• Help Me Understand Your Anxiety Disorder: Spiritual Practices and Other Means of Support

    This is the sixth post in a series that I am writing to help people in the church better understand mental health, and particularly anxiety disorders. Click to read the firstsecondthirdfourth, and fifth posts.

    After all I’ve shared in this series, you might be asking: if you have an anxiety disorder, and you are a Christian, how do you know if what you’re experiencing is sinful worry and something to repent of, or a symptom of your anxiety disorder? I understand wanting an answer to that question. It’s one that I’ve asked many times over the past few years and have grappled with in counseling with my Christian counselor. I don’t want to be complacent; I want to kill sin in my life at every turn. I’m also a bit of a perfectionist, and a rule-follower, and really want the security of knowing that I am doing everything correctly.

    But at the end of the day, the answer is: you can’t perfectly untangle it. If you have placed your faith in Christ alone for salvation, you are in Christ, and you have the Holy Spirit living inside of you. The Spirit will convict you of sin, and as you find sinful worry and fear in your life, you turn to Christ, repent, and remind yourself again that in him you are righteous. But you will likely never be able to perfectly delineate exactly whether every thought you have is springing into your mind from a misplaced reliance on self and lack of faith in God versus being driven into your mind by your disregulated nervous system. 

    In many cases, believers with anxiety disorders are extremely vigilant about rooting out sinful worry, because they are more aware of their tendencies and they have done a lot of work to understand and confront their fears and worries with truth. I know this is true for me. In fact, while my anxiety disorder has been a source of great suffering for me, it has also been one of the greatest sources of my sanctification. 

    I truly believe that God could heal me at any moment, and I have begged him to—but at the same time, when I see the good fruit that has come from my suffering, there is a part of me that has great peace about continuing to bear it. I hate having an anxiety disorder—and yet, how can I hate the thing that has made me the most like Christ?

    If you’re suffering from an anxiety disorder and still feeling crushed under the belief that it is solely due to your own sin, or if you are someone who persists in believing that the root of all anxiety disorders is sin, I would simply say this: I think a good rule of thumb is that sin does not make you more Christ-like. If something is making a person more like Christ, it’s very unlikely that it’s caused by unrepentant sin. We are all sinners, but if you think of someone experiencing an anxiety disorder as more of a sinner than a sufferer, I plead with you to reconsider.

    If you are a believer with an anxiety disorder, you surrender yourself to God and you do the work that you can, as best as you can. There are lots of things that will affect the severity and frequency of the disregulation of your nervous system and the physical symptoms that you experience. For example, sleep has an enormous effect on the body’s ability to regulate itself. So, you do what you can to get good sleep—but if you’re a new parent, or have to work long hours to make ends meet, or any of a host of other reasons why you might have disrupted, too little, or low-quality sleep—you may experience more symptoms. You are not failing if this happens—you are simply experiencing the reality of life in this broken world.

    If you are a believer and you think you may suffer from an anxiety disorder, I highly, HIGHLY recommend that you see a counselor. The primary counselor I see is a Christian counselor, meaning that she incorporates our mutual convictions about God, sin, and the gospel into my therapy, but is also educated and knowledgeable about various methods of evidence-based therapy that are not solely based on the Biblical text. This is not true of all counselors who are Christian. You should RUN, not walk, away from any counselor who does not acknowledge the basic realities of how mental illnesses, including anxiety disorders, work. If you go to a counselor and it’s clear that they believe anxiety is only sinful, they are not educated about the role of physiology in anxiety disorders, and deny or only pay lip service to the common grace God has given us in medicine, medication, and psychological research, their approach is not Biblical, but rather Gnostic. If this is their approach, they likely are not even qualified to assess whether your anxiety is clinical in nature. Please be wary, because there are many purported counselors who are Christians and take this sadly misinformed approach.

    I have also found good support in working with a counselor who is trained in Cognitive Behavioral Therapy. Especially if you are prone to panic attacks, this approach can be extremely helpful.

    This is how I have learned to wisely manage my own anxiety disorder. I don’t simply throw up my hands and say there’s nothing that I can do, but I also accept that God has providentially allowed this limitation, this suffering, this particular form of brokenness in our sin-crushed world, into my life, and I cannot ignore it, or pretend it doesn’t exist, or make it go away unless and until He wills it. I accept that there is grace for me in my imperfection. He knows my frame; he remembers that I am dust.

    Fellow sufferer, he knows your frame, and he remembers that you are dust. We are not simply disembodied brains floating around in the world—we are embodied souls. When God created us, he gave us our bodies—the ones that betray us, yes, but also the one that is an integral part of who we are, that is part of our whole humanity, that will one day be redeemed and glorified.

    I have only scratched the surface in this series, and there is so much more that can be said about issues of mental health and the church. I am passionate about the church understanding these issues. If you have questions, please let me know. If you have an anxiety disorder, I hope this is encouraging to you. If you do not, I hope this is educational. My fervent prayer is that we, the Church, would not inadvertently wound those who are suffering from anxiety disorders or other mental health problems due to misinformation or ignorance about these issues.

  • Help Me Understand Your Anxiety Disorder: Fear or Worry vs. Clinical Anxiety

    This is the third post in a series that I am writing to help people in the church better understand mental health, and particularly anxiety disorders. Click here to read the first post, and here to read the second post.

    At the outset, I want to make clear that as I go through the differences between fear or worry versus clinical anxiety below, these are based primarily on my own personal experiences. Therefore, please don’t understand me to be speaking for every person who has an anxiety disorder, because these disorders can manifest in a variety of ways, and it is not my intent here to discount or negate someone else’s experience. I simply want to offer my experiences as one means to provide understanding and education about anxiety disorders.

    People who have anxiety disorders, like every other human being, experience worry and fear. If you are a Christian, you believe that a person also experiences sinful worry and fear. However, speaking from my own experience, the primary indicator that you have an anxiety disorder is NOT simply that you worry a lot.

    I’m going to say that again.

    The primary indicator that you have an anxiety disorder is NOT simply that you worry a lot.

    Let me explain.

    Think about a time that you were worried–say, about a big test, or a review at work, or because you were about to see someone with whom you have a strained relationship. Now, think about how your body felt in that moment. If you have to, close your eyes and recall it. How did you know that you were worried? Did your stomach feel slightly sick? Was your heart beating a little faster than normal? Did you feel lightheaded? Did you feel slightly shaky? Were you sweating? Did your brain feel a bit fuzzy or easily distracted? You may not have felt all or any of these specific things, but if you pay close attention, there were physiological changes that caused physical sensations in your body that you associate with being worried.

    Okay, similar exercise. Think about a time that you felt afraid, say, when your home alarm went off in the middle of the night, or you almost got into a car wreck, or you were walking alone on a street at night and thought you heard someone following you. How did your body feel in that moment? Again, if you have to, close your eyes and recall it. Did you feel your heart beating in your chest? Did you feel blood rushing in your ears? Did you feel your face flush and get warm? Did your heartbeat quicken? Did you suddenly feel colder or warmer? Again, you may not have felt any or all of these specific things, but because you are an embodied being, your experience of feeling fear included some number of physiological changes caused either by having an emotional experience of fear or an instinctual response to a threatening situation. These changes, in turn, caused physical symptoms that you associate with being afraid.

    Still with me? Okay. If you have an anxiety disorder, one of the things that happens is that your body experiences the physical sensations that you associate with worry or fear when there is no external stimulus that is causing you worry or fear and you are not actually emotionally experiencing worry or fear. One more time, just to emphasize: if you have an anxiety disorder, one of the things that happens is that your body experiences the physical sensations that you associate with worry or fear when there is no external stimulus that is causing you worry or fear and you are not actually emotionally experiencing worry or fear.

    I find that many people don’t even realize that the body plays a role in their experience of emotions until you point it out to them. In fact, at first, many people will say that they don’t experience any physical symptoms or sensations when they are experiencing an emotion. We tend to have this idea that emotions are something that is purely a matter of the mind, or maybe the mind and the heart. We often are so tuned out from our bodies that we don’t even realize the role that they are playing in our experience of the world. Unfortunately, there is a particularly significant lack of understanding in the church about the ways in which the brain and body play a role in causing and experiencing emotions like fear and worry.

    In extremely simplistic terms, your autonomic nervous system has two divisions: the sympathetic nervous system (fight-or-flight) and the parasympathetic nervous system (rest and digest). Typically, the two balance each other out. When your sympathetic nervous system is activated and your body pumps out adrenaline and other chemicals which have corresponding physical symptoms, your parasympathetic nervous system then kicks in to calm the body back down when this function is no longer needed.

    However, if you have an anxiety disorder, your parasympathetic nervous system does not function properly and does not kick in to regulate your sympathetic nervous system as it should. Therefore, your body is unable to properly regulate your sympathetic nervous system response, and it can spiral out of control, because there is no counterbalancing system kicking into effect. In this sense, the term “mental illness” doesn’t really capture the reality of suffering from an anxiety disorder, because what in actuality is occurring is a physiological malfunction that can then have emotional and mental consequences.

    Next time, I’ll talk more about what it’s like to have an anxiety disorder and some helpful and unhelpful ways to respond.

    *Please note: I am not a medical or counseling professional and this series is not intended to be any sort of substitute for any counseling, medical treatment, or other care that you or anyone else has received for mental health issues. I am simply sharing my own experience for general educational purposes.*

  • Help Me Understand Your Anxiety Disorder: Terminology

    This is the second post in a series that I am writing to help people in the church better understand mental health, and particularly anxiety disorders. To read the first post in the series, click here.

    There is a significant amount of confusion and misinformation about anxiety disorders in the world at large, and especially in the church. Part of the confusion stems from the terminology. “Anxiety” is not by definition a clinical term. So a person can say that they are anxious, or struggling with anxiety, and simply mean that they are worrying about something.

    Indisputably, the Bible has much to say about worry. Take, for example, Christ’s words in the Sermon on the Mount:

    “Therefore I tell you: Don’t worry about your life, what you will eat or what you will drink; or about your body, what you will wear. Isn’t life more than food and the body more than clothing? Consider the birds of the sky: They don’t sow or reap or gather into barns, yet your heavenly Father feeds them. Aren’t you worth more than they? Can any of you add one moment to his life span by worrying? And why do you worry about clothes? Observe how the wildflowers of the field grow: They don’t labor or spin thread. Yet I tell you that not even Solomon in all his splendor was adorned like one of these. If that’s how God clothes the grass of the field, which is here today and thrown into the furnace tomorrow, won’t he do much more for you—you of little faith? So don’t worry, saying, ‘What will we eat?’ or ‘What will we drink?’ or ‘What will we wear?’ For the Gentiles eagerly seek all these things, and your heavenly Father knows that you need them. But seek first the kingdom of God and his righteousness, and all these things will be provided for you. Therefore don’t worry about tomorrow, because tomorrow will worry about itself. Each day has enough trouble of its own.”

    Matthew 6:25-34 CSB

    The word that the CSB translates in this passage as “worry” is translated in other versions (like the ESV) as “be anxious”. This is not an incorrect translation, as worry and anxiety can be synonymous. However, many people do not understand that, while you can use worry to mean anxiety, and vice versa, use of the term “anxious” or “anxiety” does not necessarily signify worry.

    We all experience worry and fear. If you are a Christian, you also believe that we all sometimes experience sinful worry, where we fail to trust God with ourselves, our lives, or our circumstances.

    I am not saying, however, that all fear is sinful. If you believe that a human being experiencing fear is inherently sinful, you are falling into the ancient heresy of Gnosticism. In brief, Gnosticism denies the goodness of material creation, including the goodness of the human body, believing instead that the spiritual is superior to the physical and that salvation comes through freeing the “self” from the material world. This, of course, is directly contrary to the Christian conception of the world, which is that God created all things and called them good, and in the case of humans, very good. Christians believe that humans are embodied souls that bear the divine image.

    Because God created us as embodied beings, our bodies are integral to our selves. So, for example, if you were attacked by a mountain lion, you would experience fear as a physical response to the danger. In fact, it would be bizarre in this situation for you not to be fearful, because that is how God created you. (There’s a separate discussion to be had about situations causing fear being a result of the fall; I won’t delve into that here, except to note that situations causing fear, and the fear response itself, are two different things.)

    There is a lot more to be said about this, so in my next post, I will continue to explore these ideas and unpack the difference between worry and clinical anxiety.