Talk about your basic question.
As a former President once said, it all depends on what you definition of "it" is. Let me refer you to one of my journals, the one entitled "Meet the Panic Family," which will give you a tour of the broad waterfront of the disorder. For now, let me simply say that unless there is some independent disease process or imbalance of your chemistry, anxiety is caused by emotional experiences which your brain has yet to resolve. You can see how this works in cases of "situational" anxiety. Example: you've got to testify in court against a co-worker friend to whom you had always promised complete secrecy and trust. Your heart pounds, you are sweaty -the whole deal. You are ANXIOUS. Pick whatever scenario scares the dickens out of you. You get the idea. But in THESE cases, the cause is clear, you see the connection between the emotional challenge and your anxious reaction.
Going with our courtroom drama, what do you DO about the anxiety? Your last best option is to get out of it entirely, so you tell the prosecuting attorney that you made up your whole story, that it was a lie, that you just wanted to get the guy in trouble. The case is dropped, the star witness turns out to have LIED. OK, the heat's off. But is it really? Your friend may never forgive you for having abandoned the friendship, the attorney and your employer see you as a fraud -there goes your promotion chances, and your wife looks at you like you are weak-kneed lilly-livered little coward. And it will take a long time to get over it -maybe, forever. BUT, your ploy "worked" in that it kept you off the stand, and the friendship, while broken, may not be totally trashed. But, did it really work? In the final analysis, you may wish you HAD gone through with it -and now, you CAN'T. Catch my drift here? You can plainly see in the here and now how all this works in terms of producing anxiety.
But suppose the challenges were was very much in your past. Back then, even perhaps as a litttle kid, you adopted behaviors that "worked." You had failed to complete a homework assignment, so you got a tummy ache. That got you sympathy, so you deployed weakness and helplessness in yet OTHER scenarios. Make up whatever you want -the point is that the adaptations worked at the time, but over the course of your life have proven to be less and less effective.
There are two problems here: first of all, the strategies you employed may have seemed sort of normal at the time -everything else just kept moving along. At the same time, you may not have been aware that your tactics were becoming more deeply embedded in your own psychology the more you used them. And how COULD you know? You were a kid -you had no adult experience, no context to compare things with. You just did what you did. The other big problem is that, as an adult, years later, the whole thing is deeply buried in your past -you really can't connect today's anxiety with the material from years ago. Which is why the anxiety can seem to come from "nowhere." Your brain, however, "knows" that things ain't workin' the way they are supposed to -so up come the signal flares -the anxiety and panic.
Medications can help take the fire out of the symptoms, but they do NOTHING in terms of putting the fire "out." That's the job of therapy -so if you have anxiety -and want to get rid of it -as opposed to just treating it, then get the therapy. This helps you figure out how it came to be in the first place, and to make adjustments that drop the old adaptations. An example: when I was in the full bloom on my 40+ years of anxiety and panic, it was very important for me to be "right." The fact that I sometimes was "right" -in terms of facts- was irrelevant; it was the NEED that was the big deal. And so, in relationships, I won a lot of battles -and lost a lot of wars. This, of course, fed back into the whole process and provided me with an undending series of conflicts. On top of that, there were many people with whom I did NOT act out my "rightness," people more powerful than me, people whose love I needed, or whatever. And so, I carried around suspicion and resentment. You can pretty well figure out how all that would give me an anxious feeling.
Anyway, in the course of therapy, I began to substitute other points of view for being right. Examples: Sometimes it is better to be good than it is to be right. What do I value the most - a functional relationship and open communications -or a "win?" I also began to understand that what someone else said or thought could "make sense" (be right to THEM) within the context of THEIR OWN experience. So I began to understand more about WHY people thought about things as they did and in many cases was persuaded to adopt their own view as my own. And, truth to tell, most of the time it hardly matters who is "right" or "wrong." The world will keep turning. Finally, when I indeed wanted to take a stand or a position, while I might attempt to explain it, I felt no need to defend it or prove it -I just DID it. Bottom line -things got better. This did not get RID of anxiety; rather, it simply moved both the causes and the effects into the here-and-now, where you know what's causing what. It therefore becomes more manageable.
Relationship with hormones? You bet! But it is not necessarily a one-to-one deal, in which a chnage in a hormone has an exact matching change somewhere else. Let's just say that hormones are both responsive to -and contributors to- perceived stress. You would not attempt to chnage the chemistry of a hormone to make anxiety disappear. The causes are in thought paterns and adaptations -so that's where the "cure" is also. Therapy "takes you there."
Zoloft did not make ME gain weight. But that's just me. Youir mileage may vary, see doctor for details.
Thanks for the question and for joining us.
Wow. Impressive response. Thank you!