UNC Health Care
little girl snuggles with grandma on a couch

Does Anxiety Run in Families?

If you deal with an anxiety disorder, which about one-fifth of Americans do each year, take a look around your family. Is anyone else anxious?

It’s very possible that your answer is yes, and that would come as no surprise to the experts who study the role of genetics in anxiety.

“We’ve seen time and time again in studies of families that anxiety does run in families. Children of parents who have a diagnosed anxiety disorder can be as much as seven times more likely to develop an anxious disorder themselves,” says UNC Health psychiatric epidemiologist Anna Bauer, PhD, MPH.

But genetics aren’t the full story. They combine with environmental factors—everything from traumatic events to a parent’s behavior—to create the conditions for anxiety to erupt.

“What runs in families is the risk to develop these disorders, and then that risk is combined with an inciting environment,” says UNC Health psychiatrist Anthony Zannas, MD, PhD.

How Genes and the Environment Intersect to Create Anxiety

There is no single “anxiety gene,” but rather many genes that interact to predispose someone to anxiety, Dr. Bauer says. Then, through a biochemical process called DNA methylation, our environment—what we eat, how we sleep, the air we breathe, the stress we face—can alter the expression of our genes.

As Dr. Zannas explains it: “We are born with our genetic code, but the environment influences the extent to which those genes will get switched on or off.”

But that’s still not the whole story. Factors such as your parents’ beliefs and behaviors play a role, too.

“There are environmental factors, in terms of your learned behaviors or situations you’re in, that might activate a stress response,” Dr. Bauer says. “We know all of these things affect anxiety.”

While your genes are not destiny, they help explain why one person who goes through a traumatic event responds by building resilience and another develops an anxiety disorder.

Anxiety is thought to be about 30 percent inherited, Dr. Bauer says. That’s less than some other mental illnesses, such as schizophrenia and bipolar disorder, which have less of an environmental component.

The Anxious Household

A big part of a person’s environmental risk comes from the home where he or she grows up. Often, parents with anxiety model anxious beliefs and behaviors without realizing it, says UNC Health psychologist Amanda Harp, PhD.

“It’s a feeling of ‘the world’s not safe, anything bad can happen to anyone at any time,’” she says.

If a mother yanks her child back on the sidewalk when a stranger approaches, the child will pick up on that sense of danger and receive a message to be fearful. This is helpful if the stranger is a threat, but much more commonly that isn’t the case.

Anxious families tend to overestimate negative information, Dr. Harp says. So if an anxious parent hears something scary or tragic on the news, it isn’t viewed as an outlier but rather a likelihood. That might keep parents from letting their children go on school trips, walk to a friend’s house or learn to drive.

“When you hear something bad,” about a car crash or a child abduction, for instance, “it is the example,” Dr. Harp says. “There’s an overestimation of incidence rates.”

Anxious parents might display superstitious behavior (“I don’t want to say I’m having a good day, because something bad will happen”), and they might teach that anxiety is protective (“if that person had been more careful, that wouldn’t have happened”). Anxious families sometimes spend a lot of time taking in news and information, even “looking for the worst stories,” Dr. Harp says.

How to Break a Family Cycle of Anxiety

Parents who are concerned about passing on anxiety can’t change their children’s genes, but they can work to create a less anxious environment.

The first step is awareness, Dr. Harp says. When she talks to mothers in her work with postpartum depression and anxiety, she asks, “Who in your family was anxious?”

“Almost always, a primary caregiver modeled that for them,” Dr. Harp says. And they realize that they might be modeling anxious beliefs and behaviors for their own children. It’s not the parents’ fault—they are simply doing what they inherited and absorbed—but it’s why treating a parent’s anxiety is critical.

If you’re a parent struggling with anxiety, getting yourself into therapy can have a major positive impact on your children. If you notice persistent anxious thoughts or behaviors in your child, talk to his or her pediatrician as early as possible so that treatment, if needed, can begin before patterns are established.

“I’m so glad when people are in treatment because it’s potentially going to have a multigenerational effect of ending the transmission of anxiety,” Dr. Harp says.

Eventually, the work of researchers such as Drs. Zannas and Bauer could lead to the precise mapping of genes that could tell a physician that a person is prone to developing anxiety just by drawing blood. It’s conceivable that someday physicians will be able to tell which children are most at risk for anxiety disorders and suggest early interventions, such as therapy before symptoms appear and treatment for parents.


If you’re concerned about mental health in your family, talk to your doctor. If you don’t have a doctor, find one near you.