Generalized Anxiety Disorder: Causes and Risk Factors

Generalized anxiety disorder can create significant disruptions in a person's life, but what exactly causes it? There is no single cause of generalized anxiety disorder, and evidence has shown that multiple factors influence the development of GAD. Some common factors include genetic predisposition, brain chemistry, family background, social influence, life experiences, and lifestyle behaviors.

Generalized anxiety disorder (GAD) is a condition marked by excessive, persistent worry. Understanding what causes this disorder can be helpful because it can help researchers and doctors determine which treatments might be most helpful.

Genetic Causes of Generalized Anxiety Disorder

Your genetics may play a role in determining whether or not you will develop GAD. As with many other mental and medical health conditions, a person can be genetically predisposed to 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 a person can have a genetic vulnerability to developing GAD if certain genetic markers have been passed onto them. Vulnerability, in combination with certain environmental factors, can trigger the development of symptoms.

First degree relatives would include family members most closely related to you, such as a parent, sibling, or 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 Differences in People with GAD

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 can be under the control of the "thinking" part of the brain, it can respond to stimuli on its own as well.

The Amygdala

The amygdala, in particular, is the part of the limbic system involved in the 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 people's ability to discern and feel fear, it may not be a surprise that imaging studies of people 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.

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 people with GAD 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.

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.

How Life Experiences Contribute to GAD

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 a person's 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 a person has gone through particularly hard experiences that leave them feeling uncertain, humiliated, or apprehensive about trusting others, it is understandable that they may become anxious in various situations in the future.

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 as this is information that can help lead to an accurate diagnosis.

Learned Behavior

Some behavioral scientists believe that anxiety is a learned behavior, suggesting that if a person has a parent or caregiver who demonstrates anxious behavior, they may tend to mirror that same anxious behavior.

Children learn how to handle challenging, stressful situations from caregivers and other important people close to them. When they model less effective methods of stressful management, children tend to do the same. These early social learning experiences can influence the development of long-lasting anxiety.

Societal Factors That Contribute to GAD

Evidence also suggests that social media exposure contributes to increased feelings of anxiety. Researchers are finding that the use of social media, particularly in excess, can greatly impact mental health, sometimes resulting in anxiety and depression.

People with GAD may be 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 nonverbal cues in communication, such as facial expressions, body language, and tone, potentially exacerbating GAD.

Lifestyle Factors That May Cause Generalized Anxiety Disorder

Additionally, lifestyle factors like the substances we use and our relationships can increase the risk of experiencing anxiety.

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

Relationships can be a source of great comfort, but also pain. Relationships can be a significant source of anxiety for women, in particular.

Research has shown that two factors contributing to 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 also 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 a person's sense of employment security.

When looking for work, you may find yourself competing with many others who are highly qualified and experienced, causing stress related to the ability to provide for ourselves and your family. Career and work-related stress, particularly the loss of a job, can be a significant source of heightened anxiety.

For example, some people discover they have GAD while going through a challenging life transition such as divorce or loss of a loved one.

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Risk Factors for Generalized Anxiety Disorder

Certain risk factors can increase the likelihood that a person may develop generalized anxiety disorder. These include:

• Being female: People who are assigned female at birth are more likely to develop GAD than those assigned male at birth. In general, women experience anxiety disorders at a higher rate than men (23.4% vs. 14.3%, respectively).
• Personality: If you have certain traits such as behavioral inhibition, neuroticism, and fearfulness, you have a greater risk of developing GAD.
• Stressful experiences: If you have a history of stressful or traumatic life experiences, your risk of developing GAD may be higher.
• Family history: If you have a family member with an anxiety condition, you may be more likely to develop the condition as well.

Can You Prevent Generalized Anxiety Disorder?

There is no surefire way to prevent generalized anxiety disorder. You cannot control all of the factors that cause the condition, including genetics, brain structure, and exposure to trauma.

While it is not preventable, there are things you can do to lessen its impact.

Recognize the Symptoms

Because GAD doesn't cause intense episodes of anxiety or panic attacks, people sometimes dismiss the symptoms. It's important to know the signs and when to reach out for help. Common symptoms of the condition include:

• Excessive, uncontrollable worry and anxiety about many things
• Fatigue
• Restlessness
• Difficulty concentrating
• Muscle aches and tension
• Irritability
• Trouble sleeping

Get Treatment

Seek treatment as soon as possible. This can reduce the impact that symptoms have on your life and prevent symptoms from worsening.

Treatment for GAD may include:

• Psychotherapy: Types of therapy that can be helpful include cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT)
• Medications: Different types of medication may be helpful, particularly when used alongside therapy. Medicines that may be used to treat GAD include antidepressants and anxiolytics.
• Lifestyle changes: Your doctor may also recommend certain lifestyle changes to help you cope with anxiety, such as avoiding caffeine, getting regular exercise, and joining an anxiety support group.
  

Care for Yourself

Use effective self-care practices to help reduce stress and anxiety. Make sure you are getting enough sleep, eating a balanced diet, and engaging in regular exercise. 

Use Relaxation Techniques

Different relaxation techniques can also help combat anxiety symptoms. Particularly effective strategies include deep breathing, yoga, and progressive muscle relaxation.

Keep in Mind

Not all GAD risk factors are in your 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.