Nervousness, panic, fear, sweating, and rapid heartbeat: can all be symptoms of anxiety. And in times of true danger, anxiety and its symptoms can be helpful. But sometimes, those feelings go into overdrive at the wrong time, and anxiety winds up interfering with daily life.
“If an individual gets to the point where worries and being careful crosses a line into what would be considered a disorder, then that person’s ability to function in daily life…is impaired,” Una McCann, MD, professor of psychiatry and director of the Anxiety Disorders Program at the Johns Hopkins School of Medicine, told Health. “It can really detrimentally affect someone’s life.”
Eventually, anxiety may escalate to the point that a person is unable to do their job, perform household duties, or care for themselves or loved ones as they normally would, explained Dr. McCann. Knowing what may be causing or worsening the anxiety may help to prevent it from getting to this level.
The triggers of anxiety are different for everyone, but here are some of the more common ones.
Thinking There's Something Physically Wrong With You
Is this pain in my chest a sign that I'm having a heart attack? Does my skin rash mean I have cancer? Anxiety can often stem from worry that there is something wrong with your body. Everyone has concerns about their health from time to time, but depending on someone's history and personality, Dr. McCann said that physical symptoms can trigger a full-on anxiety disorder if the worrying interferes with daily functioning.
The physical symptoms that first made you start feeling anxious about your health can also be very similar to some of the symptoms of anxiety itself—increased heart rate, hyperventilation, sweating, and feeling weak—which can lead to a cycle of anxiety.
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Worries About Your Loved Ones
For some, anxiety does not come from worry about themselves but rather from fear about what can happen to their loved ones. Dr. McCann said that people might fret not only about something happening to their children, close family members, or friends but also about how they can possibly cope if something bad actually does happen.
Caregivers are particularly affected. They are faced with many challenges in providing care for someone else while juggling their own needs. And according to the results of a systematic review published in PLoS One in March 2021, the more caregivers feel burdened, the more anxiety symptoms they experience.
Caregiving in the U.S. 2020, a research report from AARP and the National Alliance for Caregiving, showed that 61% of the estimated 53 million caregivers in the U.S. are women. And considering this PLoS One review from April 2020, which found a higher burden among female caregivers in most of the 22 studies the researchers looked at, female caregivers should be especially aware of these triggers.
How Much Money You Have (or Don't Have)
One reason why finances might trigger anxiety is because, in our minds, money is linked to survival. “Money is really a resource that can provide people with a sense of safety and security,” Chloe Carmichael, PhD, a psychologist in New York City told Health. “When we feel that resource is scarce, it can actually make people feel like their survival is in jeopardy on a very primal level.”
Some of the common financial stressors have to do with concerns about savings, job security, salary, lack of financial savvy, debt, identity theft, and wealth comparison.
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Not Getting Enough Sleep
According to the Centers for Disease Control and Prevention, adults should get at least 7 hours of good quality sleep per day. Not getting enough of that recommended sleep time is another factor that can worsen anxiety.
Over the years, Dr. McCann has done studies on the link between sleep deprivation and anxiety. Through this work, Dr. McCann has found that regardless of whether or not someone has an anxiety disorder, anxiety levels go up following a night of sleep deprivation.
This link can be a vicious cycle: while sleep deprivation can cause anxiety, anxiety can cause sleeping problems, as the Anxiety and Depression Association of America pointed out.
Dr. McCann also noted that when people are sleep-deprived, they become much more sensitive to the effects of anxiety-inducing substances, such as caffeine and other stimulants.
Yes, coffee can make anxiety worse. Susan Bowling, PsyD, a psychologist at the Women’s Health Center at the Wooster Branch of Cleveland Clinic, told Health that some studies show that consuming more than 200 milligrams of caffeine (about the amount in just two cups of coffee) can increase the likelihood of anxiety and panic attacks in people sensitive to it.
"The natural effects of caffeine stimulate a host of sensations, such as your heart beating faster, your body heating up, your breathing rate increasing—all things that mimic anxiety," Bowling told Health. "Psychologically, it's difficult for your mind to recognize that this is not anxiety because it feels the same."
Other stimulants can trigger anxiety too. While some with anxiety might use marijuana as a way to relax, Dr. McCann said that marijuana actually has stimulating compounds that can worsen anxiety. “Unfortunately, many people attempt to self-medicate when they become anxious, and that can really backfire,” Dr. McCann told Health.
She reminds her patients who attempt to self-medicate this: just because something says it's herbal and natural—like marijuana—doesn't mean it's safe. And when you're buying food, such as herbs, online or in the store, and the label says it can be relaxing, she said to be "very, very careful. Don't do it unless you have really expert guidance."
Taking Certain Medications
Some medications themselves are stimulants and so can trigger anxiety in certain patients; these include amphetamines and methylphenidate, both of which are used in the treatment of attention deficit hyperactivity disorder and narcolepsy.
Dr. McCann also said that some antidepressants, such as Wellbutrin XL (bupropion) and Effexor XR (venlafaxine), and some anti-asthma medications can be stimulating for some people.
Having a Diet That's Not Too Healthy
It’s no secret that if you haven’t been eating well you might not physically feel your best. But a poor diet can impact your mental health as well. According to Lily Brown, PhD, director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania, a poor diet and the way it makes you feel can make you more sensitive to the impact of anxiety.
Research published in the British Medical Journal in June 2020 showed that eating a lot of processed carbohydrates can increase the risk of anxiety. The researchers think this might be because of the repeated and rapid changes in blood glucose levels. Recurrent low blood sugar is also associated with mood disorders.
Feeling That Everything Needs To Be Done Just So
Perfectionism can be a major driver of anxiety. And for many, it’s an unexpected trigger from an underlying perfectionism trait—they might not even have seen themselves as perfectionistic.
Brown told Health that you might be able to anticipate such a trigger if you see yourself saying things like, "I can start on that task when all of these things come together. That will make it easier for me to do it; I can start on that task and have the time to really dive into it the right way—or the resources to dive into it the right way."
Having an Argument That Can Affect a Relationship
Sometimes, arguments or disagreements within your different relationships are inevitable. On top of causing feelings of sadness or depression, conflict within your social network can cause anxiety, said Brown.
In particular, Brown said, social conflict can lead people to worry about the future consequences of conflict in close relationships.
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Your social media diet can also be a trigger for anxiety. Using four or more social media platforms, being on social media for an hour or more per day, visiting social media sites 30 or more times per week, feeling an intense emotional connection to social media, and/or feeling as though you are addicted to using social media are all associated with an increased risk of anxiety, according to a study published in the American Journal of Health Behavior in March 2019.
You don't have to go cold turkey. "You just want to limit the time you engage with it so that you're not constantly checking in to see what the latest most outrageous news is or the latest social media battle is about," said Brown. "Some amount of engaging with that material is fine, but for many people, it can be a tremendously triggering experience to look at social media or to read the news." If that's the case, said Brown, "You need to be really thoughtful of whether it would make sense for you to limit your exposure."
And if you find yourself feeling so anxious that you avoid social media altogether, Brown said that spending time on social media might actually be helpful for you, so you can practice learning about your ability to tolerate anxiety: "It's all about finding that perfect balance."
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Fear of Being Separated From a Loved One
Separation from a caregiver is a common trigger of anxiety for children and adolescents, but it can be an anxiety trigger for adults as well. “They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated,” according to the National Institute of Mental Health. “This fear leads them to avoid being separated from their attachment figures and to avoid being alone.”
People whose anxiety is triggered by the thought of being separated from someone may have nightmares about the separation or experience physical symptoms when the separation occurs or is anticipated.
Concerns Over Large-Scale Disasters
Extreme weather events are happening more frequently, and scientists are increasingly linking them to climate change. This can be a two-fold stressor: the natural disasters themselves and the climate change that causes them.
“We’re going to continue to see climate catastrophes and tipping points,” Thomas Doherty, PsyD, an Oregon-based psychologist, told Health. “People have become more used to them, but these really super destructive [events] cause a lot of stress and anxiety.”
The environmental changes that may lead to many of these events can be an anxiety trigger itself, as well. It is known as eco-anxiety. “This used to be a special interest issue; now it’s much more common because of climate-related events,” said Doherty. “This is not something far away anymore.”
The COVID-19 pandemic that started in 2020 also led to the coining of a new term: coronaphobia. During the pandemic, researchers saw that COVID-19-related worries led to greater levels of anxiety, as was reported in August 2020 in Translational Psychiatry. This anxiety could stem from being uncertain about the future during the pandemic, adopting new practices and avoidance behavior, and hearing about world leaders and famous celebrities who have contracted the virus.
Not Having Control Over a Situation
This anxiety trigger is one that a lot of people have, especially during major world events like the COVID-19 pandemic. Many people had loved ones who had an increased risk of contracting SARS-CoV-2, the virus that causes COVID-19, or of dying if they did contract it, and they weren't able to see these at-risk loved ones because of the virus.
"The loss of control associated with COVID makes [the concerns about a loved one's health] even more difficult to deal with," Dr. McCann told Health. "When we have a sense of control and can see things and interact with things, it's calming in a way. But the absolute inability to see or reach out to or help people who you love and care for from afar can be very anxiety-provoking."
What You Can Do: Figure Out What Your Triggers Are
Being able to predict what can start or worsen your anxiety can be extraordinarily helpful in managing anxiety. But identifying that trigger—or triggers, if you have multiple ones—can be hard.
One way to figure out what your anxiety triggers are is to keep a thought journal. Brown will sometimes have her patients name three times in the past week they felt high-intensity emotion. For each of those situations, she'll have them write down what was going through their mind, what was going on in their body, what they were tempted to do, where they were when it happened, and what was going on. By reflecting on times when your anxiety has gone through the roof, you may start to see certain patterns emerge that suggest what may be triggering you, explained Brown.
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What You Can Do: Prepare for and Manage Your Trigger
Try to take care of your important self-care activities before any chaos happens, said Brown. "The idea here is, for all of us, at some point, something chaotic is going to happen. And so an important goal is to think about how can you prepare for the eventual chaos by taking care of yourself now so that when the chaos does happen, you feel more resilient at the base of it."
When something has triggered your anxiety, and you're experiencing high emotions because of it, self-care activities alone are unlikely enough to reduce your anxiety, explained Brown. Once that anxiousness kicks in, that's when coping mechanisms like distraction and mindfulness practice come into play, said Brown.
Opening up to others about what you are experiencing can also validate your emotions and help get you through the anxiety that the trigger has initiated.
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Identifying and dealing with these triggers sooner rather than later could be helpful in managing anxiety. But if your anxiety is to a point where you feel it is already out of control, Dr. McCann said a medical professional can help: "The really good news is there are treatments—both medication and behavioral treatments—for all of the anxiety disorders as well as stressors that might make people anxious."
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