For this post, I will outline all the different causes of anxiety. I will break my list into categories and sub-categories (note: there will be overlap – for example, emotional anxiety can cause cognitive anxiety. and ultimately every form of anxiety has biological manifestations).
1st we need to address the reality that Anxiety in 100% necessary for survival – it is impossible to have no anxiety, If you didn’t have anxiety you would not have an automatic system for avoiding danger. Anxiety is an effective mechanism which informs a person when change is necessary = Often it is not simply our job to ‘stop’ our anxiety… instead, it is our responsibility to listen to our anxiety to deduce a needed change.
note: for simplicity, I will be calling the complex neuro/biological network responsible for anxiety the – ‘anxiety system’.
The main sources of anxiety:
Health and Biological
Nutrition – What you ingest affects the neurotransmitters in your brain (both in creation and transmission) which impact the sensation of anxiety. Both your hormonal and neurological systems are impacted (and in many ways connected) to your digestive system = gut health directly impacts mental health. Studies have suggested that anti-oxidants and probiotics may impact anxiety. Many believe that in the process of human evolution our first neurological system was in our gut (intestines) – therefore, maintaining a healthy environment in our digestive system is crucial for our mental health. Additionally, what you eat can leave you more susceptible to other causes of anxiety listed below (example 1 – Ingesting too much caffeine can negatively impact your sleep = which is a major source of anxiety. Example 2, consuming food that is difficult for your digestive system to process can leave you lethargic, which can impact your social abilities and your motivation to engage in anxiety-reducing activities such as exercise). Lastly, having relatively stable blood sugar is correlated with reduced anxiety – this means that eating regularly and eating ‘easy to digest’ (not heavily processed) foods can help to manage anxiety.
Exercise – Exercise is necessary for the proper function of many biological systems including your cardiovascular system, respiratory system, and your central nervous system. Without exercise it is difficult to ‘reset’ your ‘fight or flight response’= this will leave you with more ‘alertness’ or ‘vigilance’ – When your system is in fight or flight mode – there are measurable effects such as shallow breath, increases heart rate, tense muscles and more adrenaline in your system. Exercise is one of the most effective mechanisms for 1.) a healthy central nervous system and 2.) helping your body to effectively transition between sympathetic (the ready for action state of being) and parasympathetic (the rest and digest state of being) systems. Additionally, Anxiety is a natural feedback mechanism for automatic bodily function – If you are having difficulty breathing or/and if you have an accelerated heart rate, you will experience anxiety as a biological notice for you to take reparative action – without proper respiratory and cardiovascular function, it is possible for you to feel anxiety from activities such as walking up the stairs. For many people, It is near impossible to not feel anxious without a regular exercise routine.
Sleep – Almost everything listed above under Exercise is also true for Sleep. It is relatively impossible to avoid feelings of anxiety without sufficient sleep (7 – 9 hours per night). To compensate for your fatigue, your body will utilize hormones to energize the body – this leaves you feeling anxious. Additionally, the proper function of most of your biological systems is impacted when you do not get enough sleep. Anxiety is your bodies natural way of letting you know that something isn’t right – If you don’t take care of your body it is natural for you to feel anxiety.
Breathing and Oxygen – The brain receives signals that we are drowning when it is not supplied with enough oxygen (with insufficient oxygen the sensation of anxiety occurs to inform your consciousness that there is a real problem. Often when people are having a panic attack, they exhale more than they inhale (unconsciously); this increases panic as they have too much CO2 and too little O2 in their system. During times of extreme emotions, it is common for people to engage in ineffective breathing patterns – this exacerbates our stress response and reduces our ability to engage rationally (with our cortex). Breathing impacts the central nervous system – certain breathing patterns can engage the ‘fight or flight’ system while other patterns can activate your parasympathetic (resting) system. In general, Breathing deeply into your abdomen (stomach area) reduces anxiety, while short quick breath into your chest increases anxiety (or vigilance – remember what we call ‘anxiety’ is not always a bad thing – If you are preparing for athletic competition you want to feel a little ‘anxious’).
Prolonged Stress – Stress Feedback Loop (burnout, unsafe environment, institutionalized oppression, abusive relationships etc.) – When a person is in a state of stress for a prolonged period of time, their stress creates a feedback loop, which begets more and more stress. In stressful situations, it is adaptive for our ‘anxious system’ (most notably the sympathetic nervous system and the amygdala) to activate in response to the stress to assist us in resolving the situation (fighting, running etc). During this time the body releases cortisol and other hormones such as adrenaline to 1.) assist us in taking action in the moment (increased blood flow to muscles and decreased blood flow to digestion etc) and 2.) to create and strengthen synaptic connections in the brain so that we are ‘faster’ at responding to the threat or stressor if it should come about again in the future. When the stress does not go away the body continues to release cortisol, which mylenates (makes more effective) synaptic connections which activate our ‘anxiety system’. If this continues for too long, basically anything in the environment can very quickly invoke an anxiety response = we are in a constant state of fight or flight = sympathetic activation. This type of anxiety requires a prolonged period of time in a safe environment with reduced stimulation to recover (this option is not available to all people – especially marginalized or oppressed group = community-wide social justice interventions are often necessary to reduce this form of anxiety). For other people, this means leaving an unhealthy relationship or quitting a job or creating better boundaries (turning off your electronics during rest time)etc.
Brain Hemispheric integration – when the left and the right hemisphere of the brains are well integrated – the synergistic relationship can help to manage anxiety. The left hemisphere is our logical and language center – the right hemisphere is our systemic, emotional and creative center. The left hemisphere requires the proper function of the right hemisphere to understand emotions (of the self and of another) the right hemisphere requires the language of the left hemisphere to narrate the emotions we experience. Studies have shown that the act of correctly identifying emotions reduces the felt impact of that emotion (ex. simple saying I feel guilty or embarrassed etc.). We need the right hemisphere to be aware of our anxiety, the left hemisphere to label the anxiety, the right hemisphere to create potential solutions to remedy the anxiety, and the left hemisphere to implement the details and linear strategies of the plan.
Trapped Tension or Energy – For centuries Eastern medicine has identified that the body stores anxiety and stress… many cultures believe that disease is caused by dis – ease or unresolved stress that is trapped in the body that needs assistance in being successfully released. Acupuncture and massage are two of the most well know and well-researched interventions for freeing trapped stress from the body. There are also somatic therapies (psychotherapies) which allow a person to re-experience traumatic events in a safe setting – this often involves mindfully noticing sensations in the body while allowing the body to ‘finish’ an action which was interrupted during the trauma (such as shaking uncontrollably).
Trauma – Some experiences in life are too extreme for the human condition to handle (this differs from person to person – some people might only require a slow car accident to experience trauma while others return from war zones without incident.) A traumatic event was never cataloged correctly in the brain – as such when there is an environmental trigger (‘reminder’) a person will feel as if the traumatic event is happening in the present moment. For most stressful incidents the memory of the event can still be anxiety provoking, but there is a felt sense that the stress was in the past. For a person who experienced trauma, the threat (stress) feels like it is happening in the now – this is emotionally very difficult and can be a source of constant anxiety (as you will always feel fear).
Secure Relationships – Humans have evolved for millions of years to be a relational animal. As such, many of our systems (especially the systems utilized for emotional regulation) require positive and secure relationships (vulnerable, authentic, emotionally and physically nurturing, supportive, attuned, compassionate) to function ideally. The most effective way to stay regulated is to be in the presence of a secure partner or caregiver. Studies have demonstrated that pain and fear (both related to anxiety) are significantly reduced when a person has a secure relationship present.
- There are 3 main methods of regulation: external regulation – when another person behaves in a way which offers you regulation (ex. a parent holding a child and swaying back and forth or when you receive empathy and compassion from your therapist). Self-regulation – When we engage in behaviors to regulate ourselves (ex. meditation, journaling or deep abdomen breathing), and inter-regulation -when we are regulated through a reciprocal emotionally intimate connection with another (this is often behavioral – such as having an emotionally connecting conversation, but inter-regulation will happen without additional action for people in a secure relationship. For example, simply sitting next to a loved one can have regulating effects). Humans have required secure bonds for survival for millions of years – because of this fact, relationships are thought by many (namely attachment theorist) to be basic needs for survival (like food water and shelter). If the body does not have access to a basic need it will activate the ‘anxiety’ system.
- In a secure relationship, partners can use empathy to understand their partner’s emotional reality – they then can offer compassion to nurture their partner’s emotions. Both partners will benefit from emotional intelligence to assist them in knowing themselves and knowing the need of the other.
Sex and Physical Touch – prolonged nurturing physical touch and consensual sex with a loved one release oxytocin, which reduces cortisol (responsible for perpetuating the stress feedback loop – above) and makes you feel more ‘safe and bonded’. Without regular touch, our bodies are left to manage anxiety without the influx of really helpful hormones. Sex is unbelievably helpful in promoting health in almost every variable one can think of – the positive biological, existential, and relational impacts are really useful in controlling anxiety. When Anxious, a prolonged hug (about 8 seconds or more) can assist in regulation. As many of us know, babies and young children require nurturing hugs to regulate; Though adults have other methods of regulation, are systems still favor nurturing contact with a loved one.
Attachment Style – The way that we were nurtured and cared-for by our early caregivers impacts how we engage in relationships as adults. There are three main styles. Secure – “I am confident in myself and in my partner to meet my needs”. Avoidant – “I am only confident in myself to get my needs met”. Anxious – “I am unsure about how my needs will get met, but I want you to do something.” People with an avoidant style will feel anxious if they have to rely on another person, and people who are Anxious tend to feel nervous about whether someone can or is willing to help them.
Boundaries – The ability to say ‘yes’ and ‘no’ in a way which best meets your needs is paramount to controlling unnecessary anxiety. We all have different stress threshold and levels of tolerance for certain activities or emotions etc. – our inability to monitor our needs and to set boundaries with our environment is one of the major sources of anxiety. Very often we stretch ourselves way too thin and can benefit from reducing responsibility (saying no). Other times we prioritize comfort instead of engaging in activities which would promote existential, physiological, or relational health (not saying yes).
Consciousness and Congruence
Attention – Attention is one of the main sources of Anxiety. What we place our attention on directly impacts our emotional systems. At any given point there are millions of things in the present moment that you can attend to (all of which will elicit a different emotion), additionally, there are a seemingly infinite amount of things that have happened in the past or could happen in the future that you can place your attention on. Lastly, the human brain does have limits to the amount of stimulus that it can successfully process – Often we are so inundated with stimulation that we feel anxious in response to the reality that we can not adequately categorize our environment (for survival reasons, your brain is responsible for categorizing everything in your environment as a threat, a pleasure, or neutral – this is a largely unconscious process). Placing your attention on a positive stimulus (or thought) can help you to manage anxiety.
Mindfulness – Almost everything that we feel anxious about it out of our control, already happened or is purely hypothetical. Mindfulness is the ability to place your consciousness in the present moment. In the present moment, there is very rarely anything to be anxious about (quantitatively there are very few minutes in your life where stressors are actually present – the rest of the time our minds are reminding us about stressors that happened and stressors that could happen.) Developing your ability to immerse yourself in the present moment (mindfulness exercises, yoga, meditation) is one of the most effective means of mitigating anxiety. Mindfulness also, ironically, would help us to know and understand the physiological, emotional and cognitive reality of our anxiety.
Thoughts, Beliefs, and Schemas – Often our attention is placed on our thought processes and the quality of our thoughts along without our attachment to our thoughts (or, conversely, our differentiation from our thoughts) impacts our anxiety. Cognitive Behavioral Therapy CBT is interested in helping people to identify dysfunctional thought patterns and addressing them with ration. The theory is also concerned with identifying core schemas that impact a great majority of our behavioral patterns. Schemas are essentially universal and rigid truths that we unconsciously use to guide our decisions and behaviors (ex. “Conflict is bad, I need to be liked by everyone, emotions are weak, strong people don’t depend on anyone else etc.)
Existential – Are you living a life which is congruent with who you really are? are you acting like you – or – are you being you (or are you being someone that you believe you are supposed to be that isn’t actually the ‘real’ you?) Existential Anxiety is your body and minds way of reminding you to be your self – we are all unique and have different paths towards feeling fulfilled – we all have a different purpose. Anxiety is the result of not living a life which embodies your core values and sense of meaning. If your life feels subjectively meaningless, you likely will feel quite a lot of anxiety.
Emotions – put simply, anxiety is fear (fear of failure, fear of impermanence, fear of abandonment, fear of harm etc.)… so all anxiety is related to emotions. When we ignore, avoid, deny, repress, or otherwise disregard our emotions we tend to have a low underlying anxiety. Much of this can be attributed to the fact that something important is not being attended to – some emotion is not being honored. And again, anxiety then is your bodies way of saying – please respect and acknowledge your emotional truth. Anxiety tells us what needs to be changed – our intuition and emotions give us the data needed to arrive at what change needs to take place. Becoming more aware and connected to your emotions is a great way of managing your anxiety. On the other hand, it is also very possible to be too enmeshed with our emotions – we can feel as though we Are our emotions instead of living a life in which we are Experiencing our emotions (ex. there is a huge difference between “I am sad” and “I feel sad”).
Intuition – your intuition is your automatic and largely unconscious implicit decision-making system – It is extremely intelligent – this system has the ability to provide decision making information (usually in the form of an emotion) from a large amount of data. Your explicit system, largely manually and conscious, is considerably slower in comparison and does not have the ability to process as many variables. Your intuition is therefore very often correct and is a more robust decision-making tool. (note: the system can be fooled by trauma, other life events, and intentional psychological manipulation – ex. political adds target your implicit system to manipulate your feelings and resulting decisions about candidates – so do many marketing campaigns). Anxiety is often felt when we ignore our intuition. This is because your brain ‘knows’ something that you are not consciously aware of. for example, if someone is trying to sell you a counterfeit item – your explicit system may have no way of deducing this, but you have a ‘gut feeling’ that something is wrong. Often times we experience anxiety because we are not conscious of, or do not have proof, something we ‘know’ to be true (ex. your kids are doing drugs, your friend is lying, your partner is having an affair, your job is planning on letting you go etc – again, sometimes our intuition is wrong, but sometimes it is correct, and our anxiety is the result of ignoring or denying.)
Nature – We evolved for millions of years to live within nature – for reasons not totally understood, being in nature has dramatic impacts on anxiety. Simply being immersed in nature is a natural (yes a pun!) solution. This likely means that the opposite is true = lacking regular access to nature is likely a cause of anxiety and depression.