Everyone’s experiences of anxiety are different, and the causes of anxiety can be complicated. What is clear is that the relationship between anxiety and any social and/or environmental factors is complex and bidirectional.
Social and environmental factors can contribute to the development and maintenance of anxiety and affect our ability to engage effectively in social situations. These social and environmental factors can include childhood trauma, social isolation, negative life events, stress relating to work or education, physical or mental health problems, and social and societal pressures.vi Gender can also play a part. Women are almost twice as likely to experience anxiety as men.vii
Other studies suggest that women are more likely to experience physical and mental abuse than men, and abuse has been linked to the development of anxiety disorders.viii
Social isolation
Individuals who experience social isolation or loneliness often have a reduced quantity or quality of social contacts compared to those who report positive social relationships. Social isolation can lead to difficulty initiating social interactions with others, often leading to feelings of rejection and insecurity.
Similarly, loneliness can lead to negative self-evaluation and feelings of inadequacy, further heightening an anxiety response.ix While anyone can experience loneliness, certain risk factors increase our chances of severe and lasting loneliness that can affect our mental health and sometimes increase our levels of anxiety. These include:x
- Death of a partner
- Being single
- Being unemployed
- Living alone
- Having a long-term health condition or disability
- Being between 16 and 24 years old
- Being a carer
- Being from a minority ethnic community
- Being LGBTQ+
Childhood trauma
Childhood trauma such as physical, emotional, or sexual abuse, or neglect, can cause long-lasting effects on a person’s mental health. Experiencing childhood trauma can predispose people to developing anxiety. This can be due to changes in brain development affecting our fight or flight response, memory, and emotion regulation.
Childhood trauma can also lead to negative beliefs about oneself or the world, making it more difficult to manage stressful situations and increasing the likelihood of developing anxiety.
Negative life events
Negative life events can also contribute to anxiety. These are events that cause a significant emotional impact and disrupt our sense of security or well-being.
Examples of negative life events that can, for some people, lead to anxiety include:
- Divorce or the end of a significant relationship which can leave a person feeling vulnerable and anxious.
- Experience of abuse or domestic violence which can result in living with intimidation and fear in your own home (which should be a safe space).
- Exposure to a stressful work, education, or community environment - for example, experiencing bullying, harassment, or discrimination in any of these environments which can lead to ongoing anxiety (in particular for women and marginalised communities).
- A car accident, physical assault, or other traumatic events which can trigger anxiety symptoms such as panic attacks, flashbacks, or avoidance behaviours.
- Job insecurity or an excessive workload which can also increase anxiety levels.
- Financial strain which can cause feelings of anxiety and worry. Experiencing financial issues (for example, being made redundant, living on benefits, or struggling with debt) has been known to be associated with the presence of depression and/or anxiety.xi
Societal pressures
Societal pressures can contribute to feelings of stress or anxiety, as people feel the need to meet cultural or societal expectations, standards, or norms.xiii For example, the idealisation of a ‘perfect’ body can lead to body dissatisfaction and anxiety about physical appearance.xiv The pressure to be successful, achieve high grades, or excel in your career can also lead to anxiety about performance and fear of failure.
Gender and expectations can lead to feelings of anxiety or depression, particularly for those who don’t hold specific gender roles. In addition, those who identify as LGBTQ+ are around twice as likely to report symptoms of poor mental health (i.e. anxiety, depression) than heterosexual adults.xv Although LGBTQ+ people represent only a small proportion of the total youth population, they are at increased risk of experiencing hostile environments at home and in wider society and are also subject to direct and indirect discrimination, harassment, and inequality, with detrimental consequences for their mental health.xvi
Societal pressures can also be gendered. Society has different expectations of men and of women as to how they express their emotions. Men are often socialised to suppress their emotions and hide their vulnerability. This can make it more difficult for men to recognise and seek help for anxiety, leading to a higher prevalence of undiagnosed or untreated anxiety among men.
Financial status. Society’s expectation to achieve significant milestones and acquire certain goods or services may lead to feelings of inadequacy or anxiety about financial status.
Lack of access to mental health resources and support
Many different factors can lead to unequal access to mental health resources and support. Some common barriers include waiting times, transport, education and literacy, language or cultural barriers, stigma and discrimination. When people are unable to access the right support at the right time, this can cause anxiety to worsen.
Tammie's experience of anxiety
Tammie speaks of the pressure of being a student contributing to feelings of anxiety:
“The pressure to succeed and be great and not disappoint others is very prominent. Especially when the schools you have attended have fostered an extremely competitive environment. Any thought of falling short is very anxiety-inducing.
“Also, I know that for a lot of people, when they started university, their feeling of social anxiety increased greatly. It was a very new and overwhelming environment.”
Tammie also spoke about the effect racism can have on mental health:
“Being a Black British young person has brought on many intense feelings of anxiety. There have been environments throughout my life that have been less than welcoming, and it becomes such an intense thought when I anticipate entering those environments again.“
Socio-economic factors
The relationship between socio-economic status and anxiety is complex, and influenced by a variety of individual, familial, and environmental factors. However, the evidence is clear that experiencing material deprivation and financial strain increases a person’s risk of having a mental health problem such as anxiety. Specifically, poverty, unemployment, and low education levels can all increase the risk of someone developing anxiety.
People experiencing financial stress and being unable to afford essentials including food, heat, and mortgage/rent due to rising inflation report higher levels of anxiety.xvii
Deprivation is about more than a lack of money. It can include a lack of access to resources such as adequate housing and exposure to negative stressors, such as violence, abuse and crime, or a lack of public green space. A growing body of evidence suggests the relationship between deprivation and mental health is not just about the absolute lack of resources for individuals.xviii
In our research, we asked those that had been anxious in the past two weeks what was the cause of their anxiety. The most commonly reported cause of anxiety was being able to afford to pay bills, reported by 32% of respondents. The top eleven causes of their anxiety are detailed below:
We found that some specific groups of respondents were more likely than others to be anxious about paying bills:
The cost-of-living crisis has undoubtedly led to increased levels of material deprivation and financial strain in the UK population, which is putting people’s mental health at risk. Our research provides new evidence of the extent to which financial strain is negatively affecting people’s mental health, specifically their experience of anxiety. Worryingly, some of the behaviours that are protective of mental health (for example, getting enough sleep and maintaining connections with family and friends) are the very behaviours that people may be reducing to cope with the increased cost-of-living.
Uncertain times: Anxiety in the UK and how to tackle it.
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vi - Marmot, M. Fair society, healthy lives : the Marmot Review : strategic review of health inequalities in England post-2010. (2010) ISBN 9780956487001
vii - Remes, O et al. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain and Behavior; 6 June 2016; DOI: 10.1002/brb3.497
viii - Kinderman P, Schwannauer M, Pontin E, Tai S (2013) Psychological Processes Mediate the Impact of Familial Risk, Social Circumstances and Life Events on Mental Health. PLoS ONE 8(10): e76564.
ix - National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.
x - https://www.mentalhealth.org.uk/our-work/research/loneliness-and-mental…
xi - Dijkstra-Kersten, Sandra & Biesheuvel-Leliefeld, Karolien & Van der Wouden, Johannes C & Penninx, B.W. & Van Marwijk, Harm. (2015). Associations of financial strain and income with depressive and anxiety disorders. Journal of epidemiology and community health. 69. 10.1136/jech-2014-205088.
xii - Dejonckheere, E., et al. (2022). Perceiving societal pressure to be happy is linked to poor well-being, especially in happy nations. Scientific reports, 12(1), 1514. https://doi.org/10.1038/s41598-021-04262-z
xiii - Harper B., Tiggemann M. The effect of thin ideal media images on women’s self-objectification, mood, and body image. Sex Roles. 2008;58:649–657. doi: 10.1007/s11199-007-9379-x.
xiv - Dittmar H., Howard S. Thin-ideal internalization and social comparison tendency as moderators of media models’ impact on women’s body-focused anxiety. J. Soc. Clin. Psychol. 2004;23:768–791. doi: 10.1521/jscp.23.6.768.54799
xv - Semlyen, J., King, M., Varney, J. et al. Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC Psychiatry 16, 67 (2016). https://doi.org/10.1186/s12888-016-0767-z
xvi - Hudson-Sharp, N. & Metcalf, H., 2016. Inequality among lesbian, gay bisexual and transgender groups in the UK: a review of evidence. National Institute of Economic and Social Research 1, 1–134.
xvii - Mental Health Foundation (2023). Mental Health and the Cost-of-Living Crisis: Another pandemic in the making? Glasgow: The Mental Health Foundation
xviii - Pickett KE, James OW, Wilkinson RG. Income inequality and the prevalence of mental illness: a preliminary international analysis. J Epidemiol Community Health. 2006 Jul;60(7):646-7. doi: 10.1136/jech.2006.046631. PMID: 16790839; PMCID: PMC2652881