High Neuroticism is not a diagnosis

Neuroticism is one of the five normal traits of personality: it describes how often and how strongly you tend to react with unpleasant emotions to threat, frustration and loss (Lahey, 2009). Everyone has a score on this scale, just as everyone has a height. A high score is not a symptom, it has no cure, and it is not a neurosis. Searches for the word often pair it with "symptoms", "causes" and "treatment", and that confusion is worth clearing up.

Neuroticism and neurosis are different words

"Neurosis" is a clinical term with a long history: the Scottish physician William Cullen first used it in 1777, and its meaning later shifted with Charcot and Freud (Treccani). It names a condition of psychological suffering showing up as anxiety, irritability, phobias, obsessions or compulsions.

The Big Five trait is something else. It is a continuous dimension describing normal differences between people, measured with statements such as "Worry about things" or "Get angry easily". The resemblance between the words is a historical leftover, not a sign that the trait is a mild form of disorder. To avoid the mix-up, our site also calls it emotional sensitivity.

What research says about anxiety and depression

The link is real, and it should be said plainly. A meta-analysis of 175 studies found that people diagnosed with anxiety or depressive disorders score, on average, much higher in Neuroticism than people without a diagnosis (Kotov and colleagues, 2010). That compares groups already diagnosed, so it does not say which comes first.

Studies that follow people over time answer that question. A synthesis of 59 prospective studies with more than 440,000 participants found that Neuroticism predicts later anxiety and depression. The effect roughly halves once symptoms already present at the start are taken into account, but it does not disappear, and it holds over the years (Jeronimus and colleagues, 2016). The authors describe it as a marker of risk present before a disorder begins.

A risk factor is not a diagnosis. Many people high in Neuroticism never develop a disorder, and some people low in it do. Our test does not measure disorders and can neither confirm nor rule one out. If you have felt bad for weeks, or anxiety or sadness keeps you from everyday tasks, the right person to talk to is a doctor or a psychologist, not a personality questionnaire.

Where it comes from

Like other traits, Neuroticism is partly heritable. A study of 250 twin pairs estimated that genetic differences account for about 41% of differences in Neuroticism, with nearly all the rest coming from personal experiences rather than the shared family environment (Jang, Livesley and Vernon, 1996). That matches the average for all traits, around 40% (Vukasović and Bratko, 2015). Heritable does not mean fixed.

It changes, and therapy moves it

Neuroticism falls on average with age, especially between 20 and 40 (Roberts, Walton and Viechtbauer, 2006). It is also the trait that moves most with psychotherapy: in a review of 207 studies, emotional stability changed more than any other trait during treatment, and the change lasted (Roberts and colleagues, 2017). We cover this in more detail in the article on how personality changes.

Does it have upsides?

You often read that a little Neuroticism is good for you. The evidence is thinner than the headlines suggest. The most studied version, "healthy neuroticism" in people who are also highly conscientious, partly held for some habits such as smoking but found no support for chronic disease in studies of tens of thousands of people (see the article on trait combinations). From an evolutionary view, every level of every trait has costs and benefits, with no single best value (Nettle, 2006): noticing sooner what might go wrong has a price and a use.

A high score says that unpleasant emotions reach you more often and more strongly than they reach the average person. It does not say you have a problem. The Neuroticism page explains what each level of the trait describes, and the test below shows where you stand.