The functional medicine approach to anxiety highlights an individualized, systems based approach to treatment. We know that your neurotransmitters are imbalanced, but what causes them to be dysfunctional in the first place? This is where individualized testing and treatment take precedence. For some, a neurotransmitter imbalance may be caused by HPA (hypothalamic–pituitary–adrenal) axis hyper-, or hypo-function. For others, the cause may be gut dysfunction, nutritional deficiencies, sex hormone imbalances, neural inflammation, vascular insufficiency or a combination of these factors. Being a multi-casual disorder, it is irrational to treat everyone with the same approach.