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Over the past year, our world has experienced uncertainty and confusion as we’ve been forced to adjust to a “new normal” that is anything but normal. In these unprecedented times, fear has risen and anxiety has soared in much of the population. We felt it beneficial to speak to an expert about mental health, and so we asked Stephen Grcevich, MD, to answer some of our questions about anxiety.

What causes anxiety? Is it different from fear?

Anxiety involves anticipation of future threats, while fear describes the emotional response to imminent threats, whether real or perceived. Fear is associated with the necessarily physiologic arousal for fight or flight responses—a sense of immediate danger and need to escape—while anxiety is often accompanied by muscle tension and hypervigilance, along with excessively cautious or avoidant behavior. An anxious person drives ten hours to Chicago to avoid the need to fly. A fearful person becomes so distressed when the plane pulls away from the jetway that the pilot has to taxi back to the gate.

Is anxiety always due to a lack of faith in God?

This question reveals a couple of assumptions. The first assumption is that if anxiety isn’t always due to a lack of faith, it is much or most of the time. I see little evidence that is true. The perception that anxiety and other mental health conditions are indicative of either a lack of faith or a sin problem has produced a degree of stigmatization in the church greater than in the larger culture. Are anxiety or depression sometimes a consequence of sin? Absolutely. I see this in my practice when sexual relationships go too far or young adults get sucked into pornography. But that’s the exception as opposed to the norm. Anxiety is typically a byproduct of genetic disposition, thought patterns that shape our interpretations of the world around us, and coping strategies learned through observing the reactions of our parents and other important people in our lives to stressful situations. The question also presumes anxiety is a bad thing. Anxiety is neither good nor bad. Some anxiety is necessary and helpful. Anxiety often provides a necessary impetus to teens and college students to complete assignments and study for tests. Anxiety becomes problematic when it inhibits us from performing to our potential at work or in school, negatively impacts friendships and family relationships, or prevents us from participating in community activities, including church.

When people we love are struggling with anxiety, it’s tempting to be like Job’s friends and offer advice that may do more harm than good. What are some ways Christians can help those who are experiencing anxiety?

God rebuked the friends at the end of the story (Job 42:7-9) for distorting His character while persisting in their false accusations of Job. God’s rebuke should remind us of the need to be very careful in making presumptions about the spiritual condition of someone with significant anxiety or any other mental health condition. When our ministry trains churches on mental health inclusion we suggest the best inclusion strategy is encouraging a trusted friend to come alongside someone with anxiety to help them navigate interactions and situations likely to cause discomfort. Imagine how challenging it is for someone with social anxiety to visit a church for the first time when they think they’re being scrutinized by everyone they encounter! We can help through pursuing spiritual friendships with persons with anxiety and by offering sensitive encouragement when anxiety impacts activities of daily life.

Many Christians are well-versed in Scripture and know what the Bible says about anxiety, but they still experience it, which often leads to guilt on top of that anxiety. How can we stop that vicious cycle?

Christians with anxiety are prone to misinterpret God’s words and intentions in the same way they would with a parent, a boss, or a romantic partner. Because they’re anxious about where they stand in their faith, they often seek out biblical passages that address anxiety and view themselves in a far more negative light than other Christians might. A good biblical or Christian counselor can help them to recognize when interpretations of Scripture are off the mark in the same way a good cognitive-behavioral therapist might challenge a client’s “thinking errors” that distort their interpretations of the thoughts and actions of the people around them.

We often hear that anxiety comes from the fear of things that never come to fruition. However, in the case of COVID-19, things ended up being much worse than initially expected. As rare as those situations are, when things like that hit, how can we avoid letting our anxiety soar?

The first thing one can do is to turn off the news when things get bad. If you’re someone who struggles to let go of bothersome thoughts, avoiding triggers to obsessive thinking or rumination is simply good prevention. Another strategy is to pursue opportunities to serve others in greater need than oneself. Living out our faith through difficult times puts the gospel on display and serves as a distraction from anxious thoughts. Finally, we can be deliberate about filling our minds with healthy thoughts and information in the same way we care for our bodies by eating healthy food. Watch a classic film. Go to a nearby museum and reflect upon the beauty of the art inside. Read a good book. Read the Bible.

When anxiety gets bad, we have a tendency to cancel our plans and stay home. Are we justified in doing that, or do we need to force ourselves to do what’s uncomfortable?

The answer is somewhere in between. In my profession we typically teach people strategies for identifying unrealistic perceptions and thought patterns that trigger irrational worry, and we suggest relaxation techniques for managing physical symptoms of anxiety. After providing some coping skills and techniques we then gradually expose them to situations causing the greatest anxiety. Let’s say we have a kid who is afraid to go to school. We may start by having the parents put him in the car, drive to the school, and park in front. The next day we’ll have him get out of the car and walk to the front door. Then we may have him go to the office and meet with the guidance counselor when other kids aren’t in the building. We’ll then encourage him to sit through one class, followed by an entire morning. A gradual approach is more likely to be successful than throwing someone in the deep end of the pool and expecting them to swim.

When things get hard, we all have our ways of coping. How can we make sure we’re avoiding negative coping mechanisms?

The two most unhealthy approaches to anxiety I see among young adults in my practice are persistent avoidance and self-medication, most often with alcohol and marijuana. A colleague of mine who does lots of research on the relationship between mental health and substance abuse refers to self-medication as “primitive psychopharmacology” in that persons who self-medicate expose themselves to many potential consequences when other safer and more proven approaches are available. I like Paul’s suggestions for positive coping methods (Philippians 4:8-9): filling our minds with whatever is true, noble, right, pure, lovely, admirable, excellent, or praiseworthy and reflecting upon those things. Other positive coping strategies include redirecting our thoughts by serving and caring for others and going to a counselor, therapist, or doctor when anxiety negatively impacts important relationships.

How can we let God redeem our anxiety for His purpose?

I’ve encountered many faithful and mature Christians who are incredibly fruitful in ministry while struggling greatly with anxiety. When I’m asked why God allows them to experience incapacitating anxiety despite persistent and heartfelt prayer, here’s how I respond: God may use our anxiety to draw us into a closer relationship with Him. He is more concerned about our relationship with Him than our immediate comfort. If persistent anxiety leads us to spend more time in prayer or getting to know God through the Bible, the benefits in God’s mind represent a greater good. Our ability to remain steadfast in our faith while suffering with anxiety brings about a more powerful witness to God. John Piper said that God is most glorified in us when we are most satisfied in Him. Is it possible that the works of God are most on display in us when we demonstrate contentment and joy in the midst of distress? God may use people with firsthand experience of mental illness to comfort and minister with others who are similarly affected. The end result of Paul’s suffering was that he was better prepared to encourage others experiencing similar afflictions (2 Corinthians 1:3-7). Might God prepare us to care for others in a similar manner?

Stephen Grcevich
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