Societal Factors Of people who are on social media, it has been shown that approximately 30 percent are plugged into social media for 15 hours or more per week. Researchers are finding that the use of social media, particularly in excess, can greatly impact our mental health, sometimes resulting in anxiety and depression. Interacting with others through social media can present us with the same challenges as when we are interacting in people, such as feelings of loneliness, rejection, abandonment, or humiliation. People with GAD are less effective in accurately interpreting social cues and interactions, leaving them to potentially feel a heightened sense of danger or rejection, even when there is no observable threat present.?? Interactions through social media can be interpreted in these same inaccurate ways, possibly even more so when we are, at times, missing essential non-verbal cues in communication such as facial expressions, body language, and tone and exacerbating GAD. Lifestyle Factors Caffeine Using everyday addictive substances like caffeine can heighten feelings of worry or nervousness, contributing to the development of anxiety.?? Our culture tends to ask more and more of us, pushing us to perform, and leaving us to fear feeling left behind, socially, financially, physically or otherwise. Relying on caffeine sources such as coffee, tea, soda and energy drinks can cause some people to feel restless and anxious, especially when used in large quantities. Relationships Our relationships can be a source of great comfort, but also pain. Relationships can be a significant source of anxiety for women, in particular. Women are twice as likely as men to develop GAD. Research has shown that two main factors of anxiety, specifically related to women, were being afraid of and/or humiliated by a current partner or ex-partner. Dangerous and fearful experiences within intimate relationships can influence the development of anxiety. Job Stress Work can be a great source of stress and become a trigger in the development of anxiety.?? Some employers expect extraordinarily high levels of performance and productivity that can threaten our sense of employment security. When looking for work, we can find ourselves competing with many others who are highly qualified and experienced, causing stress related to the ability to provide for ourselves and our families. Career and work-related stress, particularly the loss of a job, can be a significant source of heightened anxiety. In general, the potential for developing anxiety-related conditions is increased during periods of severe and prolonged stressâ€"regardless of source. For example, some people discover they have GAD while going through a challenging life transition such as divorce or loss of a loved one. A Word From Verywell Not all GAD risk factors are in our control, but many are modifiable and manageable. There are effective strategies for coping with trauma and stress. If you think you are at risk or think you have GAD, take a step forward and reach out for assistance. There are professionals and other people willing to help! How Is Generalized Anxiety Disorder Treated?