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The Anatomy and Physiology of Anxiety Disorder: Hereditary Factors and Statistical Facts

The Anatomy and Physiology of Anxiety Disorder: Hereditary Factors and Statistical Facts

Anxiety is a mental health disorder that has become the object of significant attention from psychologists and psychiatrists trying to find the best treatment to combat this issue. While anxiety may be viewed as a normal emotional reaction whenever individuals feel nervous, this condition might be a health disorder if they are uncertain of the outcome. Thus, individuals overwhelmed with constant fear might exhibit other physical symptoms. For this reason, it is appropriate to review the anxiety issue, including the anatomical, physiological, and pathological anomalies and hereditary factors, statistical facts about the condition, the overall cost, and the outcome of patients suffering from this condition.

Anatomical, Physiological, and Pathological Issues

Like any other normal body organ, the brain is the control center for all emotional responses. As such, anxiety is likely to result from an anatomical defect in the brain. Specifically, being an emotional reaction, anxiety disorder is likely the result of a malfunction in the limbic system, particularly the amygdala segment. In a study involving adolescents with this disorder, it was observed that the amygdala was robustly activated in response to anxiety-presenting situations compared to their healthy peers’ normal behavior. Presumably, the malfunction in the regulation of the amygdala by the dorsal prefrontal cortices is caused by impaired functional connectivity between the two, resulting in the disruptions of the regulation of emotions.

The amygdala activation results in a series of physiological fear responses in the body. Thus, the hypothalamus is activated, and neurotransmitters in the sympathetic nervous system, including norepinephrine, dopamine, and serotonin, are released while decreasing the release of gamma-aminobutyric acid (GABA). The overall impact is a pathological heightened ‘fight and flight’ response even in conditions that normally should not elicit this response. As a result, individuals with anxiety disorders will pathologically experience persistent fear and worry and will often exhibit a heightened state of arousal due to the activities of neurotransmitters in the body. Additionally, such patients will have difficulties controlling their fear and worry; they may also experience restlessness, easy fatigability, difficulty concentrating, insomnia, and muscle tension. As such, the focus of patient management should be on rectifying these anatomical and physiological anomalies while also seeking to respond to pathological issues.

Is Anxiety Disorder Hereditary?

It is difficult to specify that anxiety disorder is purely hereditary due to multiple etiological factors attributed to this condition. However, it has been demonstrated that anxiety disorders are common among family members, indicating that this condition may be hereditary. In addition, some evidence suggests that children of parents with anxiety disorders are more likely to develop similar conditions six-fold compared to children whose parents do not have any of the conditions associated with an anxiety disorder. In addition, a systematic review guide by Gottschalk and Domschke reveals generalized anxiety disorder as a moderately heritable condition at a 30% risk of hereditability due to the genetic factors at interplay and associated studies among family members and twin studies. As such, it can be argued that, to some extent, the disorder is hereditary.

However, apart from heredity, other factors lead to the development of anxiety disorder. Notably, genetic, biological, and stress factors might be combined. In their argument, Bystritsky et al. note that while genetics may play a role in the development of the disorder, its onset can be pinpointed to previous experiences with striking stressful events in life, such as a traumatic childhood experience, which may result in various forms of anxiety at adulthood. In addition, biological factors, such as an underlying medical condition, medications, or substance use, can induce various types of anxiety disorders as they alter the normal body physiology. To this end, it can be concluded that a genetic predisposition characterized by a positive family history, in addition to exposure to any of those mentioned above associated etiological factors, increases an individual’s chances of being diagnosed with an anxiety disorder.

Statistical Facts Related to Anxiety

As aforementioned, anxiety is a moderately common mental condition. It is estimated that at least a third of individuals worldwide are affected by an anxiety disorder at one point in their lifespan. The median onset for such disorders is thought to be at 11 years, with the highest prevalence for this disorder occurring at midlife, while the lowest prevalence is registered among the elderly aged 65 to 79 years. Specifically, Patel and Fancher note that generalized anxiety disorder alone affects about 7 million adult Americans. Moreover, it has also been noted that the condition is twice more likely to be diagnosed among women as compared to men. However, it is difficult to report whether anxiety disorders increase or reduce among the general population due to the constant changes in the diagnostic scale. Nevertheless, quite a good proportion of the general population is affected by this condition.

While anxiety disorder is perceived to be common in society, statistical evidence indicates that not so many people seek treatment for their condition. This is partially attributed to these disorders being severely underrecognized and undertreated. For instance, Bandelow & Michaelis (2013) mention that a study by the World Health Organization has revealed that less than 50% of anxiety cases have been diagnosed worldwide. In particular, a survey study revealed that only 23.2% of patients sought treatment in health facilities, of which 19.6% received psychological treatment, including cognitive-behavior therapy, while 26.5% received pharmacological interventions and psychotherapy. Consequently, more efforts are needed to promote cognitive-behavior therapy as a possible approach to treating anxiety disorders.

Cost and Outcomes Related to Anxiety Disorders

The burden of illness resulting from anxiety disorders is heavy. In European countries, it was estimated that up to 41 billion Euros were spent in 2004 to cover the treatment expenses of anxiety disorders. In addition, the number of productive work days lost in seeking treatment for anxiety disorders and associated comorbidities was higher than for other somatic illnesses. Moreover, anxiety disorders can lead to considerable impairment in the normal functioning of individuals, thus making them less productive and an economic burden to society due to the extensive amount of time required to provide them with care and the cost of their treatment.

The outcome may be poor without appropriate pharmacological and psychotherapy interventions, with comorbidities setting in. However, they can be prevented, and outcomes improved with cognitive-behavioral therapy alone or combined with drugs. Specifically, a long-term follow-up study by Kodal et al. reveals that cognitive-behavioral therapy could help improve patient outcomes as it immensely contributes to reduced symptoms and improved recovery. In addition, Bystritsky et al. (2013) also reveal that compared to medications, the treatment efficacy of cognitive-behavioral therapy is high, especially when patients continue to practice the learned skills throughout their life to manage their symptoms. However, Bystritsky et al. also note that patient outcomes are more enhanced if pharmacological intervention and psychotherapy are combined and delivered effectively to meet patients’ needs and healthcare goals. Overall, with the right treatment approach, including cognitive-behavioral therapy, it is possible to improve the health outcomes of such patients and minimize the healthcare expenditure on their treatment.


Anxiety disorder continues to burden the healthcare system due to its high prevalence among the global population. The disorder is associated with an anatomically malfunctioning amygdala, resulting in a series of physiological defects that impair emotional control, especially fear. While the condition may be considered hereditary, other factors, such as biological and stress, must also be considered when establishing the cause and approach to treatment. Although underrecognized and undertreated, anxiety disorder is prevalent in the general population. Thus, healthcare providers should always consider cognitive-behavioral therapy interventions as they seek to improve patients’ health outcomes and curb the economic burden of anxiety disorder.

πŸ“Ž References

1. Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327–335.
2. Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current diagnosis and treatment of anxiety disorders. Pharmacy and Therapeutics, 38(1), 30–57.
3. Carpenter, K. L., Angold, A., Chen, N. K., Copeland, W. E., Gaur, P., Pelphrey, K., … Egger, H. L. (2015). Preschool anxiety disorders predict different patterns of amygdala-prefrontal connectivity at school-age. PloS one, 10(1), e0116854. https://doi.org/10.1371/journal.pone.0116854
4. Gottschalk, M. G., & Domschke, K. (2017). Genetics of generalized anxiety disorder and related traits. Dialogues in Clinical Neuroscience, 19(2), 159–168.
5. Kodal, A., Fjermestad, K., Bjelland, I., Gjestad, R., Γ–st, L. G., Bjaastad, J. F., … Wergeland, G. J. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of Anxiety Disorders, 53, 58-67. https://doi.org/10.1016/j.janxdis.2017.11.003
6. Patel, G., & Fancher, T. L. (2013). Generalized anxiety disorder. Annals of Internal Medicine, 159(11), ITC1-12. https://doi.org/10.7326/0003-4819-159-11-201312030-01006