In 2016, I began treatment for generalized anxiety disorder. In truth, I should’ve gotten treatment years sooner, but I had no idea what was going on with me. I decided to self-medicate with alcohol instead. What caused my anxiety? How did I let things get so bad?
As it turns out, there are numerous causes and factors that lead to anxiety disorders in human beings. Often times it isn’t just one thing that does it, but a perfect storm of genetic and environmental factors that come together to wreak havoc on the lives of men and, mostly, women.
What Is Anxiety?
It’s important to distinguish between anxiety, a general emotion that all human beings experience, and anxiety disorders. Normal anxiety is your body’s natural response to stressors. It’s worrying about a test or how you’re going to pay your mortgage after losing your job.
Anxiety becomes disordered when it is severe, chronic, and debilitating. People with Generalized Anxiety Disorder (GAD) are plagued by persistent worry, that is usually disproportionate to what the event actually warrants. It’s worrying about worrying, an inability to relax or let the worry go.
It is (and I speak from personal experience here) incredibly exhausting. My mind can be a ridiculous place. I have to constantly bat away worse-case-scenarios that seem to run on autopilot in my brain. There are things that shouldn’t stress me out, that do – to the point where I shut down completely.
Want a good laugh? Time me trying to make a decision in the beauty aisle as I shop for a new face wash.
The Many Types of Anxiety Disorders
Unfortunately for many anxiety sufferers, this condition is a package deal. So many types and you’re likely to have more than one! The Baskin-Robbins of mental health disorders if you will.
The website Anxiety.org is a fantastic resource for all things anxiety, but I will give you a brief summary of SOME of the different types of anxiety here. (There are many and I will let you peruse on your own if you’re interested.)
1. Social Anxiety Disorder
This is defined as “excessive fear of becoming embarrassed or humiliated in social situations, which often leads to significant avoidance behaviors.” It is NOT being shy. For whatever reason, social anxiety has started to become the “it” problem that self-proclaimed lifestyle gurus are trying to fix these days and most of them have it all wrong.
Please understand that this disorder goes beyond feeling uncomfortable in social situations. It is debilitating fear that impacts those who suffer from it every single day and requires counseling to cope.
Thanks for coming to my Ted Talk.
2. Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) is a psychiatric disorder characterized by a constant sense of worry and fear that interferes with daily life. People with Generalized Anxiety Disorder may experience feelings of dread, distress, or agitation for no discernible reason – psychiatrists refer to this unexplained, trigger-less anxiety as “free floating anxiety”.
“Free floating anxiety” has an almost peaceful ring to it, doesn’t it? Oh, the irony! I suffer from this one, and though I lead a relatively normal life, I’m constantly relying on valuable tools and coping strategies to manage the ongoing worry in my head. The kicker is that most of us know that what we’re worrying about is ridiculous, but we just can’t seem to find the permanent off-switch.
3. Panic Disorder
Also me, though not as bad as a lot of people. This disorder applies to panic or anxiety attacks. Think Randall in This Is Us.
What most people get wrong about these attacks is that they usually aren’t triggered by any specific event. The Hollywood version often goes something like this: a person encounters a stressful situation, sweat beads form on the head, now must suddenly breathe into a bag.
Panic attacks are random. My attacks have occurred while mindlessly checking e-mail or walking around the mall. There’s no rhyme or reason to them, which leads many sufferers to constantly worry that an attack could come on at any minute.
What do panic attacks feel like?
A little like dying. You might sweat, get numb, feel faint, or have a racing heart that feels like a heart attack (or what you envision a heart attack to feel like). My attacks always start with seeing spots like I just looked directly at the flash of a camera, followed by my ears getting warm, and then I can’t see straight. Then, the elephant sits on my chest.
It’s not fun.
4. Obsessive Compulsive Disorder (OCD)
This one completes my own personal trifecta. Most people have some familiarity with OCD, though perhaps not a complete picture of the disorder.
It is defined as “Repeated and persistent thoughts (“obsessions”) that typically cause distress and that an individual attempts to alleviate by repeatedly performing specific actions (“compulsions”). ”
For some, this can seem a little extreme – like believing if they don’t tap the refrigerator door three times before opening it, something horrible will happen. I remember when I first heard about OCD in the mid-’90s. It was after the host of Double Dare, Marc Summers, came out to talk about the disease and how his wife found him lying on the floor of their living room straightening the fringe of their rug.
Crazy right? Little did I know that twenty years later, I would end up suffering as well. I didn’t/don’t have it nearly as bad as some, including Marc Summers, but I eventually fell victim to the “checking” compulsion.
It’s really no wonder that these behaviors started right around the time I started drinking heavily at least five days out of the week.
My Personal OCD Hell
At my worst, it took me about twenty minutes to leave my apartment for work because I was CONSTANTLY checking that my stove was off. I was terrified that I would burn my apartment down. Depending on what kind of morning I was having, I would check 5-10 times in the apartment before mustering up the courage to actually leave.
Then, I would lock my door, which (you might guess) required more checking. I tested the doorknob to make sure it was locked a couple times, then headed down the stairs (I lived in a walk-up). I would often stop midway to go back up and check the handle again. Sometimes I would open the door to check ONE MORE TIME that the stove was off, go back outside, and repeat.
On REALLY bad days, I would actually get outside of my building and start heading towards the subway, only to turn around and run back up to the apartment and check that damned stove again. Suffice it to say, this was not a particularly punctual period in my life.
I’ve mostly beaten this one, but every now and again, I catch myself getting out of bed to double check that the stove is off. (Why is it always the stove? No idea.)
5. Post-Traumatic Stress Disorder (PTSD)
This is another one that most people are familiar with, although it is just one of several stress-related anxiety disorders. According to Anxiety.org, PTSD is defined as:
(T)he development of certain trauma-related symptoms following exposure to a traumatic event (see “Diagnostic criteria” below). While most people experience negative, upsetting, and/or anxious reactions following a traumatic event, a diagnosis of PTSD is made when symptoms and negative reactions persist for more than a month and disrupt daily life and functioning.
Again, it is important to note that EVERYONE experiences stress from trauma-related experiences, but not everyone experiences PTSD. As is the case with most anxiety disorders, the difference between having a normal, emotional reaction to an event and an actual disorder generally boils down to the duration of the of the symptoms and the degree to which they disrupt daily life.
And that is NOT to diminish the very real and painful everyday experiences and emotions that we face. Severe grief, anguish, and stress are real for all of us. I just want to be clear that not all intense emotions qualify as disorders (and honestly, you should prefer it that way. Disorders suck.)
What Causes Anxiety?
Instinctively, we might think that difficult life situations lead to anxiety, and eventually, anxiety disorders, but it’s actually far more complicated than that. Here are 9 different factors that can cause anxiety and anxiety disorders.
In the ongoing battle of nature versus nurture, our mental health continues to be (at least partially) subject to our DNA. Total bummer, but that’s just the reality.
Clinical studies have shown that genetic factors account for somewhere between 30-67% of anxiety disorders. This is why your doctor will ask if there is a family history of anxiety or mental health issues in your family.
2. Parental Behavior
If you grew up in a household where your parents demonstrated high levels of control when they interacted with you, you may be at an increased risk for developing anxiety disorders.
Parents who also demonstrated anxious behaviors around their children or rejection of their children also contribute to an increased risk of developing anxiety disorders.
This is because of the highly adaptive nature of our brains, particularly when we are young and still developing. Early childhood experiences greatly impact the development of neural responses within the brain. A study by Dr. Kristin Buss at Penn State showed that highly fearful preschoolers who demonstrated heightened responses to making errors were often subjected to harsh parenting styles as toddlers.
Because the brain is malleable, thankfully, much of this damage can be undone through meditation and therapy.
3. Experiencing Stressful Life Events or Chronic Stress
Whereas stress is a normal part of everyday life, exposure to chronic stress is not and CAN lead to more serious, anxiety disorders. Examples of this include, but are not limited to: emotional or physical abuse, neglect as a child, loss of a parent, being bullied or socially excluded.
With the advent of social media, online bullying, and more cases of young people and children taking their own lives, we need to pay attention and start treating these issues with the seriousness they deserve. I honestly think if I read one more article about a seven or eight-year-old child committing suicide after months or years of being bullied, my heart might explode. But I digress.
What some people try to brush off as normal childhood experiences or “kids being kids” must be reframed in the minds of the adults who are tasked with the overall wellbeing of children. Schools, parents, and other stakeholders in the community need to understand the long-term impact these traumas can have on young people.
Why This Is Near And Dear To My Heart
This is one cause I am certain applies to my own battle with anxiety and depression. I was bullied relentlessly from middle school (approximately age 11) until high school (age 17). I was a liberally minded White girl with Black friends in a predominately White, working-class Indiana school where racism was widely accepted (and still is, frankly).
We clashed. The boys harassed me, called me the n-word, or n-word lover, physically intimidated me, drew KKK paraphernalia on my books and locker, flashed the Sieg Heil salute at every chance they got and draped themselves in Confederate flag garb to get a rise out of me or anyone else who might care. It was constant and because they were the “popular” boys, my so-called friends never stood up for me. Hell, they dated and, in some cases, married these guys. The school also did nothing about it and the impact of their abuse stayed with me long after I graduated.
I am NOT looking for sympathy. Kids experience way worse than me on a daily basis. But this was my experience with bullying and I know that I experienced a lot of mental health struggles during and after as a result.
A Note About Chronic Stress
Chronic stress is hard to talk about because the ability to escape it, to a large extent, can be a matter of privilege. TO THE GREATEST EXTENT POSSIBLE, we all need to work to eliminate sources of chronic stress from our lives.
I worked as a middle school teacher for 14 years, which was approximately 13.5 years too long. If you’ve ever been an educator, you already know what kind of high-stress, high-demand job this can be. I worked in schools where the kids were dealing with pretty big battles of their own and I struggled to meet their needs.
I did not know how much this job had impacted my mental health until I finally resigned in June 2018 and started writing fulltime. Of course, I knew it stressed me out, but I didn’t realize the extent to which it was exacerbating my mental and physical health issues.
Now, I can honestly say, that this is the happiest I have been in my life. If you are stuck in a situation, whether it be professional or personal, that is sucking the life out of you, and you have the ability to get out of it, please do. If it means taking a pay cut or starting over in a new career, and you’re able to swing it, do not be afraid of making that leap.
My family is currently living on %40 of the income we were making when I was teaching, so our lifestyle has changed, but I am a better person and parent as a result so it’s been worth it.
There is no benefit to hanging on to a job that is killing you.
This one is connected with chronic life stress, but it’s worth highlighting that having lower access to socioeconomic resources and/or being a member of a minority group increases your risk of developing anxiety orders. There’s nothing innate about these groups that causes this. Rather, it is the chronic stress associated with being members of these groups which heightens the risk.
This one was a little shocking to me, but here are some diseases that have been linked to anxiety symptoms. They are thyroid disease, menopause, heart disease, diabetes, and sleep conditions like insomnia.
6. Drug & Alcohol Abuse
I’ve written about the connection between alcohol abuse and anxiety before, but it bears repeating. Drug and alcohol abuse impact the chemistry of your brain in ways that leads to very bad things, including anxiety disorders. It’s a little chicken and egg. Did you start abusing drugs and alcohol because you suffer from anxiety or do you suffer from anxiety because you started abusing drugs and alcohol?
Who’s to say?
What IS clear is that you need to deal with both if you’re going to have a chance at living a healthier, sober lifestyle. I could go into bigger detail about the impact of drugs and alcohol on your brain chemistry but this article is already incredibly long so I will leave that for another day.
It should seem a bit intuitive though, no? Oh, cocaine use leads to anxiety? Go figure!
I know this one is gonna hurt a few feelings, but guys…excessive tobacco use increases your risk of anxiety.
First, let me say that I 100% get it. I used to be a HEAVY smoker. I smoked when I was stressed, which was all the time. Smoking relieved that stress for about thirty seconds. The sad truth of it all is that smoking actually increases anxiety in the long term.
I have the utmost sympathy for folks stuck in the cycle of, “I smoke because I’m stressed, but quitting also makes me stressed. Oh my god. This horrible.”
It. Gets. Better. I promise. But you really should quit.
This one is obvious, right?
Sorry ladies, but we don’t fare so well in the anxiety department. Women are twice as likely as men to suffer from anxiety disorders. Why?
Apparently, we have ovarian hormones, like estrogen and progesterone, to thank. The average onset of anxiety in us lucky gals is around 31 years of age, which is approximately the time I started checking my stove 29 times before going to work in the morning.
What Should You Do If You Think You May Be Suffering From An Anxiety Disorder?
1. See a trained professional.
You can visit your primary care physician or a therapist who specializes in anxiety disorders.
2. Do NOT be afraid of medication.
If your doctor thinks medication is best for you, and you aren’t too sure, get a second opinion. If THAT doctor also thinks medication is the best choice for you, then try it. Do not listen to “internet health gurus” when it comes to making serious decisions about your health.
It may be that medication doesn’t work for you at all, but you need to try it for yourself, under the supervision of a trained medical professional. It doesn’t mean you’ll be on it forever, but it might be what you need RIGHT NOW.
I say this as someone for whom medication has played an integral roll in my own recovery. I am NOT, however, suggesting that it is necessary or right for everyone – only that a medical professional should be assisting you with the decision.
(I’m going to show a video of someone who disagrees slightly with me on this because I am not a therapist and it is important to hear a variety of perspectives)
3. Go to therapy.
Cognitive Behavioral Therapy has worked wonders for many anxiety sufferers. Depending on the root causes of your anxiety, you may need talk therapy to work through past traumas. If you have access, please make an appointment.
4. Find a supplemental anxiety management regimen that works for you.
Whether it’s meditation, exercise, or knitting class, find something that can help you manage your emotions in healthy ways. Meditation is an important tool for reshaping your brain to better deal with stress, and exercise is scientifically proven to lower stress and help stabilize mood.
These are things you need in your life, so get to it!
Don’t Be Discouraged
This stuff is hard and it takes time, but you will start to see improvements. Mental health issues do not heal overnight and anyone who’s trying to sell you a “5 Easy Steps to Beat Depression Today!” is full of shit.
You WILL get better if you do the work and a month or two from now, you’ll wake up and think, “Okay, I’m starting to see the light a little.”
Recovery is not a straight line. You’re going to have good mental health days, and bad. The goal is to get the tools you need to manage these ups and downs in healthier ways that won’t further compromise your wellbeing.
I’ll provide more tips on this in future posts, but for now, please enjoy these additional resources.