What causes generalized anxiety disorder (GAD)?

Dr. Jeanne Morrison, PhD
Family Practitioner

Doctors are not exactly sure what specifically causes generalized anxiety disorder. Researchers believe it may be linked to genetic factors, stress, or environmental factors like learned behavior. It is also possible that the condition is a product of imbalanced levels of neurotransmitters in the brain, specifically serotonin, dopamine, and norepinephrine. Generalized anxiety disorder is quite common, and may be caused by a combination of factors.

You may wonder why you are anxious. Is it something that you have done (or not done)? Are you at fault? Although you may feel your worries are all psychological, in fact an underlying biological condition may be triggering these feelings. Research indicates there are genetic and biological reasons that may explain why you experience feelings of anxiety. You may have inherited a brain neurotransmitter imbalance or a misguided adrenaline trigger. These are simply chemical imbalances in the body that can be safely and easily controlled with medications.

There also are environmental factors that may contribute to anxiety. People with anxiety disorders often report having parents who were overprotective or controlling. Childhood separation anxiety, shyness, and limited social interaction also are associated with anxiety. Stressful events such as the death of or separation from a loved one, the loss of your home or business (such as in a fire or natural disaster), illness and marital conflict may precipitate the onset of anxiety disorders.

Common stimulants such as nicotine, caffeine, some nonprescription (over-the-counter) decongestants and appetite suppressants may trigger your feelings of anxiety. For some people, even a minimal amount of caffeine or nicotine can increase anxiety levels.

Fortunately, there are very effective treatments available, including psychological, medicinal and self-care methods, for anxiety disorders. The first step is to learn more about anxiety and to identify if you have GAD.

Dr. Marni Feuerman, LCSW, MFT
Marriage & Family Therapy

It is thought that a number of factors, including genetics, brain chemistry, and environmental stressors appear to contribute to development of generalized anxiety disorder, also known as GAD.

Genetics: Some research suggests that family history plays a role in increasing the likelihood that a person will develop GAD, therefore, the tendency to develop GAD may be passed on in families.

Brain chemistry: GAD has been associated with abnormal levels of certain neurotransmitters in the brain. Neurotransmitters are special chemical messengers that help move information from nerve cell to nerve cell. If the neurotransmitters are out of balance, messages cannot get through the brain properly. This can change the way the brain reacts in certain situations and possibly lead to anxiety.

Environmental factors: Trauma and stressful events, such as abuse, sudden loss, divorce, changing jobs or schools, may be examples of things that lead to GAD. GAD also may become worse during periods of stress. The use of, and withdrawal from, addictive substances, including alcohol, caffeine and nicotine, can also worsen anxiety.

The exact mechanisms that cause generalized anxiety disorder (GAD) are not yet well understood. Biological, environmental, and psychological factors all contribute to the development of GAD. Biological factors, including a genetic predisposition to GAD, as well as alterations in brain chemistry, may increase your risk of GAD.

Research into environmental factors suggests that traumatic events in early life can make a person vulnerable to anxiety disorders. Parenting style, family environment and culture may influence susceptibility to GAD. Traumatic and stressful events, such as abuse, the death of a family or friend, or divorce, may contribute to GAD. In addition, the use of and withdrawal from addictive substances (alcohol, caffeine and nicotine), which are often used to “self-medicate,” can further increase anxiety.

Many psychological factors also appear to play a role in the development and maintenance of GAD. One of these factors is intolerance of uncertainty. Research also shows that people with GAD have greater difficulty dealing with uncertainty than individuals with other anxiety disorders and people from the general population.

The general consensus is that psychological factors like intolerance of uncertainty interact with biological and environmental factors in leading to the development and maintenance of GAD. Other factors may also contribute to the disorder:
  • built-up stress
  • coping with a serious or prolonged physical illness
  • a personality type of disorder that is more prone to anxiety
  • an anxiety disorder in your family
  • specific medical conditions

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.