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Roxanne has always been anxious. For as long as she can remember, her days have been touched by an intermittent feeling of dread and unease. She’s feeling it now more than ever. She’s in the middle of a cross-country move, transitioning into a new job, and recently got married. Roxanne knows that through all the changes, her anxiety will be extremely high. The unknowns are especially difficult to bear.

Shawn feels pressure in his mind and body frequently. After a long day of work, a visit from his parents, or even a social gathering, his body feels stiff and tense. He often says he’s stressed but has trouble identifying why. His wife is beginning to grow frustrated with him…she wishes she could read Shawn’s mind in times when he is clearly overwhelmed but unable to communicate what he’s feeling beneath anxiety.

Zoe grew up in a family that greatly valued hard work and education. She was on the basketball team, the dance team, and just about every club that fit into her schedule in high school. Her parents would reward her straight A’s with vacations each year, and proudly placed her report cards and medals around the house. Now that Zoe is in college, she’s beginning to question her tendency to overwork herself. Exhausted and worn out, she’s exploring who she is separate from her productivity. Zoe wants to find time to relax and enjoy college life, but each time she attempts to have fun, she feels anxious.

Tightness in your chest, difficulty breathing, feeling hot and sweaty, a pit in your stomach, or a lump in your throat…these are some of the physical sensations that come with anxiety. It’s unpleasant. It’s dreadful. And it’s the reality for many.

For more than 20 years, I’ve worked as a psychologist and treated many cases of anxiety. Anxiety is a general term, and it actually takes many different shapes, sizes, and forms. Roxanne, Shawn, and Zoe are experiencing anxiety, but the way it developed and how it has been managed may look quite different.

Anxiety in 3 Forms: Why It Develops and How to Manage It

1. Genetics

Anxiety isn’t solely a byproduct of one’s stressful experiences throughout life. In fact, some people are born with anxious tendencies in their DNA. Babies who are reactive, fussy, and sensitive may grow into anxious adults. If you suffer from anxiety, think about who else in your family might suffer as well. Many times, anxiety is passed down through generations.

Roxanne probably has biological anxiety. She has her ups and downs and notices her anxiety spike during significant life changes. Her anxiety is something that has been a part of her since birth and will continue throughout her lifetime.

How to Manage: If you have biological anxiety and need tools for managing it, consider seeing a cognitive behavioral therapist and/or a psychiatrist for antidepressant medication. The tools for effectively managing anxiety are plentiful. Here are two of my favorites: (1) When you begin to battle with your anxiety, you’ve already lost! Don’t give in to the temptation to engage with your anxious thoughts. (2) Focus on the here and now. Identify five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste.

2. Childhood Emotional Neglect

You experienced childhood emotional neglect if your parents failed to pay attention to your feelings and emotional needs as you were raised. Without emotional guidance, you pushed down your feelings to adapt to your childhood home. However, suppressing feelings doesn’t mean they go away. In fact, they get trapped under the surface, looming and waiting to be acknowledged. This creates a general state of tension and unease—in other words: anxiety. Because you aren’t tapped into your emotions, you can end up living in a state of numbness or anxiousness with little in between.

Shawn has difficulty understanding his emotions. Growing up with emotionally neglectful parents forced him to build a wall between himself and his feelings. As a result, he’s unable to access them, identify them, or use them, creating confusion toward his feelings, his anxiety, and the physical tension in his body as he continues to push down his invaluable emotions.

How to Manage: If you experienced childhood emotional neglect like Shawn, your first step toward managing your anxiety is slowly chipping away at the wall standing between you and your emotions. Start paying attention to your feelings, identifying them, attempting to understand them, accepting them, and putting them into words. When you put this into practice, you’ll begin to feel emotional and physical relief.

3. Personal Growth and Change

This type of anxiety rears its head when you’re about to take steps, no matter how big or small, to challenge unhealthy patterns in your life. It’s uncomfortable to do something different. Your mind and body are accustomed to operating in a certain way, even if it’s not getting you where you want to be. So, when you take steps toward emotional or psychological growth, anxiety can easily deter you, keeping you stuck.

Zoe has identified an unhealthy pattern learned from childhood: Her worth was dependent on how much she achieved. Just recognizing the pattern is an amazing step, and it’s even more amazing that she has chosen to take further steps toward overcoming this erroneous belief. Anxiety stands in her way as she does this, making her feel deeply uncomfortable about changing how she lives her life. Even though it’s the healthiest and best thing for her, it feels scary and dangerous.

How to Manage: When anxiety pops up in moments when you’re attempting to change old patterns, remember this: Anxiety is uncomfortable, but it’s not dangerous. Recognize that your anxiety is signaling discomfort, but be wise enough to know that you don’t need to listen to it. Allow it to be there and continue taking steps toward new, healthy patterns.

For Zoe, it’s imperative that she allows for rest and opportunities for fun in her college experience despite her feelings of anxiety. Each time she takes a step away from productivity and toward rest, she’s reprogramming her brain to understand that rest does not make her unworthy. In fact, rest is necessary and healthy.

The bottom line: Do the opposite of what your anxiety tells you to do. If anxiety tells you that you are in danger, remind yourself you are not. If anxiety tells you not to spend time with your friends, spend time with your friends. If anxiety tells you that you can’t repair old patterns, know that you can.

And you will. Because you can identify your anxiety, understand the cause, and choose to take steps that lead you toward the life you want to live.