In my family medicine practice, I often have patients come in with signs and symptoms of anxiety.  They often ask “why do I feel anxious?”  The truth is that anxiety, in part, is a normal human phenomenon.  Everybody experiences anxiety to some extent. Anxiety is produced primarily in the brain, but because the brain is connected to the body – physical symptoms can also result.  Understanding the cause of anxiety and its symptoms may help you begin to manage the anxiety.

What is important before considering any anxiety disorder as a diagnosis, is to rule out any potential medical causes that could mimic symptoms of anxiety. 

So why do I feel anxious? 

To answer the question of “why do I feel anxious”, it is best to understand how the body produces anxiety. Sometimes this is helpful for people suffering with anxiety to understand that anxiety and its symptoms, primarily, begin within the brain. 

Have you ever wondered why a situation that provoked strong fear stands really strong in your memory?  This is because the fear centre of our brain (amygdala) lies very close to a structure that is responsible for memory (known as our hippocampus).  In anxiety disorders, key areas in the brain are not functioning properly.

When this happens, the brain becomes activated and experiences threats (or perceived threats) in everyday life.  This can lead to worries that are difficult to control.  Because the brain is connected to the body, physical symptoms can also result. 

When anxiety kicks in, you may experience some of these physical symptoms

• Headaches and muscle tension
• Feeling lightheaded or fainting
• Sweating
• Heart palpitations
• Tightness of chest, shortness of breath, or feeling like it’s difficult to breathe
• Stomach discomfort, diarrhea, constipation

Note: if you are anxiety and its symptoms, it is important to see your primary care provider to see if there maybe another contributing illness that may be causing these symptoms.

Anxiety often begins in early childhood development, and can persist into adulthood

Anxiety is also influenced by our childhood development, any history or experiences of abuse, relationships and attachment to our parents, as well as any significant stresses or losses.  That being said, anxiety may not become a “disorder” until later in life.

Psychological causes of anxiety and its symptoms

Anxiety and its symptoms, to some extent, are normal in all humans. But anxiety can become an “anxiety disorder” when it is so severe that the symptoms impact a person’s ability to function.

There are many psychological theories as to why people develop anxiety disorders.  At its most basic level, anxiety disorders develop when individuals have difficulty with:

1. Emotions: when a person is unable to recognizing or manage strong emotions
2. Physical symptoms of anxiety: may not be noticed, may be neglected, dismissed, or may be mis-interpreted
3. Behaviours that worsen the anxiety: When individuals with anxiety have difficulty managing emotions and the physical symptoms of anxiety, these may result in behaviours that serve to worsen or continue the anxiety. 

The psychology behind anxiety and its symptoms can be complex, and it can be hard to notice and pay attention to.  This is why the use of a skilled healthcare professional may be helpful in understanding your own unique challenges with anxiety. 

This post was co-authored by Suzanne Black, MD, BSc and Stephanie Liu, MD, MSc, CCFP, BHSc.

References

1. Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (Eleventh edition.)