Six years ago, I received a cancer diagnosis. The stressful diagnostic process included several tests, including an MRI. I prayed throughout the procedure and tried to manage my thoughts. But when the MRI was over, I suddenly felt as though I had no control over my own body. I couldn’t stand up, I couldn’t think clearly, and I could barely talk. I didn’t know what was happening to me.

Concerned staff members had me lie down on a gurney in the hallway outside the room and discussed sending me to the emergency room. After a while, however, I sat up and finally managed to walk on my own. I had just experienced a panic attack.

What Is Anxiety?

In simple terms, anxiety is a sense of uneasiness, apprehension, or distress over a real or perceived threat. Everyone experiences anxiety at times. But for some, these relentless feelings interfere with daily life and may even become debilitating.

According to the National Institute of Mental Health, about 3 in 10 U.S. adults will experience an anxiety disorder at some point in their lives. These conditions include generalized anxiety disorder, panic disorder (recurrent panic attacks), and phobia-related disorders (such as social anxiety).

Even when it doesn’t reach the level of a clinical disorder, anxiety can feel overwhelming at times — especially during crises. In a 2020 survey by the American Psychological Association, 78% of adult respondents said the pandemic was a “significant source of stress” for them.

The Centers for Disease Control and Prevention reported in the summer of 2020 that the share of U.S. adults experiencing anxiety symptoms had increased considerably compared to the same period in 2019.

What Causes It?

Anxiety is a complex problem with a variety of causes. It’s often difficult to ascertain the cause with certainty. Some anxiety arises from physiological issues and needs to be treated as the medical condition it is. Anxiety may be driven by a biochemical imbalance, which can be diagnosed by a medical professional.

For others, anxiety may have a spiritual root, from unconfessed sin (Psalm 32:1–5), difficulty trusting God (Philippians 4:6–7), condemnation (Romans 8:1–2), a weak or faulty theology, or other spiritual concerns.

As pastors, we have the power of the Spirit and the mind of Christ (1 Corinthians 2:16) to help us discern the cause of a parishioner’s anxiety and minister to their spiritual and emotional needs. We are called to explain “spiritual realities with Spirit-taught words” (1 Corinthians 2:13).

However, since anxiety can arise from various causes, we also need to know when to treat anxiety as a spiritual issue and when to refer to a medical professional or qualified counselor.

Sometimes anxiety is the product of unhealthy thinking patterns, such as insecurity, irrational fear, perfectionism, or distorted perceptions of reality. As negative messages play over and over in the mind, they create ruts in neural pathways. What started out as one destructive thought can become a harmful pattern. Anxiety can be self-perpetuating. As it escalates, it may lead to new worries and fears.

Trauma, including unresolved grief, adverse childhood experiences, or other stressful events, can cause severe anxiety.

The Greek word merimna — often translated as “worries” (Matthew 13:22) or “anxiety” (1 Peter 5:7) in the New Testament — suggests a state of being distracted or pulled in different directions. This is an accurate description of what anxiety can do to a person’s mental or emotional state.

What Can You Do?

Anxiety is exhausting, and an anxious lifestyle can become toxic. We can’t just wish anxiety out of our lives or talk someone else out of it.

God wants to replace fear and anxiety with His peace and joy.

While it’s normal to have some anxiety, if constant anxiety is the norm, it’s time for some changes. Here are several suggestions to help manage anxiety:

1. Grow in self-awareness. Pay attention to emotions and physical reactions to them. Many people notice the physical effects of anxiety — such as a headache, upset stomach, or tight muscles — before they are aware of the psychological issue triggering these responses.

2. Change the internal dialogue. Take steps to identify harmful thinking patterns and replace them with healthier ones. Negative self-talk colors a person’s attitude and outlook. When thinking gets distorted, it’s time to realign thoughts with the truth of God’s Word and what He says.

3. Practice self-care. Schedule time off, observe a weekly day of sabbath rest, and take vacations. Find a hobby. Exercise, eat a nutritious and balanced diet, and get sufficient sleep.

4. Give and receive grace. People will never beat anxiety by beating up on themselves. We all need grace — from God, from others, and even from ourselves. God describes himself as “compassionate and gracious” (Exodus 34:6), not harsh and critical. The gospel is good news for the anxious.

5. Develop healthy coping skills. Try deep breathing, time outdoors, or other calming activities.

6. Build a support network. A network of friends, family, mentors, pastors, and counselors can offer perspective, encouragement and support.

7. Pray. Consider a prayer like Psalm 139:23–24, “Search me, God, and know my heart; test me and know my anxious thoughts. See if there is any offensive way in me, and lead me in the way everlasting.” To paraphrase, “God, You know my anxiety. You know my pain and sorrow. Lead me in Your way.”

8. Meditate on Scripture. When my husband and I left the mission field, we didn’t know where our next paycheck was coming from. When anxiety would rise, I meditated on Matthew 6:25–34. “Therefore, do not worry about tomorrow, for tomorrow will worry about itself” (verse 34). I found a photo of a vast field of flowers and made it my computer background to remind me to release my worry to God, who provides for us with even more care and attention than He gives the flowers.

9. Seek treatment. There is no shame in seeing a doctor or Christian counselor for anxiety, or in taking medication when prescribed. Don’t hesitate to seek help from, or refer parishioners to, qualified professionals.

Members of your congregation are most certainly experiencing anxiety. Besides offering the above advice to those you are counseling, here are some tools to help others:

• Use a distress scale. Using a scale from 1–10, with 1 being low and 10 being the highest level of distress, ask the person to identify his or her level of anguish.
• Help the person identify and deal with stressors. Some stressors can be removed, creating a lighter load. If it is not possible to remove the stressors, help the person learn new ways of handling the stress by reframing or changing thinking patterns.
• Help the person recognize unhealthy ways of thinking. Getting to the root of the anxious thoughts is important. Often, an outside perspective can help the person understand his or her thinking patterns.
• Offer a listening ear. The power of presence is healing. Allow the person to express hurts. Using active listening, paraphrase back what you are hearing.

It is possible not only to manage anxiety, but also to overcome it. God wants to replace fear and anxiety with His peace and joy. There is hope.

The testimony of Psalm 94:18–19 can become our story as well: “When I said, ‘My foot is slipping,’ your unfailing love, Lord, supported me. When anxiety was great within me, your consolation brought me joy.”

This article appears in the Fall 2021 edition of Influence magazine.