Anxiety risk factors: who is more likely to have an anxiety disorder

What an anxiety disorder is

Feeling anxious is a normal part of life. Many people worry about things such as health, money, school, work, or family. Anxiety disorders involve more than occasional worry or fear: the anxiety does not go away, is felt in many situations, and can get worse over time (NIMH). The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships (MedlinePlus).

About a third of U.S. adolescents and adults experience an anxiety disorder at some point in their lives (NIMH). The main types are:

• Generalized anxiety disorder (GAD). People with GAD worry about ordinary issues such as health, money, work, and family, but their worries are excessive, and they have them almost every day for at least 6 months (MedlinePlus).
• Panic disorder. Frequent and unexpected panic attacks: a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger (NIMH).
• Phobias, including social anxiety. An intense fear of something that poses little or no actual danger, such as spiders, flying, crowded places, or social situations (MedlinePlus).

Who is more likely to have an anxiety disorder

The cause of anxiety is unknown. Factors such as genetics, brain biology and chemistry, stress, and your environment may play a role (MedlinePlus). Risk factors can vary by type: GAD and phobias are more common in women, while social anxiety affects men and women equally (MedlinePlus). MedlinePlus lists these general risk factors for all types:

• Certain personality traits, such as being shy or withdrawn in new situations or when meeting new people (MedlinePlus).
• Traumatic events in early childhood or adulthood (MedlinePlus).
• Family history of anxiety or other mental disorders (MedlinePlus).
• Some physical health conditions, such as thyroid problems or arrhythmia (MedlinePlus).

For generalized anxiety disorder, NIMH adds that GAD may run in families, and that external causes, such as experiencing a traumatic event or being in a stressful environment, may put a person at higher risk (NIMH). GAD develops gradually and usually starts in early adulthood, although it can occur at any age. Women are more likely than men to have GAD, and some women have it during pregnancy and the postpartum period (NIMH).

For panic disorder, it sometimes runs in families, often begins in the late teens or early adulthood, and is more common in women than in men (NIMH). Researchers are also looking at the ways stress and environmental factors play a role (NIMH).

Using caffeine, other substances, and certain medicines can make anxiety symptoms worse (MedlinePlus).

Signs and symptoms

The different types have different symptoms, but they all have a combination of anxious thoughts or beliefs that are hard to control; physical symptoms, such as a pounding or rapid heartbeat, unexplained aches and pains, dizziness, and shortness of breath; and changes in behavior, such as avoiding everyday activities you used to do (MedlinePlus).

People with GAD may worry excessively about everyday things, have trouble controlling their worries, feel irritable or "on edge", feel restless, have a hard time concentrating, have trouble sleeping or feel tired, and have headaches, muscle aches, stomachaches, or tension (NIMH). Children and teens with GAD often worry about school, activities, friendships, and the future, and may strive for perfection as a way to manage their anxiety (NIMH).

During a panic attack, symptoms may include a pounding or racing heart, sweating, chills, trembling, difficulty breathing, weakness or dizziness, tingly or numb hands, chest pain, and stomach pain or nausea (NIMH). A single panic attack is not a mental disorder; panic disorder may be diagnosed when attacks are recurrent and unexpected, with ongoing worry or behavior changes due to fear of future attacks (NIMH).

Conditions that often occur with anxiety

Some people with GAD also have depression, other anxiety disorders, post-traumatic stress disorder, chronic pain syndromes, cardiovascular problems, or suicidal thoughts or behaviors, and GAD is commonly associated with alcohol and substance misuse (NIMH). See depression risk factors and the alcohol screening (AUDIT-C).

Diagnosis and screening

A health care provider will ask about your symptoms and medical history, and may do a physical exam and lab tests to make sure a different health problem is not the cause. If you don't have another health problem, you will get a psychological evaluation (MedlinePlus). To be diagnosed with GAD, a person must find it difficult to control worry on most days for at least 6 months and have at least three of these symptoms: feeling restless or "on edge", fatigue, trouble concentrating, irritability, muscle tension, or problems with sleep (NIMH).

The GAD-7 anxiety screening is a 7-question questionnaire you can take here and bring to a provider; for ages 8 to 18, see anxiety screening in children and teens. A screening score is not a diagnosis.

Treatment and getting help

The main treatments for anxiety disorders are psychotherapy (talk therapy), medicines, or both (MedlinePlus). Cognitive behavioral therapy (CBT) is a research-supported type of psychotherapy commonly used to treat GAD (NIMH). Healthy choices such as reducing caffeine and getting enough sleep can reduce anxiety symptoms when paired with standard care, although a healthy lifestyle alone cannot replace treatment (NIMH).

If your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life, such as at school, at work, or with friends and family, it's time to seek professional help. A primary care provider can refer you to a qualified mental health professional (NIMH).

The 988 Lifeline is free and confidential and available 24/7 (988 Lifeline).

Related guides: eating disorders risk factors, OCD risk factors, ADHD risk factors and autism risk factors.

Common questions

Does anxiety run in families?

It can. A family history of anxiety or other mental disorders is a risk factor for all types of anxiety disorders (MedlinePlus), and both GAD and panic disorder may run in families (NIMH) (NIMH). A family history does not mean you will have an anxiety disorder.

Is it normal stress or an anxiety disorder?

Everyone feels stress from time to time, and occasional stress and anxiety are normal. If anxiety doesn't go away and begins to interfere with your daily activities, you may have an anxiety disorder (NIMH).

Can a panic attack be dangerous?

Panic attacks can feel like a heart attack, but panic attacks themselves are not life-threatening, and the physical symptoms usually resolve with time (NIMH). Chest pain can also have other causes, so new or unexplained chest pain needs prompt medical care. (General safety advice, not part of the NIMH text.)

Can anxiety occur with bipolar disorder?

Yes. Many people with bipolar disorder also have anxiety disorders (NIMH). See bipolar disorder risk factors.

Can anxiety occur with PTSD?

Yes. People with post-traumatic stress disorder (PTSD) often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders (NIMH). See PTSD risk factors.