Causes of Anxiety Disorders


Anxiety disorders develop from a complex interplay of genetic, biological, cognitive, developmental and other factors, such as personal, socio-economic and workplace stress. A variety of theories has been proposed to explain how these factors contribute to the development of anxiety disorders.
The first is experiential: people may learn their fear from an initial experience, such as an embarrassing situation, physical or sexual abuse, or the witnessing of a violent act. Similar subsequent experiences serve to reinforce the fear. A second theory relates to cognition or thinking, in that people believe or predict that the result of a specific situation will be embarrassing or harmful. This may occur, for example, if parents are over-protective and continually warn against potential problems. A third theory focuses on a biological basis. Research suggests that the amygdala, a structure deep within the brain, serves as a communication hub that signals the presence of a threat and triggers a fear response or anxiety. It also stores emotional memories, and may play a role in the development of anxiety disorders. The children of adults with anxiety disorders are at much greater risk of an anxiety disorder than the general population, suggesting that genetics may play a role as well. Numerous studies have also confirmed that neurotransmitters in the brain, such as serotonin, norepinephrine, as well as hormonal factors influence the onset and course of anxiety disorders.






Recovery from Anxiety Disorders



Early recognition and appropriate management are imperative to the enhancement of the quality of life of individuals with anxiety disorders. Proper recognition and management also help to prevent common secondary disorders, such as depression and problematic substance use. Several factors, such as stigma, lack of knowledge or personal financial resources, or lack of available health professionals, may discourage people from seeking help for anxiety disorders. In addition, family physicians may not always recognize the pattern in an individual's symptoms that would lead to a correct diagnosis. Too often, symptoms are not taken seriously and an individual with an anxiety disorder is labelled as being emotionally unstable. Education of both the public and family physicians would help to solve this problem.

A recent review of anxiety disorders research suggests that effective treatments include drug therapy (usually with anti-depressants or antianxiety drugs) and cognitive-behavioural therapy, which helps people turn their anxious thoughts into more rational and less anxietyproducing ideas and encourages them to confront feared situations and eliminate various safety behaviours. Support groups for individuals and families can also help develop the tools for minimizing and coping with the symptoms. Anxiety disorders can be well managed in the primary care setting. Creating access to experts in cognitive-behaviour therapy through a sharedcare model can help family physicians provide optimal care for the individuals under their care.
According to the 2002 Mental Health and Wellbeing Survey (CCHS 1.2), 3 of 5 individuals with one of the selected anxiety disorders reported that they did not consult a health professional about their condition. (Figure 5-8) The most commonly consulted professional was the family doctor, followed by a psychiatrist, social worker or psychiatrist.
Source: Statistics Canada, Canadian Community Health Survey, 2002, Mental Health and Well-being Cycle 1.2