COPING WITH ANXIETY

Greg Swenson, Ph.D.

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  Most studies indicate that between four and fifteen percent of our population suffers from an anxiety disorder.

Anxiety-related problems are among the most common that psychologists deal with We all know what anxiety is because it is common to all people. We've all experienced feelings of fear or dread. An anxiety disorder could be defined as a propensity to experience fear or dread, more intensely and more often than the average person does. Anxiety disorders interfere in a person's ability to function in daily life. Those who experience them may have difficulty concentrating, suffer physically, consume excessive amounts of alcohol and drugs in an attempt to alleviate anxiety, or simply stay home most or all of the time.

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    We think of anxiety as an emotion, but anxiety disorders have mental and physiological components that are as important as the emotions involved.

Fear begins with the perception that something is a threat to us. That thought prompts the feelings we associate with anxiety, as well as characteristic physiological responses: muscle tension and headaches, gastro-intestinal upset, changes in heart rate and blood circulation, and rapid, shallow breathing.

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    What is "normal" anxiety and what isn't?  

Fear, and pain are unpleasant but necessary experiences. They are important because they tell us what to avoid. Feeling pain when we touch a hot stove prevents us from severely burning ourselves. Children who have grown up in an abusive situation show us how important fear and pain are. Often, these children develop a tendency to dissociate when repeatedly abused, dulling their sense of pain and fear. In later life, it isn't uncommon for them to be abused again, partly because they are insensitive to the cues that would tell others to avoid potential abusers. Anxiety is normal in situations where a threat is present. During war, in combat situations, anxiety is not abnormal. Panic is not abnormal after swerving to avoid a head-on collision. Fear is abnormal when it is a response to something that really isn't a valid threat, when it lingers long after the source of fear is gone, or when the fear response is excessive.

• Abnormal anxiety, or anxiety disorders, has been separated into five categories: panic disorders, generalized anxiety disorder, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder.

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    Panic Disorder  

Panic disorder is an extreme fear reaction, such as you might experience in a life-threatening situation, which occurs when you are not in real danger. People with this problem begin to avoid places and situations that might be associated with the panic and falsely attribute their panic reaction to the wrong sources. They begin to avoid many normal parts of life, such as shopping, driving, going to church, or leaving town. When this occurs, they develop agoraphobia in addition to the panic disorder.

    Generalized Anxiety Disorder  

The primary component of GAD is anticipatory anxiety, or worry. People with this disorder are consumed with thoughts of bad things that might happen. Their worry almost assumes a magical quality, as if they can prevent things from happening by anticipating them and thinking about them. They seem afraid to let go of their worries. When one concern is eventually resolved, another inevitably replaces it.

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    Phobias

A phobia is an unrealistic fear of something that doesn't warrant fear. There are many examples, some of the most common being fears of heights, flying, snakes, and spiders. Usually phobic objects can be effectively avoided and consequently don't cause major problems for people. One exception is social phobia, which causes a great deal of anguish and isolation. Many people lead lives with very limited relationships because of this fear. They may avoid church, neighbors, and family gatherings throughout their lives.

  Obsessive-compulsive Disorder

OCD is one of the anxiety disorders most difficult for non-anxious people to relate to. The symptoms seem more deviant than the other disorders. OCD is actually a deviant way of coping with anxiety that becomes a lifestyle. OCD victims find that by going through mental or behavioral rituals, their anxiety is temporarily reduced. But because it is temporary, they must perform the rituals repeatedly. It appears that the rituals distract them from the source of anxiety, which becomes obscured over time. The rituals become the most prominent part of their life. They might involve such things as repetitious thoughts, saving large quantities of certain objects, constantly checking that doors are locked, or the classic repetitious hand washing.

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    Post-traumatic Stress Disorder

PTSD is the result of a severe, distressing event the magnitude of which most people never experience. Essentially, it causes such intense emotions that they cannot be contained, even for weeks, months, or years after the event. The emotions overflow into daily life in unmanageable ways, such as sudden intrusive memories of the event in the midst of work, frequent nightmares, and inappropriate startle responses. PTSD is common in combat veterans, victims of abuse, and disaster survivors.

    What does the Bible have to say about anxiety?  

A lot. My personal favorite is found in Isaiah 26:3: "You will keep in perfect peace him whose mind is steadfast because he trusts in you." It seems to encapsulate the ultimate antidote to anxiety: God's presence. There are many more references to anxiety and its antithesis, peace. I will share with you a few that frame my approach.

Isaiah 53:5 "The punishment that brought us peace was upon him."

Romans 5:1 "Since we have been justified through faith, we have peace with God through our Lord Jesus Christ."

God's presence requires reconciliation with him. Thus, Christ becomes the provider of our peace. Many fears can be reduced to the fear of death, and the fear of death to facing God. Christ changes God from the ultimate source of fear to the source of peace. Isaiah 57:20 says, "There is no peace for the wicked." (Those who remain estranged from God)

There are many admonishments to grab hold of the peace God provides:

Colossians 3:15 "Let the peace of Christ rule in our hearts."

John 14:27 "Peace I leave with you . . . Do not let your hearts be troubled and do not be afraid."

Philippians 4:6 "Do not be anxious about anything, but in everything, by prayer and supplication, with thanksgiving, present your requests to God."

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    If freedom from anxiety is as simple as seeking God's presence and dwelling in his care, why do we have so much trouble with anxiety?  

For many, of course, the answer is that they don't recognize God or look to him. They seek peace in the wrong places. But many who do recognize God and who have been reconciled to him through Christ are anxious too. I think a key is found in Psalm 34:14: "Seek peace and pursue it." Utilizing the peace God provides requires an active effort on our part. Since we live in a world that is not directed by God's truth, we have to search out the peace God provides.

Here are some suggestions:

Take time to focus on God. Ps. 46:10: "Be still and know that I am God." Meditation, or reflection on who God is, is basic to putting everything else in life into perspective. There is no substitute for being quiet and contemplating God.

We need to see that God is relevant to our lives and capable of dealing with our concerns. Contemplate God's ability to deal with the worst things we have to face.

Matthew 28:20 "Surely I will be with you always, to the very end of the age."

Consider what God asks you to do, and what he does not ask you to do.

Matthew 11:28-30 "Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me . . . For my yoke is easy and my burden is light." It is when we try to do more than what God asks that we become anxious and distressed.

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Panic disorders require training in the ability to consciously relax the body, alleviating the physical symptoms that often perpetuate cycles of panic. Relaxation training includes such activities as deep breathing, muscle tension and relaxation, and visualization. It is essential that this be followed by a carefully planned program of exposure to the feared stimuli. Many people try to accomplish too much, too fast, resulting in a sense of failure and despair. Cognitive retraining, or learning to view sources of anxiety from a more realistic perspective, is another important component. Education regarding the body's modes of responding to anxiety and learning to control them is another component.

Phobias are dealt with in a similar fashion.

Generalized anxiety disorder is treated by teaching people to confine their thinking. This might involve techniques such as "thought-stopping", and learning to substitute activities for thinking.

Medication can play a role in the treatment of anxiety. However, it is important that it be used judiciously, as an adjunct to treatment, rather than a cure. Some people are highly resistant to using medication, and some have had bad experiences with it, which have actually enhanced their anxiety. It seems to be more important in some disorders, such as OCD, than in others.

Regardless of which anxiety disorder a person has, I find it important to cultivate an aggressive attitude within the person afflicted. People who suffer chronic anxiety are accustomed to feeling that their attempts to defeat anxiety are futile, and come to see themselves as passive and hapless. They need encouragement, partnership with another who gives them enthusiasm and strength to "attack" anxiety, and determination to not allow anxiety to dictate what they can and cannot do with their lives. 

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