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Causes

By Mayo Clinic staff

As with many mental health conditions, the exact cause of anxiety disorders isn't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to becoming anxious. Inherited traits also are a factor.

Medical causes
For some people, anxiety is linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators that you have a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order lab tests and other tests to look for signs of a problem.

Physical problems that can be linked to anxiety include:

  • Heart disease
  • Diabetes
  • Thyroid problems (such as hypothyroidism or hyperthyroidism)
  • Asthma
  • Drug abuse
  • Alcohol withdrawal
  • Withdrawal from anti-anxiety medications (benzodiazepines)
  • Rare tumors that produce certain "fight-or-flight" hormones
  • Muscle cramps or spasms
  • Tingling, burning or prickling sensations that may have no apparent cause

It's more likely that your anxiety may be due to an underlying medical condition if:

  • Your anxiety symptoms started after age 35
  • You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder
  • You didn't have an anxiety disorder as a child
  • You don't avoid certain things or situations because of anxiety
  • No events have occurred in your life that were triggered by significant anxiety
  • Medications used to treat feelings of panic (such as benzodiazepines) don't ease your anxiety symptoms
Risk factors Symptoms
References
  1. Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed May 17, 2012.
  2. Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed May 17, 2012.
  3. Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed May 18, 2012.
  4. Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed May 18, 2012.
  5. Hicks D, et al. An approach to the patient with anxiety. Medical Clinics of North America. 2010;94:1127.
  6. Roy-Byrne PP, et al. Anxiety disorders and comorbid medical illness. General Hospital Psychiatry. 2008;30:208.
  7. Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed May 21, 2012.
  8. Lakhan SE, et al. Nutritional and herbal supplements for anxiety and anxiety-related disorders: Systematic review. Nutrition Journal. 2010;9:42.
  9. Natural medicines in the clinical management of anxiety. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 24, 2012.
  10. Kava linked to liver damage. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/news/alerts/kava. Accessed May 24, 2012.
  11. Mayo Clinic statement: Recommendations regarding the safety concern with citalopram (Celexa) therapy. Mayo Clinic. http://mayoweb.mayo.edu/mfpfc-cmte/1202citalopramStatement.pdf. Accessed June 5, 2012.
  12. Jacka FN, et al. Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry. 2010;167:305.
  13. Teschke R, et al. Risk of kava hepatotoxicity and the FDA consumer advisory. Journal of the American Medical Association. 2010;304:2174.
  14. Valerian. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/valerian. Accessed June 5, 2012.
  15. Miyasaka LS, et al. Passiflora for anxiety disorder. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004518.pub2/abstract. Accessed June 5, 2012.
  16. Support & programs. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?section=Find_Support. Accessed June 5, 2012.
  17. Getting support. Anxiety and Depression Association of America. http://www.adaa.org/finding-help/getting-support. Accessed June 5, 2012.
DS01187 June 30, 2012

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