Anxiety Disorders: Causes

Pathogenesis (development of disease)

The pathogenesis of anxiety disorders is not yet clear. It is thought to be multifactorial in origin, with social influences playing a role in addition to genetic ones. Traumatic life experiences, malconditioning, and neurobiologic dysfunction are discussed as possible etiologic factors.

Furthermore, a lowered arousal threshold of the limbic system with involvement of the amygdala and hypothalamus is suspected.

Anxiety disorders can be further divided into a primary anxiety disorder, as well as a form due to physical or mental illness.

The same pathomechanisms apply to generalized anxiety disorder (GAS).

Etiology (causes)

Biographical causes

  • Genetic burden from parents, grandparents (proportion of genetic factors in the development of anxiety disorders is about 30% to 65%)
    • At least four variants of the gene GLRB (glycine receptor B) are risk factors for anxiety and panic disorders.
  • Birth weight < 1,000 grams; a larger sample suggests that there is no persistent increased risk for anxiety disorders in infants born before 32 weeks’ gestation or at less than 1,500 grams
  • Disorder-specific developmental history: anxious, shy, passive, new situation-avoiding infants.
  • Living alone

Behavioral causes

  • Consumption of stimulants
    • Coffee, tea (caffeine)*
    • Alcohol (woman: > 40 g/day; man: > 60 g/day) [alcohol abuse].
  • Drug use
    • Amphetamines* e.g. Ectasy (synonym: Molly; MDMA: 3,4-methylenedioxy-N-methylamphetamine) or similarly acting sympathomimetics; metamphetamines (“crystal meth”).
    • Cannabis* (hashish and marijuana).
    • Hallucinogens*
    • Heroin
    • Inhalants, i.e. sniffing substances* .
    • Cocaine
    • Phencyclidine* (e.g. “Angel Dust”)
  • Overweight (BMI ≥ 25; obesity).

Disease-related causes

  • Diabetes mellitus
  • Almost any organic disease can lead to anxiety disorders
  • Non-treatable diseases often lead to anxiety disorders
  • Many psychiatric illnesses (e.g., depression, eating disorders) lead to anxiety disorders

Medication

Operations

  • Condition before or after major surgery

* Substance-induced anxiety disorder.