Living with Anxiety

As one of the many people living with an anxiety disorder, I hope to use this article to pass along a few things I have learned which might prove beneficial to you, and as always to dispel certain misperceptions. Rather than sticking to my usual essay format, I'd like to offer a some initial thoughts about anxiety, and then provide four lists that address the most common queries I receive: Things to know about psychiatric medications, characteristics to look for in a counselor, practical things that may help, and a few scripture verses particularly relevant for those who suffer from anxiety. I hope this will allow me to cover the most ground in the shortest amount of time.

Here then are some basic things to keep in mind about anxiety disorders:

1. Anxiety is the war you never wanted to fight. There you were, minding your own business, when suddenly something in your mind seemed to snap. Your thoughts became increasingly self-absorbed and obsessive. You started having alarming physical symptoms. Things that most people would not consider difficult suddenly became challenging. Perhaps you now wake up every morning with your heart pounding. Try as you might, these things have not simply gone away. They have continued day after day without reprieve. The unrelenting character of the disorder is part of what makes it so utterly discouraging. You find yourself at war with your own body and mind, struggling to regain a sense of normalcy. Yes, you feel like you are doing battle every day, and you struggle to understand how you got in this situation and if there is any way out. 

2. Anxiety has physical, mental, and spiritual components. Too many people miss one or more of these elements. Anxiety disorders have real physical symptoms (rapid heart rate, tensed muscles, shortness of breath, fatigue, chest pain, etc.) brought on by identifiable physical things like the hormone epinephrine. However, anxiety also reveals the intimate connection between the mind and body. Sometimes anxious thoughts precede an increase in physical symptoms, while at other times the body seems to go haywire for no reason, leading to a downward spiral of negative emotions. As a Christian, I also believe that there is a spiritual component to anxiety. No, this does not mean that your anxiety disorder is necessarily the result of sin or a lack of faith. There is also no sure way to tell if it involves some form of spiritual warfare. What we do know is that anything this major in the life of a Christian surely affects one’s relationship with God and spiritual well-being. There is no separating the mental and emotional from the spiritual. Do not be ashamed by this, but simply acknowledge it as a fact of how God made us.

3. Anxiety is more than just being scared. People complain about being anxious or worried all the time, but clinically diagnosable anxiety goes beyond this. The human body is designed to respond quickly to alarming stimuli: It’s part of what keeps us alive. In a world full of lies, we are naturally doubtful of certain information that is presented to us. Knowing our own flaws, we question whether we have done everything correctly. An anxiety disorder takes all of these usually beneficial things and pushes them into overdrive, to the point that they hinder normal functioning. I call this "the mind turning in on itself." Things that shouldn’t cause alarm become terrifying, and doubt is attached to everything. Whereas our minds and bodies are intended to stay in a highly alert state only long enough to react to danger, anxiety keeps a person in that state constantly, with the mind so overloaded with fears that the result is something close to paralysis. This can continue for weeks, months, or even years.

4. Anxiety has an evil cousin, and they love to hang out. That evil cousin is depression. While there is much that we still do not know about the human brain, statistics and basic observation confirm that those with an anxiety disorder are more likely to suffer from clinical depression and vice versa. Some of the same neurotransmitters involved in one condition also affect the other, and certain medications can help to treat both. The fact that these two conditions tend to exist side-by-side makes them both that much more miserable. A whole host of other conditions also seem to be associated with anxiety or make it more likely, such as irritable bowel syndrome, fibromyalgia, bipolar disorder, and post-traumatic stress disorder.

5. Anxiety is a very common disorder. One does not have to look far to find statistics that confirm this. The Anxiety and Depression Association of America states that 18.1% of Americans will suffer from diagnosable anxiety in any given year, though the majority will not receive treatment.[1] The National Institute of Mental Health provides a figure of 19.1% per year and 31.1% over the course of a lifetime, with significantly more females suffering in a given year (23.4%) than males (14.3%).[2] This makes it highly likely that either you or a loved one will suffer from diagnosable anxiety at some point.

6. Anxiety is not proof of personal weakness. The latest clinical research suggests that anxiety is caused by a complex host of factors, such as genetics, underlying physical conditions, and stressful life circumstances. More research is certainly needed, but given what we now know about how the brain is affected by neurotransmitters (e.g., dopamine, serotonin, and norepinephrine), there is no reason to believe that an anxiety disorder is the result of personal weakness any more than autoimmune disorders, poor vision, or cancer. Anxiety can perhaps reveal our weaknesses in a most unpleasant way, reminding us of our human frailty. However, the fact that one person suffers and another does not is not proof of their respective levels of bravery or strength. Courage is what we do in spite of fear, and faith is what we believe in spite of doubt.

7. Anxiety is not a battle you have to fight alone. Although this condition can be very isolating, we know that those who are in Christ are never alone. His Spirit is with us constantly. We can speak to God at every moment, and we know that He is working to bring about our good in everything. We also know that the redemption of our bodies is nigh, and God will be glorified in our weakness. In addition, the vast majority of us have family, friends, co-workers, neighbors, and fellow church members who may be in a position to help us. There are doctors, pastors, and counselors ready to lend a helping hand. Remember those who are on your side, praying for you and supporting you. Find people you can trust, and open up to them. Build a team in your fight against anxiety.

8. Anxiety is best addressed with an “all of the above” or “both/and” strategy. There is intense debate in the Christian community about the best way to manage conditions like anxiety. Some insist that the medical community has nothing useful to offer Christians, and all the treatment you need can be found in God’s Word. Others are equally convinced, perhaps due to negative personal experiences, that the Church is only likely to harm you with its ignorance and you should stick to the proven benefits of medicine. I say that when you go to war, you don’t do so with one hand tied behind your back. If anxiety involves physical, mental, and spiritual components, then you need to treat all those things. Yes, you need to make sure that your pastor or counselor is not ignorant of or antagonistic toward the medical aspects of your disorder and its treatment. Likewise, you do not want a doctor who simply throws a prescription at you with little thought or a counselor who is dismissive of your deeply held beliefs. Both the Church and the medical community have a role to play in your healing. If one of them proves ineffective or harmful, the answer is to seek out different people, not give up on one or the other entirely.

Having covered those initial points, I now offer a series of quick thoughts that may be helpful to those who suffer from anxiety.

Things to know about psychiatric medications:

• Psychiatric medication in and of itself is neither good nor evil, even as most other medicines are morally neutral in and of themselves.
• Different medications will have varying effects depending on the person and a host of circumstantial factors, so you may need to endure a period of trial, error, and adjustments.
• There are different classes of medications, each of which must be properly understood.
• Some medications take weeks to build up in your system, while the effects of others are felt almost immediately.
• Many medications have potentially negative side effects and withdrawal effects; ask your doctor about them and seek information from other reputable sources.
• Some medications come with warnings for pregnant women, or can interact badly with other substances such as alcohol.
• Medications are worth considering if your normal functioning has been affected for a significant amount of time, particularly if standard coping mechanisms have proved insufficient.
• Some people see a great benefit from medication, but medication alone does not fully solve the problem of anxiety.
• Contact your doctor right away if you experience serious side effects mentioned in the warning information for your medication, such as suicidal thoughts.
• All changes in medication should be made in concert with a knowledgeable, licensed physician who oversees your treatment plan. This last point is key! Many, many people have put themselves to grief by making abrupt changes without proper consultation.

Characteristics to look for in a counselor:

• Someone who understands that anxiety involves physical, mental, and spiritual components.
• Someone who is sympathetic to your condition and never disrespects you.
• Someone with a high level of discretion.
• Someone who strikes a good balance of listening and advising.
• Someone who will frequently point you to scriptural truth if they are a Christian.
• If they are not a Christian, someone who does not suggest that your faith is the problem or attempt to denigrate it in any way.
• Someone with a wealth of experience and wisdom.
• Someone who does not rely on or recommend resources that include false information or teachings.
• Someone who seems to be a good fit with you in terms of personality.
• Someone who will challenge you, but always in a gracious manner.

Practical things that may help, all tested by this author:

• Set small, achievable goals and celebrate their completion.
• Stick to a comfortable routine, but anticipate that it might be interrupted.
• Leave encouraging notes for yourself to read in obvious places.
• Understand the rhythm of your anxiety: Is it worse at a particular time of day or around a certain type of event?
• Keep a supply of relatively nutritious comfort foods on hand.
• Incorporate some form of exercise into your day; it need not be strenuous.
• If you live in a place with little daylight in winter, spend some time outside, try to sit near a sunny window, use a sunlight imitating light in the morning, or walk around inside a brightly lit indoor space.
• Take time during the day to stop and breathe deeply, particularly if you start to feel panicked.
• Seek out a trusted friend who can pray with you regularly.
• If living alone, ask a loved one to call you periodically.
• Strive to make it to church whenever you can; you will be encouraged!
• Expect to have some setbacks, but aim for a general upward trajectory.
• Commit your fears to the Lord by name when you pray.
• Especially spend time reading the Psalms.
• Get going; sitting around in anticipation can be worse than the actual event.
• Watch, read, or listen to things that will make you laugh.
• Take advantage of things that will help to de-stress your life (e.g., maid service, grocery delivery, accepting an offer of assistance from a friend).
• If possible, attempt to gently and graciously spend less time conversing with persons who are known sources of stress in your life.
• Get a massage intended to calmly relieve muscle tension or soak in hot water.
• Listen to music that inspires and calms you, such as beloved hymns or classical pieces.

Cling to scripture verses like these:

“‘I love You, O Lord, my strength.’
The Lord is my rock and my fortress and my deliverer,
My God, my rock, in whom I take refuge;
My shield and the horn of my salvation, my stronghold.” (Psalm 18:1-2)

“If the Lord had not been my help,
My soul would soon have dwelt in the abode of silence.
If I should say, ‘My foot has slipped,’
Your lovingkindness, O Lord, will hold me up.
When my anxious thoughts multiply within me,
Your consolations delight my soul.” (Psalm 94:17-19)

“If I say, ‘Surely the darkness will overwhelm me,
And the light around me will be night,’
Even the darkness is not dark to You,
And the night is as bright as the day.
Darkness and light are alike to You.” (Psalm 139:11-12)

“This I recall to my mind,
Therefore I have hope.
The Lord’s loving kindnesses indeed never cease,
For His compassions never fail.
They are new every morning;
Great is Your faithfulness.” (Lamentations 3:21-23)

“For I consider that the sufferings of this present time are not worthy to be compared with the glory that is to be revealed to us. For the anxious longing of the creation waits eagerly for the revealing of the sons of God. For the creation was subjected to futility, not willingly, but because of Him who subjected it, in hope that the creation itself also will be set free from its slavery to corruption into the freedom of the glory of the children of God.” (Romans 8:18-21)

“Because of the surpassing greatness of the revelations, for this reason, to keep me from exalting myself, there was given me a thorn in the flesh, a messenger of Satan to torment me—to keep me from exalting myself! Concerning this I implored the Lord three times that it might leave me. And He has said to me, ‘My grace is sufficient for you, for power is perfected in weakness.’ Most gladly, therefore, I will rather boast about my weaknesses, so that the power of Christ may dwell in me.” (2 Corinthians 12:7-9)

“Therefore, since we have so great a cloud of witnesses surrounding us, let us also lay aside every encumbrance and the sin which so easily entangles us, and let us run with endurance the race that is set before us, fixing our eyes on Jesus, the author and perfecter of faith, who for the joy set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God.” (Hebrews 12:1-2)

All scripture verses are from the 1995 New American Standard Bible, copyright The Lockman Foundation.

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[1] https://adaa.org/about-adaa/press-room/facts-statistics

[2] https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml

Amy Mantravadi holds a B.A. in Biblical Literature from Taylor University. She is an active member of Patterson Park Church in Beavercreek, Ohio. You can read her blog at www.amymantravadi.com or follow her on Twitter @AmyMantravadi.