It really does not make a difference. It could be a combination of all of them. If you have these symptoms, there is no blanket treatment for them. There are plenty of skills you can learn to make living with them easier.

Some things that can make a difference are:

Your age

Your hormones

Your diet

Your stress level

More drug use/abuse

Past alcohol abuse, especially as an adolescent

Illness

Environmental toxins


So, there could be so many causes that you should be focusing on skills to work-around these struggles.