What Causes Anxiety?

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 20, 2021

what causes anxiety

What Causes Anxiety?

Anxiety is caused by apprehensive behavior. Behavior is defined as the ways we think and act. Therefore, we cause anxiety when we behave in anxious ways.

Worry – imagining something bad or unpleasant might happen – is an example of apprehensive behavior that causes anxiety.


We can arrive at the above conclusion based on the following rationale:

Anxiety is defined as:

  • A state of uneasiness and apprehension, as about future uncertainties.[1]
  • A state of apprehension, uncertainty, and fear resulting from the anticipation of a real or imagined event, situation, or circumstance that we think might be threatening.[1]

Apprehension is defined as:

  • anxious or fearful that something bad or unpleasant will happen.[1]

Anticipate is defined as:

  • an expectation or prediction[1]
  • to imagine or expect something will happen[2]

Expectation can be defined as:

  • the belief that something could, should, or will happen.[3]

Based on these definitions, we arrive at the conclusion that anxiety is a state of apprehension that results from anticipating something we think might be dangerous or harmful.

Therefore, anxiety is caused by anticipating a future situation or circumstance has the potential to be dangerous or cause harm.

Worry creates anxiety because worry involves imagining that some future situation or circumstance could cause unpleasantness or harm.

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Fear Is The Nucleus Of Anxiety

Fear drives anxiety. As such, anxiety is based on a fear that something unpleasant or bad might happen that could cause harm. To be fearful, we have to predict that something has the potential to cause harm.

Making a prediction requires assessing certain risk factors, and then making a decision about the likely outcome. For instance, some of the risk assessment factors include:

  • Can a situation or circumstance (the threat) cause harm?
  • What harm could the threat cause?
  • How severe could the harm be?
  • How might this harm affect the quality of my life?
  • How might this harm affect the rest of my life?
  • Do I have the ability or resources to protect myself against the threat?
  • Is the threat imminent?

To be fearful, we have to make decisions about all of the above. To make decisions, we have to anticipate likely outcomes. To anticipate, we must make predictions about what COULD, SHOULD, or WILL happen.

Even though a conclusion can arise in the blink of an eye, it still requires a series of thought processes that result in a conclusion. As such, there is no other cause of anxiety other than a series of thought processes that result in the prediction that some future situation or circumstance could be dangerous or harmful.

The Degree Of Anxiety Is Proportional To The Degree Of Fear

The degree of fear is directly proportional to the severity of the threat. For example, threats that have the potential to cause significant harm cause significant fear, whereas threats that have the potential to cause little to no harm cause little to no fear.

Therefore, the degree of perceived harm determines the degree of fear. And, the degree of fear determines the degree of anxiety since fear drives anxiety.

For example, if we determine that a threat has the potential to cause great harm, we’ll likely be greatly anxious. But if the potential harm is only slight, we’ll likely experience little fear resulting in little anxiety.

Threat assessment drives fear, and fear drives anxiety.

The degree of threat determines the degree of anxiety.

Overall, anxiety results from making a prediction that something dangerous or harmful could, should, or will happen.

Therefore, anxiety is caused by being anxious (fearful) about a potentially dangerous or harmful future situation or circumstance that MIGHT happen.

The state of anxiety occurs when we behave apprehensively.

This leads us to our initial conclusion that: anxiety is caused by apprehensive behavior. Apprehensive behavior is threat assessing and imagining something bad or unpleasant might happen.

Again, worry is a good example of how apprehensive behavior creates the state of being anxious.

You can test this rationale by removing fear. For instance, think of something you were worrying about that created great anxiety. Now, imagine that the threat is no longer dangerous and has no potential to cause unpleasantness or harm.

Did you see how removing the threat eliminates the fear and resulting anxiety?

Let’s say you have become afraid of having panic attacks. Worrying about panic attacks creates anxiety. Unfortunately, anxiety about having panic attacks fuels panic attacks. So, fear of having panic attacks and having them becomes a vicious cycle where one fuels the other, which so often happens with panic disorder sufferers.

Now, let’s say you’ve discovered a way you could shut panic attacks off right away and every time a panic attack started. Even though the panic attack could be strong, you could shut it off in a matter of moments, and every time. Would you still be afraid of them? Would they still cause anxiety?

No! If you knew you could control panic attacks 100 percent and every time, there would be no potential for unpleasantness or harm.

By removing the fear component, we eliminate anxiety.

Fortunately, with the above example, we CAN shut off panic attacks any time we want, and no matter how severe. Learning how to control panic attacks is what has set so many people (including myself) free from panic disorder.

If you are struggling with panic disorder and would like to learn how to control them every time, I recommend connecting with one of our recommended anxiety disorder therapists to help you learn this important skill.

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What causes anxiety disorder?

Anxiety disorder occurs when anxiety interferes with a normal lifestyle. In this regard, overly apprehensive behavior, which creates lifestyle impacting issues with anxiety, causes anxiety disorder.

It’s important to note that “anxiety disorder” is not a medical term.[4] It’s a layman’s term used to describe someone who has issues with anxiety. As such, anxiety disorder is not a medical diagnosis. It’s a mental health term used to categorize people whose lives are disrupted by anxiety.

If Apprehensive Behavior Creates Anxiety, What Causes Apprehensive Behavior?

There are many theories about what causes the apprehensive behavior that causes issues with anxiety. Some of these theories include:

Environmental factors

Environmental factors associated with anxiety include:

  • Early life trauma
  • Early life abuse (physical, psychological, emotional, sexual, spiritual, etc.)
  • Being raised by parents with unhealthy parenting skills
  • Being rejected, abandoned, or abused by a parent(s)
  • Being separated from a parent(s)
  • Being raised by a parent(s) who overprotects, overindulges, or is overly critical
  • Experiencing an early life serious medical problem
  • Being raised by a parent(s) who uses recreational drugs
  • Being raised by a parent(s) who has issues with anxiety

To name a few.

Research has shown a strong link between environmental factors and the development of anxiety disorder.[5][6][7] It’s my opinion, environmental factors play the largest role in the development of anxiety disorder.


It’s well established that anxiety disorders run in families. Consequently, many sources claim that genes play a role in the development anxiety disorder. Yet, no “anxiety gene” or “set of genes” have been found to conclusively prove they do indeed cause anxiety disorder. At this time, the only “real” link is circumstantial rather than actual.

It’s my opinion that the reason anxiety disorder runs in families is because of learned and passed on behavior rather than genes. There is substantive research that shows this pathway,[5][6][7] as previously mentioned.

There are many other reasons why I don’t believe genes cause anxiety disorder. While genes might be implicated, the link might be an “effect” rather than a cause since behavior can affect gene expression.

At this time, there is a great deal that is unknown about genes and the role they play in behavior, including those behaviors that cause issues with anxiety.

Unfortunately, there is a mountain of enthusiastic speculation. Until more is known about the link between genes and behavior, the “genetic predisposition” theory remains postulation. More research is required.

Medical factors

There are many medical conditions and medications that can cause anxiety-like symptoms. There are also medical conditions and procedures people worry about.

But medical conditions themselves don’t cause people to risk assess in anxious ways. Here again, while medical factors can play a role, anxious behavior creates problems with anxiety.

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Biological factors associated with the brain

There have been, and continue to be, many theories about the link between anxiety and the biological makeup of the brain.

For instance, it was previously theorized that a “chemical imbalance” in the brain caused anxiety (and other mental illnesses). That theory was proven wrong and officially discarded in 2011. You can read our article “Chemical Imbalance Theory – Officially Proven False” for more information.

It was also once thought that people who had anxiety disorder had brain abnormalities that caused issues with anxiety. That theory was also discarded years ago.

Yes, there are differences in brain function, structure, and chemistry with people who have anxiety disorder. But these differences occur because of how apprehensive behavior and stress affect the brain[8] rather than these differences causing issues with anxiety.

Visit our “Stress Response” and “Hyperstimulation” articles for more information about how apprehensive behavior affects the biological make-up of the body and brain.

Yes, there are biological factors that can create issues with anxiety for some people, such as brain cancer, fetal alcohol syndrome, physical damage such as via an accident, and so on. But these account for a very small percentage of those who struggle with anxiety disorder.

Do biological factors associated with the brain cause anxiety, or does apprehensive behavior cause biological factors that result from apprehensive behavior? At this time, it’s believed that the majority of anxiety is caused by behavior.

Also keep in mind that everyone is anxious from time to time. Therefore, anxiety is not an abnormal reaction. In fact, anxiety is an important part of the body’s built-in emergency mechanism that is essential to our survival.

For most people, anxiety disorder is not caused by something that has gone wrong in the brain, but that overly anxious people have become afraid of more things than those who aren’t overly anxious.

So, the problem lies with risk assessment – a style of behavior – which is learned rather than something that’s gone wrong in the brain.

Use of or withdrawal from prescription medication

Use or withdrawal from prescription medication can cause many side effects, including heightening our sense of danger. But just because we have a heightened sense of danger doesn’t mean we have to risk assess in overly fearful ways.

While the side effects of medication can stir the body up, we don’t have to react to the side effects or how the body is affected in an anxious manner. Reacting anxiously is behavior.

Use of or withdrawal from recreational drugs

Use or withdrawal from recreational drugs can also cause many side effects, including a heightened sense of danger. But again, just because we have a heightened sense of danger doesn’t mean we have to risk assess in overly anxious ways.

While the side effects of drugs can stir the body up, we don’t have to react to those side effects in an anxious manner. Reacting anxiously is behavior.

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Underlying Factors That Cause Apprehensive Behavior

Based on our 30+ years of personal, practical, and professional experience with and helping people overcome anxiety disorder, we’ve determined that apprehensive behavior is caused by a number of underlying factors. The underlying factors that cause issues with anxiety can be defined as: the unhealthy behaviors (thoughts and actions), situations, and circumstances that influence apprehensive behavior.

All of these underlying factors stem from the environment we were raised in, experienced, and formed conclusions about. Visit our “System Of Beliefs” article for more information about how our beliefs and behaviors are shaped.

For instance, research has shown that generalized anxiety disorder runs in families because parent-to-child transmission is a common pathway to anxiety disorder.[8] There are other well-known pathways of parent-to-child transmission, such as helicopter parenting, over-indulgent parenting, over-critical parenting, and so on. These environments condition children to adopt an overall apprehensive approach to life.

Experiencing early life trauma, neglect, and abandonment are other environmental factors that influence the child’s development and behavior adoption.

We’ve identified over 100 underlying factors that pre-condition a person to develop an overly apprehensive approach to life. An overly apprehensive approach to life creates unhealthy anxiety, which in turn creates elevated stress and symptoms. It’s these underlying factors, their mix, and severities that cause the various forms of anxiety disorder.

Recovery Support members can read about the many underlying factors and their causes in Chapter 7 in the Recovery Support area.

Fortunately, identifying and successfully addressing anxiety’s underlying factors leads to the resolution of anxiety disorder. See our “Anxiety Disorder Recovery” article for more information about the Two Levels Of Anxiety Disorder Recovery.

Closing Comments

Therapy is the most effective treatment for anxiety disorder.[9][10][11] Why? Because working with an experienced anxiety disorder therapist addresses the underlying factors that create issues with overly apprehensive behavior, which is the cause of issues with anxiety. Replacing anxious behavior with healthy behavior solves the anxiety disorder problem.

Recovery Support members can read about the many underlying factors that cause anxiety disorder in Chapter 7.

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Millions of anxiety disorder sufferers have overcome their struggle with anxiety disorder by making healthy behavioral change. This record of success verifies that anxiety disorder is caused by behavior and not by genes, a biological problem with the brain, or use or withdrawal from prescription or recreational drugs.

Anxiety is caused by apprehensive behavior. Consequently, anxiety disorder can be overcome by addressing apprehensive behavior. The most effective way to work through and overcome a struggle with anxiety disorder is with the help of an experienced anxiety disorder therapist since self-help materials alone seldom produce meaningful or lasting results.

For more information about how to attain lasting success over anxiety disorder, visit our article, “Anxiety Disorder Recovery.”

Related articles:

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our Anxiety Articles page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including What Causes Anxiety?


1. Dictionary.com

2. “ANTICIPATE: Definition in the Cambridge English Dictionary.” ANTICIPATE | Definition in the Cambridge English Dictionary, 23 Aug. 2019.

3. “EXPECTATION: Definition in the Cambridge English Dictionary.” EXPECTATION | Definition in the Cambridge English Dictionary, 23 Aug. 2019.

4. Shelder, Jonathan. “A Psychiatric Diagnosis Is Not a Disease.” Psychology Today, Sussex Publishers, 27 July 2019.

5. Waszczuk, M.A., et al. "Genetic and environmental influences on relationship between anxiety sensitivity and anxiety subscales in children." Journal of Anxiety Disorders, 27 June 2013.

6. Brook, Christina, Schmidt, Louis. "Social anxiety disorder: A review of environmental risk factors." Neuropsychiatric Disease and Treatment, Feb. 2008.

7. Aktar, Evin, et al. "Environmental transmission of generalized anxiety disorder from parents to children: worries, experiential avoidance, and intolerance of uncertainty." Dialogues in Clinical Neuroscience, June 2017.

8. McEwen, Bruce, et al. "Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex." Neuropsychopharmacology, Jan. 2016.

9. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.

10. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

11. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.