Cause of Anxiety Disorders: Introduction
Anxiety disorders can present themselves in many ways and have many different causes. They can be mild or severe, general or specific to certain circumstances and they can have one or many different causative factors. They may be somewhat understandable or may be absolutely irrational.
When considering the causes of anxiety disorders there are a couple of things to keep in mind. The first is that although you may understand the cause of an anxiety disorder it may not be absolutely necessary in order to learn to cope with or diminish it. Many of the techniques used to deal with anxiety disorders such as relaxation, exercise, changing self-talk and mistaken beliefs and so forth do not really depend on understanding the underlying cause of the anxiety disorder. The second important factor is that frequently there is not one certain cause, there could be several or even many operating on several different levels. These different levels could include hereditary factors, biology, family background, experiences and even beliefs.
“Single Cause” Theories of Anxiety Disorders:
There are some experts in the field of mental health who see anxiety disorders as developing from a single cause. Often, this perspective is not very helpful in working with anxiety disorders as they may come from various biological and psychological considerations. This oversimplification may result in two different mistaken lines of reasoning referred to as the biological fallacy and the psychological fallacy. The biological fallacy refers to the usually mistaken belief that the anxiety disorder is caused specifically by an underlying biological or physiological imbalance in the brain or body or a specific dysfunction in a certain part of the brain. Frequently, we will hear advertisements and even individuals refer to their depression or anxiety disorder as a chemical imbalance. This is usually an oversimplification that fails to recognize the dynamic interplay between our brains and the environment that surrounds us.

The Biological Fallacy:
It obviously is helpful to know the physiological components involved in anxiety disorders, but it is not helpful to ignore the potential complexity of the disorder. You may ask yourself, “What caused the physiological disturbance?” It is a known fact that chronic stress and psychological conflict may cause the locus ceruleus to malfunction in panic disorder, for example. Also, it has been identified that chronically suppressed anger may change the serotonin (neurotransmitter or brain messenger) levels in the brain contributing to obsessive-compulsive disorder. Both of these causative factors may be more related to the environment and the way an individual is raised rather than any specific inherited physiological or biological factors. To say that these are just chemical imbalances is very much an oversimplification and really not very helpful in the treatment of anxiety disorders.
The Psychological Fallacy:
The psychological fallacy of the cause of anxiety disorder can be equally as mistaken as the biological fallacy. To say that a specific anxiety disorder such as generalized anxiety disorder or social phobia are as a result of being neglected or abused as a child, or related to any other negative childhood experiences may be very misplaced and even destructive to individuals and families. In order to consider that the environment has contributed to the manifestation of an anxiety disorder doesn’t mean that it’s necessary to exclude biological factors such as inherited characteristics and other physiological considerations.
Cause of Anxiety Disorders – Summary of the Psychological Fallacy and Biological Fallacy:
in summary, the idea that the cause of anxiety disorders is either strictly psychological or strictly biological neglects the whole interactive aspect of “nature versus nurture”. We interact with the environment and as a result the brain and body chemistry change. The physiological aspects can include vulnerability to anxiety disorders but to say which came first may be impossible to know. Consequently, a comprehensive approach to treatment from anxiety disorders may include a multidimensional approach as opposed to treating specific factors in isolation. An effective treatment approach may include a consideration of biological, behavioral, mental, interpersonal, and even spiritual factors for lasting, meaningful treatment to take place.

Cause of anxiety disorders – Additional considerations:
In addition to the physiological and psychological aspects, some additional considerations include the time period over which anxiety disorders develop and are maintained. There are some factors which are considered to be predisposing factors, which may be inherited or experienced early in childhood making you more vulnerable to anxiety disorders. Others may be maintaining causes or triggering causes which are factors that continue the anxiety disorders going forward into your life.
In the Anxiety and Phobia Workbook Third Edition, Edward J. Bourne, Ph.D. has provided a list of the causes of anxiety disorders:
Causes of Anxiety Disorders:

I. Long-Term, Predisposing Causes
A. Heredity
B. Childhood Circumstances
1. Your parents communicate an overly cautious view of the world.
2. Your parents are overly critical and set excessively high standards.
3. Emotional insecurity and dependence.
4. Your parents suppress your self- assertiveness.
C. Cumulative Stress Over Time

II. Biological Causes
A. Physiology of Panic
B. Panic Attacks and the Noradrenergic Hypothesis
C. Generalized Anxiety and the GABA/Benzodiazepine Hypothesis
D. Obsessive-Compulsive Disorder and the Serotonin Hypothesis
E. Medical Conditions That Can Cause Panic Attacks or Anxiety
III. Short-Term Triggering Causes
A. Stressors That Precipitate Panic Attacks
1. Significant Personal Loss
2. Significant Life Change
3. Stimulants and Recreational Drugs
B. Conditioning and the Origin of Phobias
C. Trauma, Simple Phobias, and Post-Traumatic Stress Disorder
IV. Maintaining Causes
A. Avoidance of Phobic Situations
B. Anxious Self-Talk
C. Mistaken Beliefs
D. Withheld Feelings
E. Lack of Assertiveness
F. Lack of Self-Nurturing Skills
G. Muscle Tension
H. Stimulants and Other Dietary Factors
I. High-Stress Lifestyle
J. Lack of Meaning or Sense of Purpose
Cause of anxiety disorders: Conclusion
While the above list of the “Cause of Anxiety Disorders” is comprehensive it is not exhaustive of all the factors that may be considered when doing a diagnosis and trying to determine effective treatment of a specific anxiety disorder for a specific individual.
Some information adapted from the Anxiety and Phobia Workbook Third Edition, Edward J. Bourne, Ph.D. by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist).