Anxiety disorders – Frequently asked questionsWritten by Don Graber
What's inside this article
What causes anxiety disorders?
Our understanding of the roots of anxiety disorders is very incomplete. Anxiety disorders constitute a class of mental health issues, and the underlying causes for each one may vary. It is not clear, for example, why a specific phobia might afflict one person but not another. It's likely that genetic and environmental factors combine to make some people more susceptible to certain anxiety disorders, and research is currently being done to increase our knowledge.
Why might someone not seek help for an anxiety disorder?
Some people with anxiety disorders never get the help that's available. They may simply be unaware that something can be done about their anxiety, or they may avoid getting help because they fear that dealing with anxiety or reaching out for help will be perceived as weakness. Sometimes Christians don't get help because they believe anxiety is a sign of spiritual failure, or they fear the stigma in their faith community that's associated with an anxiety disorder (see below).
What can I do to help someone with an anxiety disorder?
Anxiety disorders cause tremendous suffering to those who are afflicted, but they can also devastate a patient's family and loved ones. Too often, the stress and pain of an anxiety disorder shatters families and destroys relationships. If you believe that a parishioner is dealing with an anxiety disorder, encourage them to get help. Often, a person with anxiety will seek the help he or she needs if only someone will encourage them in that direction.
What help is available for people with anxiety disorders?
Left untreated, anxiety disorders can be disabling. The good news is that there are helpful treatments for these disorders, and most people who undergo treatment see real improvements.
Individuals who believe they may have an anxiety disorder should seek a thorough examination by a physician to examine the possibility that symptoms are the result of a separate medical condition. In fact, DSM-5 lists "Anxiety Disorder Due to Another Medical Condition" as a distinct diagnosis. Medical conditions that may produce anxiety include hyperthyroidism, hypoglycemia, cardiac arrhythmia and vitamin B12 deficiency, among others. A physician can help identify and treat medical conditions that may produce anxiety. He or she may also be able to determine whether the anxiety being experienced is the result of medications or other substances (a condition known as Substance/Medication-induced Anxiety Disorder).
If it appears that anxiety is not the result of an underlying medical condition or any medication, another type of anxiety disorder may be diagnosed. A primary care doctor such as a family physician or an internal medicine specialist may prescribe medications to relieve anxiety, and may also recommend psychotherapy. A primary care professional might refer to a psychiatrist for cases that don't respond to relatively simple medical care. A psychiatrist is a medical doctor who is specially trained to treat mental disorders.
Medications cannot cure anxiety disorders, but they may relieve a person's symptoms enough to allow them to function and respond to psychotherapy. A drug that is effective in treating an anxiety disorder in one patient may not be effective in someone else. Some drugs take several weeks to exert their full effects, and patients may not experience improvements for some time. It may take a patient and his or her doctor weeks or even months to find the right medication at the dosage that works best.
Sometimes people will begin to feel better after being on medication for a while, and they may stop taking medication because they feel they no longer need it. Unfortunately, symptoms can return after a person stops taking their prescription. Abruptly quitting certain medications can result in negative side effects. Individuals who wish to discontinue their medication should do so in consultation with, and under the supervision of, a physician.
In addition to medication, psychotherapy can be an effective treatment for anxiety disorders. Psychotherapy involves talking with a qualified professional who can help patients learn how to deal with their anxiety. One form of psychotherapy that is particularly helpful in treating anxiety disorders is cognitive behavioural therapy (CBT). With CBT, individuals examine how their thoughts and behaviours contribute to anxiety. They then learn new ways to think about their experiences and circumstances and how to recognize and alter dysfunctional thought or behaviour patterns. CBT may be useful in the treatment of GAD, panic disorder, specific phobias and social anxiety disorder, as well as OCD and PTSD. Another form of therapy – desensitization – is mentioned above.
Many individuals experience best treatment results when medications are combined with psychotherapy.
Focus on the Family Canada may be able to help you locate a registered and qualified Christian psychologist, therapist, counsellor or psychiatrist in your area. For more information call Focus' counselling department at 1.800.661.9800 Monday through Friday between 8 a.m. and 4 p.m. Pacific Time.
Why am I experiencing an anxiety disorder if I am a Christian?
Christians are not immune to anxiety disorders. One tragic notion that persists in some Christian circles is the idea that problems like anxiety are primarily, if not completely, spiritual in nature. Many Christians sincerely believe that a person should not experience anxiety disorders if he or she just has enough faith and trust in God. That is simply not true.
Well-meaning Christians may quote Scripture passages such as, “There is no fear in love, but perfect love casts out fear. . . whoever fears has not been perfected in love” (1 John 4:18, ESV). This verse reminds us that God is greater than anything we will face in this world, and it assures us of the confidence we can enjoy when we stand before God someday. But it was not written as a pronouncement on anxiety disorders. Anxiety disorders can affect a person's spiritual life, and spiritual issues may be interwoven with a person's anxiety, but to say that the person with an anxiety disorder should simply trust God more is like telling the woman with a broken bone that she should just have greater faith, and she will be well. We wouldn't scold or throw out-of-context Bible verses at a person with a broken bone. Why would we do that to a fellow believer who's suffering the torments of an anxiety disorder?
In a similar vein, some Christians disparage the use of medications in treating anxiety disorders or other mental health problems. But we wouldn't dismiss a diabetic who takes insulin as someone who obviously lacks trust in God. In the same way, we ought not to look at those who take medication for anxiety as somehow deficient in their faith.
If you know of someone who is dealing with an anxiety disorder, and they feel that the use of medications is somehow sinful or evidence of a lack of faith, urge them to reconsider. For some people, the use of medications is a lifeline, allowing them to function normally and helping them to reconnect with others and with God in ways that might not otherwise be possible.
Anxiety and substance abuse
Some people with anxiety disorders use alcohol or drugs to medicate themselves and relieve feelings of distress. Unfortunately, illicit drugs and alcohol are no more helpful for treating anxiety disorders than they would be for treating pneumonia.
Alcohol and drugs can mask the symptoms of anxiety disorders, making diagnosis and treatment more difficult. In some people, they can worsen or actually cause anxiety. Additionally, using drugs or alcohol to deal with anxiety increases risks for drug addiction or alcoholism. If someone uses drugs or alcohol to cope with an anxiety disorder, counsel them to speak to a qualified mental health professional. Substance abuse has only downsides, never an upside.
Help is available
Anxiety disorders are much more than simple jitters or nervousness; the feelings of fear and anxiety that accompany them can be debilitating. The good news is that help is available and these conditions can be managed with the proper combination of medical and psychological care and spiritual support. While not discussed in detail above, this last element is extremely important, as anxiety disorders can challenge the notion that God is a loving Father who is trustworthy and cares for us and is in control of all things. If you know of someone who is dealing with an anxiety disorder, encourage them to consider the benefits of Christian counselling, pastoral care and the support of a strong faith community. Combined with other forms of care, these can help people struggling with anxiety to live a vibrant and effective life for Christ.
Dr. Donald Graber is a member of Focus on the Family's Physicians Resource Council. He retired in 2013 after working as a psychiatrist for over 35 years.
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