I’ve written before on Faithroots about depression and have recently contributed to a book on the subject. Here I want to talk about another aspect of mental health sometimes linked to depression. When I was signed off sick by my GP I was diagnosed with Mixed Anxiety and Depressive Disorder (no the anachronym for that one isn’t great. I know). Now often when we talk about emotional health we focus on the “depressive” bit and about the sense of darkness and being seriously low in our moods. Yet anxiety on its own or along with depression too is something we need to be aware of.
AS Mind say here, anxiety is a normal part of life:
“Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future.”
So, just as feeling a bit low sometimes does not mean you have depression, so, we also want to distinguish feeling a bit tense, worrying or even ruminating over something and getting stressed from anxiety disorder. This also means that we will want to see that when Jesus says “Do not wory” he is not saying “Do not suffer from an illness” but he is talking about how we respond to day to day worries and concerns, he is saying “don’t let your day to day concerns and circumstances rule your life.” He is saying don’t be materialistic.
Anxiety becomes a mental health issue if
- your feelings of anxiety are very strong or last for a long time
- your fears or worries are out of proportion to the situation
- you avoid situations that might cause you to feel anxious
- your worries feel very distressing or are hard to control
- you regularly experience symptoms of anxiety, which could include panic attacks
- you find it hard to go about your everyday life or do things you enjoy. 
So, we are dealing here with a situation where someone’s experience of anxiety is either acute and severe or persistent, chronic and overwhelming so that it substantially affects their lives. Now, just as depression can be caused by specific circumstances such as things we have done or things done to us, so too can anxiety. It may arise because we have allowed ourselves to become chronic worriers, in which case the words of Jesus on the matter are particularly pertinent. However, It may arise as an aspect of PTSD in response to horrific experiences in the past. In that case, telling someone not to worry is completely inappropriate to the situation. Similarly, it is unhelpful to say “just stop being anxious” to someone when there appears to be no specific cause to the anxiety as can also be the case with depression.
When the condition is experienced in an acute form, it may come on as an anxiety attack. I think we are increasingly aware of the concept of panic attacks. The experience here will include a tenseness in the chest, a pounding heart, shortness of breath, palpitations, disorientation etc. The adrenaline rush involved on what is a kind of “fight or flight” scenario will lead to a crash afterwards so that the person is then completely exhausted. I’ve also heard people describe experiencing migraines a few days after. In fact, I suspect that this might provide some potential explanation to the connections with depression as the exhaustion is likely to include lowness of mood.
It is also worth commenting here about the experiences of pastors and preachers. I know many who have talked about the Sunday evening affect where they end up feeling not only exhausted but feeling extremely low. Now, it is worth noting that pastors are engaged in a form of spiritual warfare. This is a given anyway but then also there can be specific situations within the church that lead to an even greater sense of conflict as people react to change, especially when it includes reformation in the beliefs and practices of the church leading to groups forming that seek to fight back and to make life difficult for the elders and/or the pastor. Despite what people say, no-one, not even a pastor particularly likes conflict, especially when that includes being yelled at or gossiped about or slandered. So, I am not surprised then to hear when this leads to overwhelming anxiety including anxiety attacks followed by exhaustion and depression. This is one reason why I’m cautious about us writing those things off as “burnout”. I think that word can miss out on so much of what is going on and assumes that the pastor has simply been overworked.
So, first a word to those experiencing anxiety. I want to encourage you to find help and support and most of all not to carry around fear and shame of what others will think. This will include encouragement from Scripture that we can cling to Christ and rest on his sure provision, particularly when we know that our anxiety has developed over time through worrying about circumstances. However, as I mentioned before, be aware that there can be other factors affecting and causing anxiety including things like PTSD or there may be no specific explanation available so I would like to encourage you to take advantage of other sources of help too including medication and counselling.
Secondly a word to those with friends struggling with anxiety and to churches too. I would encourage you to be alert to the signs of anxiety and also to what might be the potential triggers for it. Take time to learn about how you can support those with anxiety and particularly in the case of churches take time to think through how you can minimise the potential for triggers especially to those who are suffering from PTSD. Be alert that though someone may be experiencing extreme anxiety in a given situation that this does not mean that the situation itself is the direct and natural cause of anxiety, it may well be that the sufferer is even subconsciously associating the context with past trauma. Take time to consider whether issues of conflict have been resolved in the church and especially whether repentance is needed. Learn to be patient and to walk with sufferers through their times of trial not expecting them to “snap out of it” or recover at your pace. Finally, I want to encourage all who go through suffering whether that’s to do with mental health, physical heath, circumstances or persecution. We live in the Now and the not yet. This does mean that we will face trouble and suffering, especially if we seek to live a godly life for Christ. But keep clinging to Christ. He is good and faithful, he will bring us through to the other side and there is the hope ahead of the day when all worry and anxiety, all pain, suffering, fear and anxiety will be gone and we will see Christ face to face.
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