Is Anxiety Genetic?

It’s important to recognize that occasional anxiety is a normal part of life and should be looked at differently from clinical anxiety: an anxiety disorder. How do you know when anxiety is a clinical issue versus a normal part of life? When anxiety interferes with your ability to conduct relationships or enjoy other areas of your life, including activities you once enjoyed, you can safely assume that professional intervention is an essential next step.

That said, anxiety has both genetic and environmental components. Research suggests that genetic factors can play a role in predisposing an individual to anxiety disorders, with some studies estimating that genetic factors account for about 30% of the risk¹. However, it is essential to recognize that anxiety is as complex as the individual experiencing it. It is unlikely to be entirely attributed to a single gene or simple genetic pattern. Instead, we know that multiple genes interact with one another and with environmental factors to influence the development of anxiety disorders.

How Does Anxiety Manifest? What Are the Signs and Symptoms?

If you suspect you have an anxiety disorder, you should look for patterns of symptoms that persist or significantly interfere with your daily life. Some common signs and symptoms of anxiety disorders include:

1. Persistent, excessive worry or feeling on edge about everyday situations, often disproportionate to the actual event. This is often worsened by difficulty falling asleep, staying asleep, or experiencing restless, unsatisfying sleep
2. Anxiety can make it challenging to focus or concentrate on tasks, often due to intrusive thoughts or excessive worry
3. Anxiety can cause physical and mental exhaustion, even when there is no apparent reason for feeling tired
4. People with anxiety may experience muscle tension, aches, or soreness
5. Sudden episodes of intense fear, accompanied by physical symptoms like rapid heartbeat, shortness of breath, dizziness, or chest pain, can indicate a panic disorder
6. Avoiding situations or places that trigger anxiety, such as social events
7. Experiencing intense, irrational fears about specific objects or situations

What Does “Genetic” Mean?

When referring to medical and psychological conditions and diseases, the term “genetic” means that the disease is caused by changes or mutations in one or more genes. Genetic disorders can be inherited from one or both parents or caused by mutations throughout an individual’s development. You can imagine how challenging it is to accurately determine if a problem is genetic or environmental, but modern genetic research has made great strides, and we know a lot more about how to diagnose and ultimately treat these conditions.

There are several ways in which genetic diseases can be inherited:

1. Autosomal dominant inheritance: One parent’s single copy of the problematic gene is enough to cause the disease. If one parent has the disease, there is a 50% chance that their child will inherit the mutated gene
2. Autosomal recessive inheritance: Both gene copies (one from each parent) must be mutated for the disease to manifest. If both parents are carriers of the mutated gene, there is a 25% chance that their child will inherit both mutated copies and develop the disease
3. X-linked dominant inheritance: The mutated gene is on the X chromosome, and a single copy is sufficient to cause the disease. In this case, males, who only have one X chromosome, are more likely to be affected than females, who have two
4. X-linked recessive inheritance: The mutated gene is on the X chromosome, and both copies must be mutated for the disease to manifest in females. Males, with only one X chromosome, are more likely to be affected if they inherit the mutated gene from their mother
5. Mitochondrial inheritance: The mutated gene is in the mitochondrial DNA inherited exclusively from the mother. All children can be affected

Studies of identical twins have found a higher likelihood of both twins developing anxiety disorders if one twin has the condition, compared to fraternal twins. Further, specific genes have been linked to an increased risk of anxiety disorders. However, genetics is not the only factor in developing anxiety disorders, as environmental factors and life experiences can also play a significant role. Therefore, while genetics may contribute to an individual’s susceptibility to anxiety, it is not a definitive predictor of anxiety disorders.

What Genes Can Cause Anxiety?

While no “anxiety gene” exists, researchers have identified several genes associated with an increased risk of developing anxiety disorders. Some of the genes and genetic variants that have been implicated in anxiety include:

1. SLC6A4: This gene encodes the serotonin transporter, and variations have been linked to anxiety-related disorders, such as panic disorder and obsessive-compulsive disorder (OCD).
2. 5-HTTLPR: This is a genetic variant in the promoter region of the SLC6A4 gene. The short (S) allele of 5-HTTLPR has been associated with increased anxiety-related behavior and heightened responsiveness to stress.
3. COMT: The catechol-O-methyltransferase (COMT) gene is involved in the breakdown of catecholamines, such as dopamine and norepinephrine. Variations in the COMT gene have been associated with generalized anxiety disorder (GAD) and panic disorder.
4. BDNF: Brain-derived neurotrophic factor (BDNF) plays a crucial role in neuronal growth and survival. Variants in the BDNF gene have been linked to anxiety disorders and stress vulnerability.
5. CRHR1: The corticotropin-releasing hormone receptor 1 (CRHR1) gene is involved in the stress response. Variations in this gene have been associated with an increased risk of developing anxiety and mood disorders.
6. FKBP5: The FK506 binding protein 5 (FKBP5) gene regulates the stress hormone cortisol. Variants in the FKBP5 gene have been implicated in anxiety disorders and stress-related psychiatric conditions.
7. GABRA2: The gamma-aminobutyric acid (GABA) receptor subunit alpha 2 (GABRA2) gene is part of the GABAergic system, the primary inhibitory neurotransmitter system in the brain. Variations in GABRA2 have been linked to anxiety disorders and alcohol dependence.

We still do not know plenty about the genetic factors and genes associated with anxiety. Further research is critical to better understanding the diagnosis and treatment related to these genetic factors and others.

The Prognosis for Gene-Related Diseases

Undoubtedly, genetically linked diseases are a significant challenge we face today and well into the future. However, this does not mean that treatment options are not available. Advances in genetic research and technologies, such as genetic testing and gene therapy, have improved our understanding of genetic diseases and offer promising avenues for diagnosis, treatment, and prevention.

Is Anxiety a Chemical Imbalance?

Anxiety is often described as related to a chemical imbalance in the brain, although this is an over-simplification. Anxiety disorders are complex and arise from genetic, neurological, and environmental factors. Calling it a “chemical imbalance” suggests that anxiety can be attributed to neurotransmitters, the chemical messengers that transmit neuronal signals. Underlying genetic and environmental factors can, in fact, create a chemical imbalance; however, there are many layers to peel to find the root cause. Some of the critical neurotransmitters involved in anxiety include:

1. Serotonin contributes to feelings of well-being and happiness. Imbalances have been linked to anxiety disorders, depression, and other mood disorders.
2. Norepinephrine, a.k.a. noradrenaline, is involved in the stress response and helps regulate attention and alertness. Imbalances have been implicated in anxiety disorders, particularly generalized anxiety disorder (GAD) and panic disorder.
3. Dopamine plays a role in reward and motivation, and imbalances have been associated with anxiety disorders, depression, and other psychiatric conditions.
4. Gamma-aminobutyric acid (GABA) is an important neurotransmitter in the brain, helping regulate neuron activity. Imbalances in GABA have been linked to several psychiatric conditions.

Environmental Contributors to Anxiety

Environmental factors can significantly contribute to the development and worsening of anxiety disorders. While not a complete list, some of the common environmental factors associated with anxiety include:

1. Adverse childhood experiences (ACEs), such as abuse, neglect, or witnessing violence
2. Exposure to traumatic events, such as accidents, natural disasters, war, or assault, can lead to the development of post-traumatic stress disorder (PTSD) and anxiety
3. Prolonged stress from work, relationships, financial difficulties, or other life circumstances
4. The use and abuse of certain substances, such as caffeine, alcohol, or illicit drugs
5. Some medical conditions, such as hormonal imbalances, heart problems, or respiratory issues, can cause symptoms that mimic anxiety or worsen existing anxiety.
6. Some medications, particularly those that affect the central nervous system.
7. Parenting style: Overprotective, controlling, or overly critical parenting can promote anxiety disorders in children
8. Bullying, social isolation, or discrimination can increase anxiety levels
9. Poor diet, lack of exercise, and insufficient sleep
10. Sudden life changes: Significant life changes, such as moving, losing a job, the death of a loved one, or the end of a relationship

Age of Onset

Anxiety disorders can develop at any age, but the onset of specific anxiety disorders may vary depending on the type of disorder and individual factors. Some common anxiety disorders and their typical age of onset include:

1. Separation anxiety disorder often begins in childhood, usually between 6 and 8. Children with separation anxiety disorder have an excessive fear of being separated from their caregivers or loved ones
2. Phobias tend to develop during childhood or adolescence, although they can start at any age
3. Social anxiety disorder: Social anxiety disorder, also known as social phobia, typically begins in adolescence, with a median age of onset of around 13 years. However, if left untreated, it can start in childhood and persist into adulthood
4. Generalized anxiety disorder (GAD) can develop at any age, but the average age of onset is around 30. However, GAD symptoms can emerge during adolescence or childhood
5. Panic disorder often starts during late adolescence or early adulthood, with an average age of onset in the early twenties. It can also begin in childhood or later in life

It’s important to note that the age of onset can vary between individuals, and early intervention and treatment are crucial for managing anxiety disorders effectively.

Next Steps

If you recognize these signs and symptoms and feel they negatively affect your daily life, you should consult a mental health professional, such as those at The Sylvia Brafman Mental Health Center, for a proper evaluation and diagnosis. They can help determine whether you have an anxiety disorder and recommend appropriate treatment options to manage your anxiety.

Resource:

1. Gottschalk MG, Domschke K. Genetics of generalized anxiety disorder and related traits. Dialogues Clin Neurosci. 2017 Jun;19(2):159-168. doi: 10.31887/DCNS.2017.19.2/kdomschke. PMID: 28867940; PMCID: PMC5573560.