“My anxiety is silent. You wouldn’t even notice a change on the outside but I’m honestly so stressed I can’t even manage simple tasks. People call me lazy when, in reality, I’m just overwhelmed.” ~Samantha Gluck
 
 “I sought the Lord, and he answered me; he delivered me from all my fears.” ~ Psalm 34:4
 

In the early days of COVID-19, as the death toll in Italy rose, so did my anxiety. I stood before my wardrobe one day thinking that I might never wear these clothes again. Sleep alluded me. I lay awake and catastrophised. I worried about my soon-to-be-born granddaughter and how grief-stricken my daughter would be when I died. And what would happen if my husband caught COVID-19 and died first? How would I cope? The ache of anxiety can crush the spirit.
 
Oliver Hazard Perry, a famous naval commander in the War of 1812, sent a victorious message back to General William Henry Harrison after his forces had won the Battle of Lake Erie. The message became a well-known quotation: “We have met the enemy, and they are ours.” Pogo, Walt Kelly’s comic strip character, applied it to human nature: “We have met the enemy, and he is us” (larrybush2013, 2014) – the enemy exists within, rather than without. Anxiety is one of Satan’s greatest weapons. More than worry, it can interfere with the capacity to function in daily life. Most people are ashamed to seek help, even though anxiety disorders are the most common of all mental disorders. In fact, anxiety is the most common mental health condition in Australia and the most common mental health problem experienced by young Australians (Headspace.org.au., 2015). On average, 1 in 4 people (1 in 3 women and 1 in 5 men) will experience anxiety (ABS, 2008). This is huge!
 
Interestingly, there is only one word for anxiety in the English language, but anxiety has different meanings in other languages (Iliesco, 2018, p. 213). Anxiety has many expressions and naming it correctly is essential to obtaining a suitable remedy. Everybody is a little worried and anxious at times. In particular instances it is a “warning system” like a smoke alarm that God has built into us to get our attention. If we ignore it, it will not go away. Worry and anxiety are normal responses to stress and fear-provoking circumstances that everyone experiences, but they can also be abnormal responses, morphing into anxiety disorders including:
 
·       Specific phobia (also known as simple phobia)
·       Social anxiety disorder (also known as social phobia)
·       Panic disorder
·       Agoraphobia
·       Generalized anxiety disorder (Headspace.org.au., 2015).
 
Anxiety disorders are a type of depressive illness. Whereas depression is a constant feeling of sadness, the sad thoughts characterising anxiety often have no specific root cause. An individual with anxiety cannot shut off the constant, fearful thoughts that keep racing through the mind, like a podcast that cannot be stopped. Sufferers often have trouble sleeping since they are unable to shut down the anxious thoughts.
 
Mild anxiety symptoms present as chronic tension, fear, irritability, poor concentration and being easily threatened by unfamiliar circumstances. Severe symptoms include panic attacks, whereby the sufferer experiences the physicality of a pounding heart, sweating and shaking. Emotional indicators include feeling consumed by fear, loss of control and fear of going crazy. Fears are magnified resulting in over­whelming, severe anxiety, often mistakenly trivialised as manageable. It is, in fact, a crippling disorder if not treated, as actor and comedian, Gary McDonald (2009, p. 1) explains:

The anxiety would paralyse me with fear. I started to get extremely fearful and I found it difficult to push through that – it was like a sort of wall, almost like a strait jacket – I was so frightened… Suddenly there was this thing sapping me of all energy and all sort of cognitive skills – it was terrifying – and the next thing is, you start to get suicidal.
 

Anxiety can also be a common secondary symptom to medical or other psychiatric disorders. Much like depression, anxiety tends to be an inherited condition which usually responds well to medications designed to correct the chemical imbalance in the brain and return the person’s thought control to normal.

What Causes Anxiety?
 
There is much discussion about the causes of anxiety; for example, personality factors, difficult life experiences and physical health. Anxiety can be generally categorised into two main groups:

1.     Biological anxiety; and,
2.     Psycho-social anxiety (environmental and/or social).
 

Both of these are connected to the spiritual part of us. Do you believe that the physical brain and the spiritual soul are connected?
 
Biological anxiety

There is clear evidence in severe anxiety for biochemical underpinnings (Martin et al., 2010). Biological anxiety is not directly condemned in scripture. The major mechanism for creating biological anxiety is stress. Sometimes this form of anxiety is also accompanied by depression. Stress is the over-arousal of the adrenal system, releasing stress hormones that affect the brain’s tranquility; for example, Glucocorticoids, Adrenaline (Epinephrine) and Cortisol. Chronic stress elevates Cortisol which blocks GABA receptors in the brain. Chronic stress depletes the natural tranquilizers in the brain and immune system. Stressed people get anxious and sick! Stress management is the only remedy.
 
It is important to note that anxiety can be the result of an underlying medical condition or any medication ingested by the sufferer. The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) (American Psychiatric Association, 2013) categorises an anxiety disorder due to another medical condition as a distinct diagnosis. Medical conditions include Mitral Valve Prolapse (MVP), Hyperthyroidism (over-active Thyroid), Hypoglycemia (low blood sugar or diabetes), cardiac arrhythmia and vitamin B12 deficiency. Substances include alcohol abuse, excessive use of Amphetamines, caffeine (coffee, soft drinks, etc.), inhalants and asthma medications, cannabis, cocaine, inhalants, sedatives and hypnotics.
 
All anxious people need to have a very thorough medical examination, where past and present illnesses, medications and ingested substances (including “natural” remedies) are reviewed. Seeking a doctor’s assistance is essential in identifying and treating medical conditions that may be the source of anxiety and may determine whether the anxiety being experienced is the result of medications or other ingested substances, a condition known as “Substance/Medication-induced Anxiety Disorder.”
 
It is also important to note that medication is available for anxiety. It will not cure anxiety, but it may assist the sufferer to re-enter the world and function on a day-to-basis and also assist them to engage in counselling for the psychological and spiritual elements present in anxiety. A doctor can assist the anxiety sufferer to find the right medication with the least side effects.
 
Psychological anxiety

In the previous blog we saw how genetic and environmental factors combine to make some people more predisposed to anxiety. Anxiety disorders can be incapacitating and Christians are not immune from the torments of severe anxiety. Phobias are clearly learned and related to early exposure to fear. If panic disorder occurs by or before age twenty, there is a seventeen-fold increased risk for close relatives indicating that there is a possible genetic factor.
 
Although I (Paula) inherited a heightened sensitivity to stress, it was insufficient to create an anxiety disorder. According to Barlow (2004), biological vulnerability to anxiety is exacerbated by the “learning” I received from my social environment (family). Even though anxiety established itself early in my childhood, it was reinforced during my difficult teenage years resulting in clinical depression in my 20’s.
 
When I finally sought help, I discovered several contributing factors including thought patterns, beliefs, and perceptions about my environment, experiences and personhood. I learned that when I was punished as a child, I had no idea what I had done wrong. It appeared random, based on my mother’s mood and stress levels. The primary purpose of her “discipline” was shaming and her negative message to me was, “If you were not such a bad child, I wouldn’t be so stressed and unable to cope.” I learned that I had no control over my environment and had to remain hyper-alert to danger. I believed that I was the cause of her distress, so I needed to make myself small and stay under the radar. Lerner (2004, pp. 10-11) claims:

At the bedrock [of shame] is the fear of being seen as essentially flawed, inadequate, and unworthy of being loved. Shame is so painful that no one talks personally about it or wants to “go there.” When was the last time you discussed your shame at the dinner table? Shame is the least-talked-about emotion because people are ashamed of their shame… Shame steers people into a life of silence, inactivity, lying and hiding. Or, to avoid feelings of shame, we may flip shame into contempt, arrogance, or displays of one-upmanship.

Early life trauma contributed to my anxiety and depression later in life, because fear memories are hard-wired into the nervous system. The critical period in early brain development is in the first five years of life before myelinization when the brain is most vulnerable to psycho-trauma. Several researchers indicate that trauma is defined by the child’s perception of the event, rather than the event. Multiple traumas are more significant than single events in early brain development (Brandt et al, 2013; Dobson & Perry, 2013; Perry, & Hambrick, 2008). During my early years, abuse, insecure attachment, separation, stress and neglect hard-wired my brain for high anxiety. Trauma became encoded in lowered sensitivity and stress thresholds (McFarlane, 2010). Whilst memory for secure children is generally experienced as cognitive, trauma causes “neurobiological memory” or a memory that has difficulty forgetting (Bisaz et al, 2014).
 
Attachment theory also sheds light on my adult struggles with anxiety. Inconsistent mothering creates an anxious ambivalent child who grows into an adult that is preoccupied with relationships (Ainsworth et al., 1971; 1978). Inconsistent mothering is more than behavioural, it reflects a core weakness. As a mother, my own emotional wounds thwarted a consistent emotional connection with my children. Unsurprisingly, hurt people, hurt people. My pattern of closeness and withdrawal was confusing for them. I was a good mother for a while and deeply desired to be a good mother, but then I would withdraw when I was triggered. My daughter’s response was a pronounced pattern of protection and defence or ambivalence. Growing up, she had to be tentative and on-guard, believing, “I cannot control things, I must stay alert.” This anxiety was the precursor to her adult struggles with anxiety. Psychological anxiety is “reactive” to our environment, it is essentially learned and it is situation-provoked or conditioned by traumatic life experiences.
 
Spiritual anxiety

Anxiety emanates from the enemy of our souls and is designed to prevent us hearing God’s voice. Perhaps we do not hear because we are afraid of what God might require of us – that it might be more than we are willing to bear. But God promises in 1 Corinthians 10:13, “No test or temptation that comes your way is beyond the course of what others have had to face. All you need to remember is that God will never let you down; he’ll never let you be pushed past your limit; he’ll always be there to help you come through it.” In our distress, believing the enemy’s lies keeps us from knowing and experiencing God’s immeasurable love. Epictetus rightfully acknowledged, “People are disturbed not by things, but by the views they take of them.”
 
During my 20’s and 30’s I lived in ignorance and shame over my struggle with anxiety/depression, because I could not explain how it occurred or what to do about it. Nor could I seek help, as I believed I was weak and a moral failure. I feared I would be stigmatised by my church that assumed anxiety is purely spiritual and is a lack faith and trust in God. This kind of judgmental response is like telling a person with a broken leg to throw away the cast and simply trust.
 
Now, as a counsellor, I see how worry, anxiety and depression give Christians some of the greatest problems, since they are so clearly denounced in scripture. Jesus did say that worry and anxiety are ultimately an issue of lack of faith. I must acknowledge that since the scriptures explicitly command us not to be anxious, there is no other conclusion than to be anxious is a lack of trust in a good God. This is difficult to hear because none of us do not struggle with anxiety and flawed faith. When faced with some new difficulty, danger or threat we are all anxious.
 
However, God responds to us with compassion, not judgement. Henri Nouwen (2006) writes:

The word compassion…means ‘to suffer with.’ Compassion asks us to go where it hurts, to enter into places of pain, to share in brokenness, fear, confusion, and anguish. Compassion challenges us to cry out with those in misery, to mourn with those who are lonely, to weep with those in tears. Compassion requires us to be weak with the weak, vulnerable with the vulnerable, and powerless with the powerless. Compassion means full immersion in the condition of being human

True compassion is full immersion in another’s distress, clearly demonstrated by Jesus as He interacted with people in the Gospels. But what does it mean to have compassion for myself as COVID 19 and other uncontrollable events threaten to steal so much? God’s desire for us is clear in Psalm 56:3, “When I am afraid, I put my trust in you.” So, what needs to happen in our hearts for faith and trust to be a reality? If worry and anxiety represent unbelief, how do we learn to trust God?
 
Declaration…
 
I declare Your ability to fulfil all Your promises, God, especially to me. I declare that You will fight for me, I need only be still. I trust God to protect me.

Prayer…
 
Lord, I thank You that You are the God of the impossible and are able to do anything. I want to trust in Your ability and not my own. Teach me to see world events and my anxiety from Your perspective. Rather than focus of what is missing or what might or might not happen, help me to focus on You and Your power even in seemingly impossible circumstances. When uncertainty and anxiety threaten to undermine me, show me Your ways. Please remind me in everything I am and do, that You are with me and promise to never leave me nor forsake me.

About the author: Dr. Paula Davis is a clinical counsellor, supervisor and educator specialising in psychological trauma. She has worked in higher education over many years as senior lecturer in counselling. Along with her husband she designs and delivers marriage enrichment/education programs in Australia, Africa, Sri Lanka, India and Europe.

References
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