While at the library a few weeks ago I found this book peeking out at me from among the graphic novels called The Worrier’s Guide to Life. It’s hysterical, because it’s true. The page I included above made me laugh out loud because I’ve had all of these – sometimes several combinations of them – keep me up at night. I showed it to my wife but I don’t think she got it (she’s usually asleep before she hits the pillow anyway). There was so much in that book that worriers and the anxiety-prone people like me to find funny, which is great because it’s good therapy to hold a mirror up to your problems and laugh at them.

I’m a Christian that has struggled with anxiety for many years. It’s something I deal with more or less on a daily basis, but it’s not as debilitating for me as it is for many others. I’ve had a few panic attacks, been on and off medication, gone to counseling, and try to manage more or less on a day to day basis. Regardless of how many ups and downs I have, I know that what I go through is nothing compared to what others do though.

Chronic anxiety is a difficult thing to understand for those that don’t experience it. That’s because the term itself can be ambiguous. Anxiety can refer to the feeling of being anxious and fearful, the state of anxiety, or both. Anxiety the feeling is natural and something we all feel from time to time. However it comes and typically goes without much fanfare. The state of anxiety is more pathological and pervasive. This is because the body’s reaction to the cause of the anxiety is so much quicker, stronger and long lasting. Dr. Claire Weekes, a noted author and leader in the treatment of anxiety, called this sensitization. As one author wrote,

“When you’re walking through [a] musty haunted house, you know what’s coming (even if you don’t know the details). You know something’s going to freak you out… You don’t know the precise nature of what’s about to scare you, but you’re anticipating something — anything — nonetheless. In that haunted house, you are sensitized. Your body and your mind are prepared to react — and to react quickly — to the frightening stimuli. Sensitization goes far beyond the haunted house scenario above. It can occur (in a mild form) when ‘our nerves have become alerted to respond too quickly, too acutely, to situations that would, at other times, leave us unmoved’, according to Weekes.”

Think of normal anxiety as being scared in a haunted house, but the anxiety is confined to that setting. Chronic anxiety is like never knowing when you’ve left the haunted house.

American Evangelicalism has had a pretty hard time understanding chronic anxiety. I think that’s because some Christian responses to anxiety typically consist of, “If you’re feeling anxious remember that Jesus commanded us in Matthew 6:25-34 to not be anxious about anything. God is in control of everything, so don’t worry and God will give you peace.” Hakuna matata.

This is what I call the “Bible bandage” approach. “Have a problem? Here’s a verse. Don’t you feel better now? No? Then there’s something wrong with your relationship with God. Better work on that.” This often has the reverse effect on people suffering from chronic anxiety. A poster on Reddit sums up the experience of many:

I’ve been diagnosed with anxiety, and have had it for near 8 years. I know that the gospel tells us to worry for nothing for God is our provider, which I whole heartedly believe in. But, sometimes I am wrought with fear and am flooded with so many “what if’s” and that everything is going wrong and I wonder if I am really doing what God wants. … But I am embarrassed that as I christian, I suffer from anxiety. Of all people, wouldn’t it be thought that christians would be the least likely to suffer from anxiety? And is my anxiety a product of me not trusting God enough or perhaps a product of sin?

While professional Christian counseling has done pretty well in being able to understand and treat anxiety and related disorders, this hasn’t been the case from the pulpit. The church has little space for those who are sad or struggling in the contemporary praise-and-worship service. Popular books and speakers typically provide shallow, quick fixes or gentle (or not so gentle) castigation to try harder, do more, and be better because even though salvation is through God’s grace you could be holding up your end of the bargain a bit better. And please don’t get me started on Calvinism.

There are many misunderstandings that Christians have about chronic anxiety and how to best handle it. Many times is addressed as a lack of knowledge or a lack of trust or faith based on that knowledge. It is also not simple “self-centeredness”, a character defect, or sin. Yet it seems as if many well-meaning people feel that addressing it only through the lens of scripture is enough. Chronic anxiety, along with every other mental and emotional disorder, is multifaceted in nature. It touches on not only the spiritual but the emotional, social, biological, behavioral, and cognitive elements of us. Liz Riggs wrote for Christianity Today,

When anxiety results from an actual chemical imbalance, a physical condition that manifested through mental stress, there are aspects of our mental state that we cannot control on our own. I cannot help that my brain cannot balance its serotonin, the chemical in the brain that helps regulate mood among other functions. I cannot control the way my body produces adrenaline when in a state of panic.

Addressing only one area such as faith is necessary but not sufficient. Does one prepare for a marathon by simply running for a long time? Hardly! It requires not only distance training but strength training, nutrition, recovery activities, mental preparation and the support of coaches and others who are also marathon runners.

Handling chronic anxiety has to involve a multifaceted approach also. Many things have helped me personally: counseling, cognitive training involving recognition of self-created “downward spirals”, self-awareness, proper rest and nutrition, grace, and of course faith and trust that in spite of whatever I feel I am loved by Jesus and others. Writing has been tremendously helpful (as has been your feedback!).

If you know someone with chronic anxiety, one of the most beneficial things you can do for them is to simply be with them without any expectations, demands, or agendas. This can be a tremendous comfort to someone who feels exhausted, afraid, and alone. Recognize that your presence may be the Jesus they need to see and experience.

Thankfully there are some very good resources, both faith-based and not, for Christians suffering from anxiety and panic attacks. Books by Cloud and Townsend in the Boundaries series are very good and offer a holistic approach to anxiety. Cognitive-behavioral therapy has also proven to be very effective in helping those with anxiety and related disorders.