What's causing the anxiety?

With mood disorders like depression and bipolar disorder, sometimes anxiety is a symptom. Other times it is a separate illness. It also may have physical, environmental or lifestyle-related causes.

When we asked people living with anxiety and a mood disorder where they thought their anxiety came from, here's what they said:

Symptom of a mood disorder 69.5%
Separate illness 11.1%
Side effect of medication 9.6%
Response to life event(s) 68.4%
Heredity 44.3%

Is anxiety a symptom of mood disorders or a separate illness?

Anxiety has some things in common with depression, such as low levels of the brain chemical serotonin. Because of this, some treatments for depression can help anxiety symptoms too, including antidepressant medications and psychotherapy. Some bipolar disorder treatments, including antipsychotic medications, can also help with anxiety symptoms.

Your health care providers are best able to figure out how to treat your anxiety and mood symptoms when you let them know all of your symptoms and concerns. If your symptoms don't go away or get worse, keep asking your providers to help you find other ways to treat them.

In the STEP-BD program at Harvard University, a National Institute of Mental Health (NIMH) study, in the first 500 patients, 52.8% of those with bipolar I disorder and 46.1% of those with bipolar II disorder had a diagnosed anxiety disorder.

Another NIMH study, the Bipolar Genetics Initiative, reported that more than 90% of people with panic disorder also had some form of depression or bipolar disorder.

Nearly 96% of the people with depression or bipolar disorder who took DBSA's 2005 online survey said they had experienced anxiety symptoms.


Physical

Other physical conditions of the brain or body, including illness, can cause or worsen anxiety symptoms. For some people, anxiety may be a result of medication side effects. If your anxiety symptoms start suddenly within the first couple of weeks after you start taking the medication, they may be side effects. Keep track of them and let your health care providers know.

Tell your provider about any other illnesses you have and medications you take. Talk about how your medications affect you and work with your providers to find ways to change your treatment and reduce your anxiety. You don't have to live with side effects. Your doctor should be able to work with you to find ways to reduce or eliminate them.


Environment

When a person spends time in stressful situations, anxiety is likely to be high. High-tension home or work relationships, or any situation in which a person's fight or flight response is triggered, can make anxiety symptoms worse. Sometimes situations can be changed, other times a person can be helped by therapy and other treatments to respond to situations with less anxiety.


Lifestyle

Many people find the increased excitement or adrenaline rush that comes with a high-risk lifestyle enjoyable. A person may also engage in high-risk activities as a symptom of mania or a response to the hopelessness of depression. A high-risk lifestyle can be a source of anxiety. Alcohol and drugs, though people often use them to cope with anxiety, can also cause anxiety by setting off chemical changes in the brain.

More about mood disorders and alcohol or drug use

Whatever is causing your anxiety, there is help.

Treating and Living with Anxiety