It’s normal to feel anxious, but anxiety disorders can interfere with a person’s life. The better we understand these disorders, the better we can help each other.
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Imagine that a member of the bishopric telephones two ward members to ask them to say the opening and closing prayers in sacrament meeting. Both members feel nervous. One has butterflies in their stomach about saying the prayer but thinks through what to say and goes through with it. The other has an overwhelming sense of dread accompanied by an elevated heart rate and hyperventilation and does not go to church that Sunday. One feels relief at being able to do something difficult. The other has other similar panic episodes over the next few months out of fear of being called on to pray and avoids going to church for quite a while.
This contrast highlights the fundamental difference between most people’s experience of anxiety and the experiences of people with anxiety disorders.
Anxiety is a normal human emotion. Everyone experiences it. It is part of the “opposition in all things,” without which there would be no “happiness nor misery, neither sense nor insensibility” (2 Nephi 2:11).1 As such, this emotion serves us well. It is part of our emotional alarm system. It motivates us to prepare for important events. It causes us to protect ourselves when we feel threatened. It enhances performance. It helps us make thoughtful decisions, solve problems, and prepare for challenges. It reveals what we care about.
On the other hand, there are also anxiety disorders. These interfere with our alarm system and its many benefits and are characterized by persistent, overwhelming, uncontrollable anxiety that impedes normal functioning. They include social anxiety; phobias; panic attacks; repetitive, intrusive, objectionable thoughts, impulses, and images; and are often accompanied by a host of physical symptoms and extreme avoidance behavior.
Many among us suffer from such disorders. Therefore, it’s important that we understand these disorders so that we can offer appropriate support and help.
How Anxiety Disorders Develop
In addition to extreme avoidance of anxiety-filled situations, several human traits come together in a “perfect storm” to create debilitating anxiety: biological vulnerability to anxiety, coupled with stress; worry; distorted perception and thinking; perfectionism; excessive niceness; and unresolved regrets.
Biological Vulnerability to Anxiety, Coupled with Excessive Stress
We inherit from our parents our physical and emotional makeup, including vulnerability to certain illnesses. Just as some families are vulnerable to high blood pressure or diabetes, some are also vulnerable to certain emotional disorders.
Vulnerability by itself will not cause an anxiety disorder. However, when it is coupled with long-term, unresolved stress, a person may develop such a disorder. Understanding this can help us know, for instance, that some people may need to take medication to manage body chemistry when they have high levels of constant anxiety.
Worry comes when we feel we are highly vulnerable to some threat and also feel we have little power to do anything about it. Like anxiety, worry can be very helpful. However, when it is excessive, persistent, and unchecked over a long period of time, it can evolve into an anxiety disorder.
Distorted Perception and Thinking
People who suffer from anxiety disorders have distorted perceptions and thoughts. Perception begins with what we experience through our five senses and then includes the meaning we give to our experience. This filtered perception accumulates over time. However, it is often false when not guided by the truth.
Anxiety disorders distort thinking. For instance, fear that a dog might bite you could be very rational in a given situation. However, thinking that you should not go outside because a dog might attack you is irrational.
A theory that counselors use to teach people how to change distorted perception and thinking states that our emotions are the result of events and experiences filtered through how we perceive and think. The simple formula of this theory is A+B=C: The key to our emotions (C) is perception (B) of an event (A) rather than the event itself. We know this because two people can experience the same thing but feel very differently about it.
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If you can replace irrational thoughts and beliefs with more rational, comforting ones, your anxiety will drop and become more normal.
Perfectionism can be functional and helpful when used as a tool to improve and grow. However, two common irrational beliefs that create anxiety are “People will look down on me if I make a mistake” and “I’m less worthwhile when I fail.” These beliefs limit our use of mistakes to teach us (see Ether 12:27; D&C 1:25, 27) and ignore the fact that we have great worth as sons and daughters of God (see D&C 18:10).
Unhealthy perfectionism causes people to hold themselves to standards they don’t hold others to. It causes procrastination. It takes the joy out of trying new things. For example, if people’s friends invite them to go bowling, they may fear what their friends will think if they bowl poorly. Of course, they themselves would not look down on friends who bowl poorly, but they do not see how irrational their thinking has become.
The Lord commanded us to be perfect (see Matthew 5:48), but He also said that if we draw close to Him, He will show us our weakness (see Ether 12:27). There appears to be a conflict between these two concepts unless you understand that perfection (completeness, wholeness) is an eternal condition that comes through the Savior’s Atonement “on conditions of repentance” (Alma 42:13). We don’t make ourselves perfect; Jesus Christ does. We just do our best and keep repenting when we fall short, relying on His grace to make weak things strong.
If we don’t resolve the distorted thinking common to perfectionism, we become the slaves rather than the masters of our high standards, and we become vulnerable to extreme anxiety.
For more on perfectionism, read President Russell M. Nelson, “Perfection Pending,” Ensign, Nov. 1995, 86; Elder Cecil O. Samuelson, “Perfectionism,” New Era, Jan. 2006, 10; and Elder Gerrit W. Gong, “Becoming Perfect in Christ,” Ensign, July 2014, 14.
Another positive trait that can nevertheless leave us vulnerable to anxiety is niceness. The Savior said, “Blessed are the peacemakers” (Matthew 5:9), and the world could surely use more of them. However, almost everyone with an anxiety disorder is excessively nice. They feel guilty and feel like failures when they’re unable to create peace and tranquility in everyone’s life, solve everyone’s problems, or make everyone happy. It’s an unreasonable and unhealthy standard to hold ourselves to.
A Specific Unresolved Regret or Guilt
Everybody has regrets. We’ve all failed or let someone down. People with anxiety disorders, however, hold on to intense regret and guilt. These feelings, coupled with excessive niceness, cause them to avoid situations where they might repeat the “offending” behavior so as to not upset or disappoint anyone ever again. This is often the root of their anxiety. Bringing the problem to conscious awareness, dealing with it directly, and taking action to resolve it and let it go usually bring rapid recovery.
Anxiety Disorders and the Spirit
The Holy Ghost is the Spirit of Truth and the Spirit of Peace. The Spirit works quietly (see 1 Nephi 17:45). Anxiety is loud and obnoxious, so to speak, making it difficult to feel the Spirit and depend on your faith. Faith is trust in God.2 The opposite of faith is uncertainty and mistrust. Is it any wonder that anxiety disorders often undermine faith?
One manifestation of the Spirit of Truth is that we are able to think clearly and rationally. Jacob says: “The Spirit speaketh the truth and lieth not. Wherefore, it speaketh of things as they really are, and of things as they really will be” (Jacob 4:13). As we listen to the Spirit, we will know the truth, and the truth will make us free (see John 8:32). In doing so, we can avoid the common error of “looking beyond the mark” (Jacob 4:14). One way we look beyond the mark is to set expectations for ourselves beyond what the Lord has set, tormenting ourselves unnecessarily. By listening to the Spirit of Truth, we can accept the reality of things that we may believe are unacceptable, such as imperfection and weakness.
Anxiety disorders may be a lifelong struggle for some, but with training in how to change distorted perceptions, thoughts, and feelings, they can become manageable. We can all benefit from understanding anxiety better. If family members, friends, or ward members are struggling, we can offer them support and empathy. Alma taught that we need to be “willing to bear one another’s burdens, that they may be light; … willing to mourn with those that mourn; yea, and comfort those that stand in need of comfort” (Mosiah 18:8–11). At the end of His mortal ministry, the Savior’s heartfelt prayer was that we be one as He and the Father are one (see John 17:9–10, 20–23; see also 3 Nephi 19:20–23, 27–29). One of the ways we can do this is to support and comfort those in anguish.
If you are struggling, you can find comfort through the gospel of Jesus Christ, assisted by professional counseling if needed. And in His Church you can find support and acceptance as we all strive together to become one and strengthen one another.
Normal Anxiety vs. Anxiety Disorders
Brief; easily resolved
Lasts several months; very difficult to resolve
Related to a specific event
Extends beyond a specific event
Caused by rational fear or worry
Irrational; distorts the truth; causes false perceptions
Motivates to action; facilitates choice and growth
Causes feeling of loss of control; limits functioning and action; causes avoidance, indecisiveness; hinders making choices; limits growth
Person has low biological vulnerability to anxiety; manages stress, worry, “niceness,” perception, perfectionism in positive ways; has no unresolved internal conflict or regret
Person has high biological vulnerability to anxiety; challenged by stress, worry, “niceness,” perception, perfectionism; may have unresolved internal conflict and regret
No physical, behavioral, social, mental, or spiritual symptoms
Symptoms include fatigue; headaches; muscle tension; nausea; loss of appetite; panic attacks; avoiding people, situations, places; difficulty concentrating, reading, learning; difficulty feeling the Spirit and having faith
How to Help People with Anxiety
Often people with anxiety are afraid of what others will think of them. They don’t want people to see them have a panic attack or other manifestation of their problem. They try to hide it. They may avoid social gatherings or skip church. Here’s how you can help them.
Help them understand that we’re all alike. People who struggle with an anxiety disorder are normal human beings responding in a predictable way to a certain set of beliefs, thoughts, and fears.
Try not to be judgmental. Anxiety is not a weakness in the person. Experiencing normal anxiety shows we care. A positive way of looking at people who struggle with anxiety is this: they just care too much.
Empathize with them. Be genuine. Listen in order to understand their feelings, appreciate why they struggle, and communicate what you understand. Empathy is the most effective quality of counseling.
Don’t tell them not to worry. Telling them “Don’t worry” isn’t going to give them any relief. It also shows that you don’t understand how change occurs or that you’re minimizing the problem. Help them identify what they can realistically do about what worries them.
Don’t tell them they’re being irrational. Telling them they’re being irrational won’t help them feel better or be rational. They’ve got to learn how to recognize this for themselves. If you tell them they’re being irrational, they may stop confiding in you, thinking, “I can’t talk to you. You think I’m an idiot.”
Give them support. Encourage them to get help. Through their bishop, they can find a good counselor. In a crisis or on a difficult day, offer to help with a difficult demand or task, such as teaching a lesson, fixing a meal, doing laundry, mowing the lawn, tending children, and so on.
Advice for People Who Suffer from Anxiety Disorders
Seek out help
If you feel you may have an anxiety disorder, find a good counselor with the help of your bishop. Learn how to work with traits that drive your anxiety.
Calm your body
In moments of low anxiety, practice breathing and relaxation exercises so that when anxiety is high, you can calm yourself a little bit.
Exercise, especially when highly anxious.
Eat a healthy diet.
Calm your mind
Practice meditation when you are not anxious.
Develop and practice positive, rational self-talk. Find specific things to say to yourself that help you calm down (scriptures, quotes, pictures).
Learn to challenge negative thinking—“Is what I believe about myself also true of other people?”
Calm your emotions
Do not try to control anxiety. That will cause it to increase. Rather, control what you do when you experience anxiety.
Instead of avoiding situations that trigger anxiety, engage them. Learn to face it. Invite anxiety to stay rather than fighting it. When you do, you become the master of it. It may even leave.
Focus on your identity and worth as a child of God. Accept that your worth is constant rather than measured by performance or what people think of you.
Read, ponder, have faith in, and take comfort from your patriarchal blessing.
Develop and write out a positive, accurate script about yourself—using scriptures, hymns, quotes, or your patriarchal blessing—which you can repeat back to yourself when you feel anxious or worried.
Accept that you will make mistakes and that they do not define you. We all make mistakes. Remember: a key to a peaceful life is learning from mistakes. When you make a mistake, ask, “What good things can I learn from this?”
Get medication if necessary
Medication may be necessary to get high anxiety under control if it goes unchecked for too long, though it should supplement and not replace counseling, self-talk, and relaxation techniques.
Sensibility is “the capacity of feeling or perceiving” (Noah Webster, An American Dictionary of the English Language , “sensibility”). If it weren’t for the Fall, we would have no joy, for we would know no misery (see 2 Nephi 2:22–23).