Is Anxiety Something to Worry About?
Anxiety is a state of inner turmoil, often accompanied by nervous behavior. One example would be pacing back and forth, somatic complaints and feelings of dread like a feeling of imminent doom. However, there is a difference between anxiety and fear.
Anxiety is feeling something intimidating in response to a perceived threat. Anxiety is feeling worried and uneasy, about a situation that's seen as menacing. It is usually accompanied by restlessness, fatigue, problems in concentration, and muscular tension.
Anxiety is a mood. However, it becomes a mental disorder when characterized by excessive, uncontrollable and often irrational worry. Most therapists diagnose it as generalized anxiety disorder (GAD). It's called generalized because worries aren't focused on any specific threat and are frequently exaggerated and irrational.
Fear is an emotional response to a perceived threat. The usual result of this behavior is referred by many as the “fight-or-flight response.” Anxiety occurs in situations only perceived as uncontrollable or unavoidable. Fear and anxiety are said to be categorized in four groups.
(1) Duration of emotional experience (2) Temporal focus (3) Specificity of the threat
(4) Motivated direction.
Fear is defined as short lived, focused towards a specific threat. Anxiety on the other hand, is defined as a long acting, future focused, intangible potential threat. Everyone has experienced anxiety at one time or another but most don't experience long-term problems with it. Long-term, severe problems with anxiety are classified as an anxiety disorder. Symptoms range in number, intensity, and frequency, depending on the individual.
The physical effects of anxiety can include heart palpitations, tachycardia, weak muscles and tension. Other symptoms may include fatigue, nausea, chest pain, shortness of breath, headache, and stomach aches. External signs of anxiety may include pallor, sweating, trembling, and pupillary dilation. Sometimes this leads to a panic attack.
Panic attacks usually come unexpectedly. Fears are generally irrational but perception of danger is real. A person experiencing a panic attack will often feel as if they are about to die or lose consciousness. Anxiety is the most common mental illness in America as approximately 40 million adults are affected by it. Not only is anxiety common in adults, but found to be more common in females.
Symptoms and Warning Signs
Properly understood, anxiety can actually lead us toward greater mental and emotional health. It can serve the same function as a smoke alarm, alerting us to potential danger. When the alarm sounds, look for the fire, extinguish it, and remove the danger. As you learn to interpret warning signs of anxiety, you will be better equipped not only to improve your own mental health but also that of others.
The symptoms of anxiety are varied and sometimes difficult to recognize. The most obvious symptoms are problems with everyday functioning: insomnia, lack of concentration, pain, headaches, impaired judgment, problems in relationships, and negative feelings. Negative feelings can include uneasiness, apprehension, dread, concern, tension, restlessness, and worry.
Sometimes a person with anxiety senses impending misfortune or disaster. As a result they might experience both anxiety and depression. The symptoms of anxiety can be divided into several categories. These symptoms can also indicate other disorders, both physical and emotional, beside anxiety.
Cardiovascular symptoms: tension headaches, chest pain, increased blood pressure, rapid heartbeat, pounding heart.
Respiratory symptoms: sighing respirations, dizziness, light-headedness, labored breathing, hyperventilation, sense of choking or smothering, shortness of breath, “lump” in throat.
Musculoskeletal symptoms: eyelid twitching, fidgeting, muscle aches, muscle tension, tightness in chest, chest pain, tremors, quivering voice.
Gastrointestinal symptoms: anorexia, dry mouth, (butterflies)
Genitourinary symptoms: painful or frequent urination.
Dermatologic symptoms: clammy hands, flushed face, pallor, sweating, cold hands or feet, tingling.
Sensory and mental symptoms: blurred vision, ears ringing, numbness, foul taste in the mouth, impaired coordination, impaired judgment, impaired mental functioning, intense dreams.
Behavioral and physiological symptoms of anxiety, include:
irrational- ability, uncertainty
jumpiness or edginess
inability to sleep or fall asleep
talking too much
impaired sexual interest and functioning
Behavioral symptoms may also include an immediate need to escape from the current situation and development of avoidance behavior.
Cognitive and Psychological Symptoms
Cognitive symptoms involve the way people think. These symptoms include fear of dying, fear of losing one's mind, fear of losing control, fear of fainting, and fear of public embarrassment.
In addition to the many symptoms described above, anxiety is a component of almost all psychiatric disorders, such as neuroses and psychoses. When anxiety is generalized and nonspecific, that is a vague sense of doom without any specific threat or danger, the condition is called a generalized anxiety disorder.
If the anxiety is focused on a neutral object, meaning a sense of anxiety about dog, elevator, flying on airplanes, or being in open places, the condition is called a phobia. Phobias are illogical fears; the person consciously fears the dog, elevator, or other object, but the real cause is hidden in the subconscious.
Anxiety isn't always easy to diagnose. The most common diagnostic method is to look for a cluster of symptoms such as those described above. The patient recounts their symptoms, and the counselor makes a diagnosis based on their clinical impression of those symptoms.
Another method of diagnosing anxiety disorders involves the use of tests Such as the Minnesota Multiphasic Personality Inventory (MMPI), which is helpful in diagnosing a variety of mental disorders including anxiety.
A less sophisticated cousin to the MMPI is the Taylor Johnson Temperament Analysis test (TJTA), which will also pick up signs of anxiety. One advantage of this method is that it is available for use by pastors in spiritual counseling.
Less reliable, because they are more subjective but still sometimes helpful, are the projective tests such as the Thematic Apperception Test (TAT) and the Rorschach Test. Their objective is to determine whether an individual symbolically projects their anxiety onto pictures, such as an inkblot or an object.
Finally, medical tests are also used to aid in diagnosing mental disorders. These tests include Computer-Assisted Tomography, commonly known as CAT scans and MRI scans. Magnetic Resonance Imaging, is like sophisticated x-rays of the brain. CAT scans and MRI scans have not been very helpful in diagnosing anxiety disorders but can be useful in diagnosing and eliminating medical conditions such as physiologically-based schizophrenia resulting from enlarged ventricles in the brain.
For the most part, these sophisticated medical tests yield only a limited amount of information and insight regarding the presence of anxiety in an individual. Anxiety is a curable problem, if the anxiety-afflicted person is willing to take responsible for their cure.
God's View of Anxiety
As Christian therapists, we believe one of the major sources of anxiety is fear people have of looking inside themselves, examining negative and conflicting emotions, recognizing sins, and dealing honestly with what they find there. Rather than courageously facing the anger, guilt, lust, and greed, or resentment within themselves, people suppress these moral and emotional realities. At some deep level they know it's there, but they have shoved it out of their conscious minds. The conflicting results between their conscious and unconscious minds is anxiety.
We believe anxiety is actually a God-given alarm system designed to expose unhealthy emotions and thoughts, so we can think, feel, and behave in healthy and godly ways.
God wants us to examine our emotions honestly and stop denying our true feelings. Deception is wrong; self deception is unhealthy. The Holy Spirit uses anxiety to get our attention and tell us our inner beings need examination.
Unfortunately, most of us are afraid of the truth. We don't want to look inside and face the pain, disordered thoughts, and unpleasant emotions lurking inside us. It's a fact of human nature we want quick, easy solutions to make our bad feelings go away. Or we want someone to tell us our problems are someone else's fault, not our own responsibility. So the normal human response is to deny it, anesthetize it with drugs such as alcohol, prescription drugs, or illegal narcotics.
God's approach to treating anxiety however, is to approach this disorder with realism, honesty, and a courageous search for the truth. As Jeremiah 17:10 tells us, “I, the Lord, search the heart, I test the mind.” And Jesus, in Revelation 2:23, says He is the one, “who searches the minds of hearts.” God knows the thoughts and motives of our hearts. He is the one who can pierce our self-deception and our defense mechanisms, so the true nature and sources of our anxieties can be brought to the surface. God's approach, which involves uncovering the true sources of our conflict so it can be understood and treated, is the most effective and successful approach to this emotional disorder.
Anxiety and Depression
People sometimes confuse anxiety with depression. Although people do sometimes experience depression in connection with anxiety, there is a difference between the two. In a broad sense, anxiety relates to the future, and depression relates more to the past. Or, put another way, anxiety is to future superimposed on the present,and depression is the past superimposed on the present.
This statement is an oversimplification of course, since the sources of anxiety, which is a sense of foreboding about the future, are rooted in hidden emotions of the past. This oversimplified distinction however, does help many people recognize and distinguish between their various feelings and emotional issues.
Forgiveness isn't pretending something wrong didn't happen to you, nor is it pretending something you did wrong didn't happen. Forgiveness isn't a matter of “forgive and forget.” Memories are indelibly etched in the biochemical pathways of your brain and they can't be forgotten by a simple force of will. Attempts to repress memories are unhealthy and actually increase your tendency toward anxiety.
Forgiveness involves becoming fully aware of your anger toward someone else or, in the case of our own wrongs, mistakes, and sins, becoming fully aware of your own responsibility and guilt, and then, with full knowledge of the awful truth, choosing not to hold the offense against that person or against yourself, by reason of God's grace through Jesus Christ.
Each of us has in due word feelings of anxiety from time to time. Is worry-free living even possible? Yes, although for most people it will always remain a goal, not an achievement. The antidote for anxiety is facing the truth. To know the truth about anxiety, you must first dispel some commonly held myths.
“Give it time, your anxiety will go away.” Emotional disorders may be submerged and repressed for a while, but they don't go away without work and insight. Anxiety is the most common mental health problem in America, yet most people ignore, deny, excuse it, or put up with it when they could find real release from. But curing anxiety takes work, and most of us are lazy. That laziness keeps us from enjoying the rich, healthy emotional life God intended for us to experience. Don't expect your anxiety to simply disappear with time. Rather than healing anxiety, time tends to make it worse.
“It's in my genes. Anxiety is just part of my family tree.” Nonsense. You may be able to inherit certain symptomatic ways your body exhibits your inner anxiety, say a tendency toward poor digestion or on blood pressure, but you can inherit anxiety itself. Anxiety is emotional conflict over real issues in your life. In your family of origin, you may have learned ways to cope with anxiety that are unhealthy, and thus you may find yourself mimicking unhealthy patterns of your parents, but that doesn't mean you inherited a genetic tendency towards anxiety. You have a choice as to whether or not you will be cured of your anxiety.
“Anxiety is a sign of weakness.” As we have already seen, anxiety is an alarm that something isn't right deep inside our emotions. Anxiety can actually be a positive reaction, which God can use to get your attention. Properly understood, it's a marvelous mechanism for alerting you to the need for self-examination. Anxiety can be a strength. It's only when you deny or repress anxiety it becomes a weakness.
“It's a sin to dig up the past.” Some people object to doing the work of uncovering the hidden emotional sources of anxiety. “Forgive and forget,” they say. But when you seek to reveal the sources of anxiety, you aren't just “rehashing the past.” You are trying to discover what hidden issues of the past are continuing to affect you in the present. Often, when issues of the past are buried landmines, they have to be dug up and defused so you will quit stepping on them. Past issues may involve your own actions for which you harbor guilt or the actions of others for which you harbor resentment. Once the subconscious issue is forced to the surface of your conscious awareness, you can make a deliberate choice to forgive. And then the healing will begin.
It has become popular in some quarters to ascribe a host of human emotional, behavioral, and spiritual problems to demonic activity. As Christian therapists, we believe in the reality of demonic activity in our world, but we also believe it's dangerous and too simplistic to look for demonic activity in every issue we face. The “Devil-made-me-to-it” explanation is attractive to some people because it holds out the promise of a “quick fix” cure for deep-seated emotional issues. The Bible makes it clear, that we are not just spiritual beings, subject to the spiritual disorders as a result of demonic opposition. We are also physical beings who experience medical disorders. And we are mental/emotional beings who are subject to mental and emotional disorders. Blaming demons or problems resulting from our actions is a copout, and easy way out. Overemphasizing demonic activity to the exclusion of personal responsibility or medical resources is a serious and dangerous error.
“Christians don't have emotional problems.” Of course they do. Ideally of course, Christians shouldn't have to suffer depression, shouldn't fall into sin, shouldn't be guilty of materialism, and shouldn't engage in selfish power struggles. But we all know Christians do. Christians are perfect; just forgiven. And God has given us many powerful tools and resources, from the Scriptures to practical guidance of psychology and psychiatry, to enable us to be built of our disorders and grow from our experiences. As Christians, our most important goal in life is to become more like Jesus; and look closely at our own lives and compare.
Seeking counseling for emotional issues isn't a sign of weak faith. In fact, Scripture encourages us to admit faults to one another, encourage one another, and pray for one another so we can be healed (James 5:16).
As we replace these myths about anxiety with the truth, we will be better equipped to face and disarm our anxieties and to live a rich, joyful life.
There is a range of treatment options for anxiety, depending on the severity of the problem, range from self-help techniques to intensive medical therapy. Some of these techniques can bring some relief almost immediately; others require a commitment to long-term changes in one's life. All of these strategies for healing can be integrated into a comprehensive coping strategy that can dramatically reduce anxiety levels.
Let's first look at a series of mental and spiritual self-help techniques that can help reduce anxiety or prevent anxiety from recurring:
We have seen this truth validated again and again: Scripture meditation works. But they are right and wrong ways to meditate on Scripture. Regularity is one key factor. Spontaneity is another. These two statements may sound contradictory, but they are not. It's important to build daily habits of Scripture reading and meditation, that's the regularity aspect. But Scripture meditation should not be just another item on our things to do list or it will become a burden, a meaningless exercise. Effective Scripture meditation should have an element of adventure, joy, and spontaneity.
Choose a quiet, relaxed environment, sitting or kneeling in a comfortable place. Don't set a goal or a set number of chapters or verses to get through. Just plan to spend 20 minutes or half an hour reading, listening for God's thoughts, stopping whenever a passage seems especially meaningful. Tailor your reading by choosing passages that address issues in your current life. If you are feeling anxious, seek out passages offering reassurance and peace. If you feel guilty, meditate on forgiveness passages.
We often counsel anxious patients to use a repetitive phrase to help them relax. This technique can work for you too. At the first hint of anxiety, try breathing deeply and slowly. Each time you exhale, repeat the same phrase. What words work best? Christians often like to use a favorite line of Scripture. Perhaps one of the verses you have meditated on will hold a special meaning for you. If so, jot it down on an index card and carry it with you to memorize for use during stressful times. Or you can choose a phrase as simple as, “Anxiety is a signal to relax.” It's a true statement; it has a certain balance and rhythm. And if you say it over and over whenever you are trying to reduce stress, you'll begin to link those words to the response you want: relaxation.
In a similar way, a relaxing hymn can also be a way to relieve anxiety. The titles of many old hymns illustrate one purpose of Christian music is to Soothe the anxious soul. Even the paranoid King Saul relaxed when David played the harpl, music is a powerful tool for altering moods, both for good or ill. If the sound is loud and beat is throbbing, anxiety can be heightened. If the melody and rhythm are balanced, they can soothe the listener's anxiety.
Exercise helps to relieve anxiety in several ways. First, it provides a diversion from worries. Second, exercise releases not only adrenaline but also endorphins and enkephalins that are natural mood-lifters, according to recent research.
Talk through Your Problems
Anxiety often builds because people don't air their feelings daily. A small problem can become a phobia if it's turned inward and allowed to fester. So work to keep lines of communication open with your family. Also, make sure you have someone with whom you can regularly share your emotional issues, openly and honestly. They could be a trusted friend, counselor, pastor, support group, or Bible study group. Talking through your problems helps to dispel anxiety surrounding current issues, keeps anxiety from turning inward, and helps you be more objective about issues in your life.
Recreation and Laughter
It has been said laughter relieves more tension than crying and it's certainly a lot more fun. It's likely endorphins and enkephalins, which help to raise spirits and overcome anxiety, are released with laughter.
Recreation is also away to drain off your anxieties. Get away from your usual routine. Take a vacation, or just a one day or half day minivacation. If you tend to be an anxious workaholic, your vacations are probably just work time in a different setting. Try to take vacations that are more orientated to relaxation and fun. The better you are able to relax and “get away from it all,” the sooner your anxiety level will decrease.
Regular Medical Checkups
Have a medical checkup once a year. Personal health is one of the biggest sources of worry. Much of this anxiety can be relieved by having a good medical checkup once a year or a more in-depth examination if needed.
As counselors, we come into contact with a lot of professional worriers. Their productivity suffers because much of their time and energy are sapped by constant fretting. If only they could schedule their worry for a specific time slot, confine it to that period, and not allow it to distract them from other matters! Although it may sound silly, this is a solution many, particularly many compulsive perfectionists, have found workable. Set aside 15 minutes in the morning and another 15 minutes in the evening for active worry. If worries surface during other times of the day, jot them down on a card and deal with them at the scheduled time. You will be more productive during the day, and will be able to list your worries by priority. By the time you get around to really worrying over them, they will probably have shrunk in importance, and the cards and problems can be discarded.
Live One Day at a Time
Jesus, the Great Physician, has a profound word of advice for worriers:
“Therefore do not worry about tomorrow, for tomorrow will worry about its own things. Sufficient for the day is its own trouble” (Matthew 6:34).
Since God cares for sparrows, wildflowers, and other less significant parts of creation, we know He cares for us and is in charge of the future. Thus, we would do well to replace anxiety with living one day at a time.
Anxious people make long lists of things to do, they fret over them, and punish themselves when they don't get everything done. A key to worry-free living is to accept the limits of a 24 hour day, to do the best you can with the time God has given you, and to accept God's grace for the things you must put off until tomorrow.
Design an Action Plan
When Mark Twain faced the task of delivering a speech to a standing room only audience, he was nearly overcome with anxiety. What could he do about it? He had three options: Cancel out and disappoint everyone; wring his hands and compound his anxiety; or write a speech and practice it until it was time to get up and speak. He chose action plan number three. The point is to do something to lessen your anxiety. Don't just fret over your circumstances. If you are worried about failing a test in school, work out a study plan to prepare yourself. If you are anxious about entertaining your husband's boss for dinner, choose a menu beforehand, send your children to a friends house for the night, and order a floral centerpiece. Then prepare the table hours in advance. Study the options, select a plan, then implement it.
There are many patients who have anxiety because of deep unresolved issues. As a result of old wounds, deep emotional hurts and repressed anxieties developed and were never dealt with. Eventually, these emotions accumulated to the point patients couldn't function, yet the motions were hidden and subconscious, so they couldn't understand why they had become unable to function. Insight-orientated therapists use approaches enabling people to uncover their deep hurts and secrets in a safe setting. The counseling process helps these individuals gain insight into how these deep emotions caused the depression, anxiety, or medical problem. Throughout the course of their therapy, clients again and again were surprised to discover why they did the things they did. The process of uncovering those buried or secret issues is never easy, but the joy of discovery when an insight is gained is beyond words.
This approach also helps people to see how these issues from the past affect their current relationships, such as when anxiety around a certain individual today may be triggered by unpleasant memories of a similar person in the past.
A counselor who wants to help individuals gain insight often begins by simply letting them talk. The term used in therapy for this venting of emotion is catharsis. This often begins with being loved enough to listen to them share their issues from deep within.
Resistance often develops because it's painful to see issues inside of us we don't want to look at. To some degree the brain has very carefully arranged a series of defense mechanisms to protect us from difficult truths. Yet lying to ourselves about the issues and feelings inside us is profoundly unhealthy.
Some of the most common past issues triggering current anxiety include parental absence, loss of parents through divorce or abandonment, parents who are either overly possessive or too harsh, parents who were distant, sibling rivalry, childhood injunctions such as “be perfect” or “don't succeed.” Other triggers might be death of a loved one, divorce or separation, personal injury or illness, loss of a job or other major financial problems, retirement, holiday stress, poor family communication, marital conflict, and conflict with teenagers.
An insight-orientated counselor helps individuals to work through anxiety patterns by asking questions, reflecting them back, and repeating keywords they shared to emphasize those concepts and issues seemingly related to anxiety. The counselor may also offer interpretations, gently explaining and restating some of the individual's attitudes and behaviors, then waiting to see what kind of resistance or acceptance comes in response.
Through this process, individuals are able to bring issues and emotions, many of which have never been consciously examined, out into the open where they can be placed in a framework of meaning and understanding. Once the true emotional underpinnings of their anxiety begin to take shape, individuals gain insights that can be profoundly helpful in enabling them to make changes to resolve emotional conflicts and dissipate anxiety.
In the hands of Christian practitioners, these approaches have an added source of insight to offer: God's Word. Hebrews 4:12 tells us our primary resource for insight, the Bible, is active, living, and surgically sharp… sharper in fact, than a double-edged sword. It pierces through to the divisions of soul and spirit and provides us with an accurate evaluation of our thoughts, including our conscious and subconscious emotions and motives.
How should you then respond? As God opens His insights to you, you should be like the Psalms in Psalm 119:59, who says, “I thought about my ways and turned my feet to your testimonies.” The consideration of your emotions and motives should lead to biblical behavior.
Although insight-orientated therapy is our approach of choice, especially when deep-rooted emotional issues are present, other approaches are sometimes indicated. Reality therapy, a present-day problem solving approach, is one such method and may be indicated for several reasons. Reality therapy might be indicated when deep issues are not present or when a person's ego structure is too fragile to stand the painful insights that may emerge.
A therapist uses a reality approach, listening, offering practical advice to overcome anxiety. Developing a specific plan for dealing with current stress, is the best approach. For example, an anxious individual may need to develop a specific plan of 8 or 10 things to do daily or weekly for the next month, to see if this would help overcome their anxiety. The plan might include such activities as a daily quiet time, calling a supportive friend, or developing a daily exercise program. They might also plan a balanced diet, or doing one specific thing this week to resolve a painful issue from the past.
Some individuals have acquired habits in their daily living that are perfect setups for depression and anxiety, and aren't even aware of it. For example, a depressed person may be sleeping late, not exercising, avoiding social contact, drinking alcohol and taking drugs, then wonder why their depression gets worse! The goal of reality therapy is to restructure the individual's life in such a way behavioral changes bring about emotional improvement.
Belief System Therapy
We all have belief systems we either adopt intellectually or accept on a “feelings” level. These beliefs affect our present-date lives and may produce intense anxiety and insecurity. When this occurs, those beliefs need to be revised to fit reality. This approach is sometimes called cognitive therapy, or rational emotive therapy.
A number of different faulty beliefs must sometimes be corrected in order to reduce anxiety. With personalization, a mother may feel when her child left a shoe in the middle of the floor, it was an intentional, personal attack on her. With generalization, a parent may generalize from a single incident, concluding for example, a child who misbehaves today will grow up to be a criminal. With polarization, issues are seen as black and white, as when a Christian views his pastor and church as either all good or all bad, not recognizing any “gray areas.” With selective abstraction, a student may focus on the five points missed during the exam rather than the 95 correct points. With magnification, a person may view a relatively routine marital conflict as catastrophic. With arbitrary inference, an individual concludes a group of people on the other side of the room is talking about him. All of these faulty beliefs can produce intense anxiety.
Among Christians, faulty religious beliefs can produce anxiety. It's important to understand these faulty beliefs may be operating at a subconscious or feelings level, and may actually conflict with the conscious theological attitudes of the individual. A Christian counselor can redirect these false beliefs to a biblical perspective by developing assignments whereby clients can see their religious belief systems are not true.
When the belief system is faulty, the individual's beliefs cause anxiety. In cognitive therapy, these belief systems are challenged, and new, healthy, reality-based belief systems are slowly developed.
The approaches we've examined are, in our opinion, the three most useful individual therapy approaches. We have found, however, that individual therapy can progress much more rapidly when coupled with group therapy.
God established the importance of the group experience during the first century, as evidenced by the many “one another” passages in the New Testament. Through interacting in the group, an individual can often overcome anxiety by learning needed social skills. They may learn to deal with conflicts in the present that symbolize unresolved past conflicts. They may gain support and receive a vicarious insight into dealing with anxiety by hearing how someone else overcame a similar conflict.
A group emphasis can be especially important in conjunction with insight-orientated therapy. It's often easier for an individual to accept insight from the group rather than one individual such as a therapist. Groups also enable an individual to receive feedback on their honesty, game plan, evasiveness, denial, and self-deception. The group solution is almost always superior to individual solutions in attacking the problem of anxiety.
Work toward Your Goal
God wants you to live a worry free life. When anxiety attacks, you can identify with the words of Psalm 94:19,
“In the multitude of my anxieties within me, your comforts delight my soul.”
Healing from anxiety can be achieved because all things are possible through Jesus Christ.