By Nanette Nelson, LCMHC
This week I’d like to address anxiety. As with depression, there are levels to the clinical presentation of anxiety. Most of us worry about things from time to time, but once again, when we are not able to function because of our worries professional help may be necessary. Anxiety can cause you to have stomach aches, headaches, irritability, difficulty concentrating, fatigue, restlessness, muscle tension, sleep problems and even panic attacks. There are also specific types of anxiety such as phobias, performance anxiety and agoraphobia which is a fear of leaving your home. So again, what does the Bible offer for those who experience anxiety.
1 Peter 5:7 “Casting all your anxieties on him, because he cares for you.” This comes from a letter where Peter describes how God will be there for you in your suffering. He offers a great coping skill.
Psalm 23:4 “Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.” Most of us know this passage and probably remember it from our darkest moments. We can also meditate on this any time we need comforting.
Isaiah 41:10 “Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.” And again, there is the “Fear not” phrase. As I noted before it appears in the Bible 365 times. Once for every day of the year. Remember every day that God does not want you to experience painful worries but to trust in him.
Psalm 37:23-24 “The LORD makes firm the steps of the one who delights in him; though he may stumble, he will not fall, for the LORD upholds him with his hand.” How hard is it to delight in the Lord when you are overwhelmed by worries or fears. This is why we have the written word, so we can read, re-read and read some more until His word sinks in. This is also a great coping skill.
As with depression, there are non-medication remedies for anxiety. Minor symptoms can be helped with lifestyle changes including keeping active, healthy eating, spending time in nature, enjoying family and friends, reducing stress and participating in enjoyable activities. For more significant symptoms a therapist can help you with deep breathing exercises, progressive muscle relaxation, imagery, and challenging irrational thoughts. Again, medication can be very useful. Most anxiety medications are very different from anti-depressants in that they don’t require a blood level to be effective. They work more like an aspirin becoming effective within minutes, last for a certain period of time and are then are gone from your blood stream. They are often called PRNs (which is from the Latin for as needed) because you can just use them for specific instances. If you are experiencing panic attacks, your anxiety may be triggered by traumatic memories. I will talk more about trauma next week, but trauma therapy is recommended with those behaviors. You might also require a combination anti-depressant and anti-anxiety medication.
I am aware that many are resistant to taking medication. I understand a medication that alters your perceptions sounds scary, but if your perceptions are curtailing your ability to function then it is no different from an antibiotic for a fever or aspirin for a headache. In the past medications have dulled people’s senses and caused addiction, but modern psychiatric medications are very different. In counseling we like to use the metaphor of training wheels. When your body chemicals rebalance and you are able to function in a healthy way, the doctor will wean you off the medication.
When treating a specific anxiety, a therapy called exposure is often used. With these anxieties, our brain has tricked us into thinking that something catastrophic would occur if we left our house, performed in front of an audience or come in contact with a spider or flew in a plane. An exposure therapist would slowly “expose” you to thoughts about an airplane, then watch a film that simulates an air flight, make arrangements to just sit in a plane and eventually take a short flight. All the while the therapist would be besides you to constantly convince your brain that you are safe. Anxiety is the underlying feeling that something fearful will happen so you feel unsafe. The basic aim of the therapy is to convince your brain that it is safe.
As before, I will be happy to speak with anyone who has questions about any aspect of mental health or illness.