Anxiety – where does it come from?

Anxiety is everywhere. The new buzzword. But what does it really mean and is it really the culprit it is made out to be?

Simply defined, anxiety is a sense of unease, nervousness, or worry. It manifests on a continuum of physical, mental, and emotional symptoms from the feelings of butterflies in the stomach before a performance, athletic event, or speech all the way to a panic attack. There is a biological basis for anxiety. It is our stress response system, or our fight, fight, or freeze response. When our brain senses any kind of imbalance or potential threat to the body system, the stress response is activated in preparation for “survival mode.” For example, walking to your car alone in a half-lighted parking lot, you feel uneasy. This is an appropriate signal to you to be alert for danger. Sometimes, however, it is activated when it doesn’t need to be or it is often activated, leading to anxiety disorders.

Internal causes of anxiety

The body loves balance. It constantly works to achieve homeostasis. When the body’s water balance is off, you feel thirsty. If the body needs more glucose, you feel hungry. When the body needs rest, you sleep. There are many systems in the body all working toward the balance goal, but when it does not achieve balance, that part of the brain that senses danger recognizes something is wrong. It doesn’t know what, it’s just wrong. So it activates the stress response. Things like hormones, muscle tension, cell counts, heart rate, or the presence of a new entity such as a virus can cause the body to alert for danger. You feel this as anxiety. 

Most of us are aware of how thoughts and emotions can be triggers for anxiety. Keep in mind that thoughts, emotions, and physical sensations create a feedback loop with each other. If you feel a physical sensation, you may have a thought about it. That thought may be negative which activates an emotion of fear. At any point in that automatic cycle, the brain can turn on the stress response. It does not interpret or discriminate. Any input of danger equals an output of anxiety. All for the cause of keeping the body safe.

It is not always known what causes anxiety and in many cases, it does not matter. Therapists who work with people experiencing anxiety will help them disrupt the cycle by addressing the three culprits. The order in which they are addressed doesn’t always matter, what matters is from which you will experience the most positive results. Cognitive behavioral therapy addresses the thought patterns as the culprit. Body-focused therapies like mindfulness training focus on physical sensations as the culprit and emotional regulation therapies tackle the emotions.

Anxiety and hair pulling

Many people with trichotillomania experience focused hair pulling which serves a purpose. One explanation for hair pulling that worsens with increased anxiety is that pulling hair out relieves stress and tension. When one is anxious, tension in the body increases. The slight pain associated with pulling out hair and the immediate feeling of release may help to discharge stress energy or disrupt the cycle of thoughts and emotions with a strong physical sensation. The focused activity of pulling out hair also serves as a mindful activity, where one focuses on the activity at hand allowing for anxiety to dissipate.

Whether hair pulling causes the thoughts, emotions, and physical sensations that cause anxiety or if anxiety causes one to pull hair, therapy for people who suffer from trichotillomania needs to include anxiety management. While research isn’t conclusive about what causes what, there is agreement that everyone can benefit from learning about anxiety and learning to manage it well.

An excellent reference for the body’s reaction to trauma and anxiety:

van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Publishing Group.