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For some people with anxiety, the triggers of an anxiety attack are impossible to miss.
These folks know that in certain situations, their anxious thoughts and symptoms are going to flare. But for others, it’s trickier to identify what triggers anxiety. Stressful feelings may show up at odd times—or all the time. And that uncertainty can make anxiety especially difficult to manage.
The good news is that experts have mapped out the most common triggers of anxiety. Knowing what these are may give you better control over your symptoms.
What is anxiety?
Anxiety is a word that many of us use to describe familiar feelings of worry, fear, or nervousness. We also sometimes talk about “being anxious” when we feel keyed up or stressed.
Anxiety is also a medical term for a handful of mental health disorders. Like milder types of stress, these types of health problems involve fear or worry. But these mood states and their symptoms persist for so long or cause such distress that they may require professional attention (Chand, 2021).
There are several different types of anxiety disorders, each one partly defined by its triggers. These situations or things cause a person’s symptoms to surge (Chand, 2021). Even if you don’t have an anxiety disorder, these triggers can cause feelings of distress.
Types of anxiety and their triggers
Healthcare providers rely on classification handbooks when trying to spot and diagnose anxiety disorders. These classifications are called the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.
According to the DSM-5, there are many different anxiety disorders, each with varying triggers.
Do I have anxiety? Types of anxiety and how to treat it
Social anxiety disorder
Also known as social phobia, this type of anxiety centers around spending time with other people or in social situations where others might judge you harshly (SAMSA-a, 2016).
This is fear or anxiety about a particular thing or experience. (SAMSA-b, 2016). The triggers of specific phobias tend to break down into five categories. These are (Samra, 2021):
- Fear of animals like spiders, snakes, or dogs
- Fear of natural environments, such as high places, bodies of water, or thunderstorms
- A fear of blood or anything to do with body punctures, including needles or surgery
- Fear of specific situations, such as flying, elevators, or tight spaces
- Other phobias that don’t fall under the above four categories
There’s evidence that people can develop a phobia about anything if they’ve had a bad experience with it. For example, someone who has been in a car accident may have anxiety about driving or being a passenger in a car (Samra, 2021).
Separation anxiety disorder
This is anxiety that comes on when you’re away from home or apart from certain people or loved ones in your life, such as a family member. This fear or anxiousness may involve worries that your loved one will be hurt, lost, kidnapped, or threatened while you’re away. You may feel anxious just thinking about being away from them (Feriante, 2021).
This is anxiety caused by a handful of specific scenarios that include:
- Using public transportation
- Being in wide, open spaces
- Being in enclosed spaces (like a store or movie theater)
- Standing in line or being in a crowd
- Leaving your home
You may notice that some of these situations overlap with the triggers of other anxiety disorders. That’s true, but there are subtle differences that can help medical providers tell these apart.
For example, in the case of people with agoraphobia, they become anxious in at least two of the above situations. But someone with a specific phobia may only feel anxious when in enclosed places (SAMSA-c, 2016).
Substance- or medication-induced anxiety disorder
This is anxiety caused by intoxicating substances (e.g., alcohol or cannabis) or medical treatments. These may trigger your anxiety while you use them or during withdrawal following use (Chand, 2021).
Other anxiety disorders
There are several other anxiety disorders in the DSM-5. These include panic disorder, which involves one or more panic attacks, and also generalized anxiety disorder (GAD). Some medical conditions can also cause anxiety. But these disorders are mainly defined by their symptoms rather than their triggers (Chand, 2021).
Generalized anxiety disorder (GAD): symptoms and diagnosis
GAD, for example, is “general” because it’s something a person associates with a range of “everyday things” or activities, such as school, work, or money matters (Munir, 2021).
More anxiety triggers
Many other situations or behaviors can cause anxiety to flare. These include:
Research has linked anxiety to certain brain chemicals—specifically dopamine and nor-adrenaline. Caffeine stimulates the release of these same chemicals (Van Son, 2018). And there’s evidence that caffeine, especially if you swallow a lot of it, may trigger anxiety or make it worse (Meredith, 2013).
Some research has linked social media with anxiety. There’s also evidence that the more time a person spends on social media, the greater that person’s risk for anxiety (Shensa, 2018).
A sedentary lifestyle
Exercise, as you know, is associated with a range of wellness and mental health benefits. Research has also found that people who spend most of their free time on sedentary activities (basically, anything that involves sitting) are at increased risk for anxiety symptoms (Hallgren, 2020).
There’s evidence that many people—16% by some estimates—experience anxiety while driving (Taylor, 2018). There’s even some research linking traffic noise to elevated anxiety (Lan, 2020).
This list could go on and on. The important thing to understand is that stress and anxiety are closely linked (Daviu, 2019). Just about anything that causes you to feel stressed—work deadlines, money concerns, public speaking, etc.—could trigger your anxiety.
How to identify anxiety triggers
In order to recognize the triggers of your anxiety, it’s important to understand the symptoms of anxiety. There are many of them, and they can be broken down into three categories (Chand, 2021).
The first category involves cognitive symptoms. These include:
- Worry or nervousness
- Fear of losing control or “going crazy”
- Fear of injury or death
- Fear that you’re having a heart attack
- Fear of negative judgment from others
- Poor concentration
- A sense of unreality or detachment
The second category involves the body. These physical symptoms include:
- A racing heart rate or heart palpitations
- High blood pressure
- Shortness of breath
- Chest pain
- Sweating or sweaty palms
- Muscle tension
- Rapid breathing
- Hot flashes
- Upset stomach
- Weakness or unsteadiness
- Problems sleeping
The final category includes behavioral symptoms. Some of these are:
- Avoiding certain things or situations
- Feeling an urge to escape or flee
- Moving away from sources of fear or worry and toward safer situations
- Seeking reassurance
Some research has found that people with mental illness who kept a mood journal—basically, a written record of their symptoms and experiences—were better able to predict and avoid relapses (Villaggi, 2015). By keeping a closer eye on your symptoms or even writing them down, you may be better able to spot their triggers.
How to manage triggers
There are many research-backed ways to manage anxiety. These include relaxation techniques such as mindfulness and breathing exercises, psychotherapy, such as cognitive-behavioral therapy (CBT), and medications (Kim, 2017; Norelli, 2020; Chand, 2021)
Your guide to anxiety medications
However, simply trying to avoid your anxiety triggers isn’t always a good move. CBT and other types of psychotherapy sometimes involve “exposure” to a trigger or anxiety source. This is thought to help people learn to control their anxiety, whereas avoiding a trigger may reinforce fear or worry. But all of this is complicated. There are some situations when avoidance may be helpful (Hofmann, 2018).
As with any mental health issue, talking with a mental health professional is a good idea. An expert can help you determine how best to manage what you’re dealing with.
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Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.