Epigenetics at the crossroads between genes, environment and resilience in anxiety disorders

The pathogenesis of anxiety disorders is multifactorial, involving complex interactions between biological factors, environmental influences and psychological mechanisms. Recent advances have highlighted the role of epigenetics in bridging the gap between multiple contributing risk factors toward an increased understanding of the pathomechanisms underlying anxiety. In this review, we present an overview of the current state of knowledge regarding putative risk mechanisms in the pathogenesis of anxiety disorders, placing a particular focus on the role of protective factors serving to buffer a risk factor constellation and the role of epigenetic processes functioning as a potent turnstile changing passage direction toward disorder risk or resilience. We discuss promising future directions in epigenetic research regarding the prediction, prevention and personalized treatment of anxiety disorders.