Does Anxiety Run in Families? Hear From an Expert

Is anxiety genetic, or is it caused by life circumstances? The answer isn’t always straightforward. Keep reading to learn more.

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If you’re one of the ~40 million people in the U.S. living with anxiety, you may be wondering: what caused it? Whether you have generalized anxiety disorder, panic disorder, social anxiety disorder, or another form of anxiety, the answer to this question is rarely straightforward. But pinpointing a single cause isn’t so easy. Is anxiety genetic? Environmental? Both? Keep reading to learn more.

Is anxiety genetic or environmental?

Anxiety disorders are generally caused by a combination of genetic and environmental factors. While everyone experiences anxiety at times, anxiety disorders involve persistent, excessive fear or worry that interferes with daily life. Whether someone develops an anxiety disorder depends on various things.

“Anxiety disorders are rarely caused by a single factor, but rather by a complex, dynamic interplay between genetic predispositions and environmental triggers,” says Nicole Lonano, M.S., a Group Facilitator at Charlie Health. 

This interplay is known as epigenetics — the way your environment can influence gene expression. “Genetics contributes to a predisposition for anxiety, but environmental factors and gene-environment interactions determine if an anxiety disorder develops,” Lonano explains. 

So, you may inherit a vulnerability to anxiety, but your lived experiences often determine whether that vulnerability shows up. This means that even if one or both of your parents have an anxiety disorder, it does not mean you will definitely develop one, too. A genetic predisposition is not a guarantee of developing any mental health condition.

The role of genetics in anxiety disorder

Anxiety is not solely caused by genetics, but genetics certainly can play a role in whether someone develops an anxiety disorder. 

Family history of anxiety disorders is one of the biggest predictors of developing an anxiety disorder. Research suggests a two-fold increased risk of developing anxiety if a first-degree relative (parent or sibling) has an anxiety disorder. Having two first-degree relatives increases your risk even more.

Genes related to anxiety

Additionally, anxiety disorders are not caused by one specific gene. “It is a polygenic condition, meaning many genes with small effects, rather than one single gene, contribute to risk,” Lonano explains. 

Research on the genetics behind anxiety is still evolving, but scientists have identified some genes and genetic variants that play a role in anxiety.

According to the American Psychiatric Association, one of the recognized genetic variants contributing to anxiety disorder risk is the serotonin transporter polymorphism (5-HTTLPR). Other genes researchers have studied include neurotrophic genes (such as BDNF) and genes related to the hypothalamic-pituitary-adrenal (HPA) axis.

Additionally, Yale researchers studied genetic profiles of around one million people around the world and identified a whopping 100 genes that may be related to anxiety. 

Is social anxiety genetic?

Yes, there is a genetic component to social anxiety disorder. However, genetic factors aren’t the only determinant. As with any other anxiety disorder, other factors come into play.

Genome-wide research has found that social anxiety is heritable, but having a relative with social anxiety disorder doesn’t mean you are guaranteed to have it. 

Environmental influence plays a big role, too. For example, if someone experiences a traumatic event or was persistently bullied, these factors could trigger or worsen social anxiety.

Environmental factors that can increase the risk of anxiety

While genetics may increase someone’s vulnerability to developing an anxiety disorder, environmental stressors often act as triggers. These experiences can shape how someone perceives danger, regulates emotions, and copes with stress.

1. Learned behavior and modeling

While not exactly genetic, environmental factors related to family contribute to learned behavior. “Children often observe and imitate the behaviors of their caregivers, adopting similar, anxious responses to threats or stress,” Lonano says. 

For example, if you grew up seeing a parent constantly worry about worst-case scenarios or avoid certain situations out of fear, you might have inadvertently learned to respond to stress in similar ways.

2. Adverse childhood experiences (ACEs)

ACEs are traumatic events that happen in childhood that can have long-lasting effects on someone’s mental health. “Abuse, neglect, parental separation, or loss of a parent during childhood can significantly increase the risk of anxiety disorders,” Lonano says. 

Additionally, research shows that if you have experienced four or more ACEs, you have a significantly higher risk of developing anxiety. 

3. Trauma

Experiencing trauma later in life can also trigger anxiety. This may include natural disasters, violent events, or personal traumatic events, Lonano says. 

In some cases, trauma may also lead to post-traumatic stress disorder (PTSD). This disorder commonly includes severe anxiety symptoms such as hypervigilance, always feeling on edge, and panic attacks.

4. Chronic socioeconomic stress

“Living in poverty, financial instability, unemployment, and lack of educational opportunities are major contributors [to anxiety],” Lonano says. Additionally, socioeconomic stressors are also linked to housing instability, another risk factor for anxiety. 

5. Discrimination and marginalization

Discrimination — due to race, gender, or sexual orientation — is a risk factor for anxiety, Lonano says. A survey of almost 30,000 U.S. adults found significantly higher risk of anxiety (as well as co-occurring anxiety and depression) in those with high exposure to discrimination. 

Biological and health-related causes of anxiety disorders

Outside of environmental and genetic factors, there are some other biological causes of anxiety disorders, including the following. 

1. Brain chemistry imbalances

Multiple brain chemicals, known as neurotransmitters, contribute to anxiety and how we regulate it. These include serotonin, dopamine, norepinephrine, and gamma-aminobutyric acid (GABA). Lonano says that when these neurotransmitters are dysregulated, it can disrupt mood and anxiety regulation. “A deficit in GABA, for example, can make it difficult to calm the nervous system, while lower serotonin levels are closely linked to heightened anxiety,” she explains.  

2. Hormonal imbalances

Thyroid problems, such as hyperthyroidism, can trigger severe anxiety, Lonano says. Hyperthyroidism occurs when your thyroid gland is overactive and produces too much thyroid hormone. On top of anxiety, it results in symptoms like a fast heart rate, weight loss, insomnia, and shakiness. 

Additionally, Lonano says that other hormonal imbalances related to adrenaline or cortisol can cause the body to remain in a constant fight-or-flight state, also resulting in feelings of anxiety.

3. Neurological conditions

Conditions that affect the brain may cause or worsen anxiety, Lonano says. These include:

• Strokes
• Epilepsy
• Multiple sclerosis (MS)
• Dementia
• Traumatic brain injuries

4. Substance use

Substance use can both trigger and worsen anxiety symptoms. Drugs like alcohol and nicotine can dysregulate your brain chemicals. In some cases, you may feel like alcohol or drugs temporarily reduce your anxiety, but over time, they can make symptoms worse, creating a vicious cycle.

What is the treatment for anxiety disorders?

No matter the cause of your anxiety, treatment is available to reduce symptoms and improve your quality of life.

For many people with anxiety, the best results come from a combination of psychotherapy and medications, Lonano says. Some of the most common therapy modalities for anxiety are:

• Cognitive behavioral therapy (CBT)
• Exposure therapy
• Acceptance and commitment therapy (ACT)
• Dialectical behavior therapy (DBT)
• Compassion-focused therapy
• Eye movement desensitization and reprocessing (EMDR)

Antidepressants can also help relieve anxiety symptoms by impacting the neurotransmitters related to the disorders. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are often the first line of medication-based treatment, Lonano says. 

Additionally, lifestyle changes are important for coping with anxiety. Lonano recommends getting regular exercise and practicing mindfulness, for example. Other lifestyle changes that can help with anxiety include:

• Getting enough sleep 
• Quitting smoking
• Eating a healthy, whole-foods-based diet
• Avoid (or limit) caffeine and alcohol
• Staying connected to friends and loved ones

How Charlie Heath can help

If you struggle with an anxiety disorder, Charlie Health is here to help. Our virtual Intensive Outpatient Program provides personalized services for people with serious mental health conditions, including anxiety disorders like generalized anxiety disorder, panic disorder, separation anxiety disorder, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your well-being is possible. Fill out the form below or give us a call to start healing today.