By Julie Golan
I. Definition
Biblical perspective
The Bible would describe anxiety as a sinful worry, often about the future (Matthew 6:25-34; Philippians 4:6). There are references in Scripture to good kinds of fear, however. The fear of the Lord, for example, is something that the Bible instructs all people to have (Deuteronomy 10:12, Psalm 33:8, Matthew 10:28). Additionally, there is biblical concern that is not sinful, which Paul uses to express genuine care, particularly in the body of Christ (1 Corinthians 12:25, 2 Corinthians 11:28-29, Philippians 2:20).
The majority of Scriptural texts mentioning anxiety or worry are in reference to sinful practices. In Matthew 6, Jesus instructs: “do not be worried about your life, as to what you will eat or what you will drink; nor for your body, as to what you will put on” (Matthew 6:25). He goes on to explain God’s provision for “the birds of the air” and “the lilies of the field”, demonstrating how much more He will provide for those who are His own (Matthew 6:26-30). Concluding, Jesus says, “So do not worry about tomorrow; for tomorrow will care for itself. Each day has enough trouble of its own” (Matthew 6:34). In Philippians, Paul commands the church to “be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God” (Philippians 4:6). Peter also speaks on anxiety, instructing the recipients of his letter to cast “all your anxiety on Him, because He cares for you” (1 Peter 5:7). The previous verse explains that doing so is an act of humility before the Lord (1 Peter 5:6-7). Before sending Israel into the promised land, God commanded Joshua to “Be strong and courageous! Do not tremble or be dismayed, for the Lord your God is with you wherever you go” (Joshua 1:9). Here, God reminded Joshua of His faithful character and promises, by which there was no need for fear. Again, God reminds those in Israel “with anxious heart” that they need not fear because of God’s promise for ultimate deliverance (Isaiah 35:4). Furthermore, there are many examples in the Psalms where believers have expressed deliverance from fear and that they need not fear because of God’s character and promises (Psalm 23:4, 27:1, 56:3-4, 118:6).
Secular Perspective
In a broad sense, the DMS 5 anxiety as “the anticipation of future threat”.[1] However, there are many different manifestations of anxiety within the realm of psychology. The DSM 5 separates anxiety into seven broad categories: separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder, substance/medication-induced anxiety disorder, anxiety disorder due to another medical condition, other specified anxiety disorder, unspecified anxiety disorder.[2]
Secular treatment for anxiety will primarily be done through medication and psychotherapy. The Harvard Mental Health Letter provides almost 10 different types of medication that can help anxiety and suggests three different types of psychotherapy.
II. History
Fear has existed since the fall, when Adam and Eve hid from God in the garden because they knew their nakedness (Genesis 3:8-10). In terms of anxiety, some have suggested that “Ancient Greek and Latin authors reported cases of pathological anxiety, and identified them as medical disorders” as early as the 3rd-4th century B.C.[3] In modern psychology, Sigmund Freud “coined many of the terms used for various anxiety disorders” in the early DSM books.[4] Beginning with a 1894 article [5], Freud became the first major psychologist to distinguish different types of anxiety. From his work came the popularization of panic attacks, obsessiveness, and phobias.[6] “Freud’s early work unified under the umbrella of ‘anxiety’ a variety of previously distinct syndromes or symptoms that had been associated with broader conditions.” [7] His work paved the way for the “diagnostic revolution of 1980.” [8] Up until this point, there was still a broad understanding of anxiety. However, the introduction of the DSM 3 in 1980 brought about a “large variety of distinct and categorical definitions of anxiety” unlike anything prior.[9] Since, developments and diagnoses of anxiety have only increased.
III. Evidence of the Problem
Generalized anxiety disorder (GAD) is “characterized by a pattern of frequent, persistent excessive anxiety and worry that is out of proportion to the impact of the event or circumstance that is the focus of the worry”.[10] Diagnostic criteria include finding it difficult to control worry, impaired functioning, and physical symptoms such as restlessness and irritability. To be diagnosed with GAD, an individual must be experiencing these symptoms regularly for a minimum of 6 months.
IV. Etiology
According to the Harvard Mental Health Letter, GAD can occur due to other psychiatric disorders such as “substance use disorder or alcohol dependence”.[11] It also notes that “severe or constant stress can produce a hyperactive anxiety reaction”.[12] Spiritual causes for anxiety are often rooted in not trusting God, as suggested by Dr. John MacArthur in his book Anxious for Nothing.[13]
Spiritual symptoms of anxiety can include doubting God’s faithfulness to be true to His character and/or promises. Physical symptoms of GAD can include fatigue, trouble sleeping, trembling, nervousness, sweating, nausea, and irritability.[14]
V. Examining the Heart
One heart theme behind anxiety could include a desire for control. The person struggling with anxiety desires their circumstances to be different and is not meditating on and trusting in God’s sovereignty within the situation. An idol within a desire for control could include the worship of comfort. A sinful desire for comfort could tempt one toward anxiety for the future, health, safety, and more.
VI. Biblical Solutions
Jay Adams suggested the method of “eliminating fear by love”.[15] Essentially, transferring the focus off the one struggling and onto loving others, ultimately God. “Love toward God means focusing upon how one may trust, worship, and serve Him; love toward one’s neighbor likewise focuses upon a giving relationship to him”.[16] Dr. John MacArthur suggests an agenda that has an emphasis on prayer, and in doing so practicing obedience to Philippians 4:6.[17]
Recommended Books
“Anxious for Nothing: God’s Cure for the Cares of Your Soul” by John MacArthur
“Overcoming Fear, Worry, and Anxiety: Becoming a Woman of Faith and Confidence” by Elyse Fitzpatrick
“Overcoming Anxiety: Relief for Worried People” by David Powlison
Recommended Homework Resources
A Homework Manual for Biblical Living by Wayne Mack
Discussion Guides in Anxious for Nothing by John MacArthur
Fear Homework Assignment Samples from The Institute for Biblical Counseling and Discipleship: https://ibcd.org/fear-homework-assignment-samples/
Bibliography
[1]Black, Donald W., and Jon E. Grant. DSM-5 Guidebook : The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing, 2014.
[2] Black, Donald W., and Jon E. Grant. DSM-5 Guidebook : The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing, 2014.
[3] Marc-Antoine Crocq. A History of Anxiety: from Hippocrates to DSM. The National Center for Biotechnology Information. 2015.
[4] Marc-Antoine Crocq. A History of Anxiety: from Hippocrates to DSM. The National Center for Biotechnology Information. 2015.
[5] “The Justification for Detaching from Neurasthenia a Particular Syndrome: The Anxiety-Neurosis”.
[6] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013, P 80
[7] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 80
[8] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 80
[9] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 6
[10] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 6
[11] Harvard Health Publishing. “Generalized Anxiety Disorder.” Harvard Health Blog. Accessed December 01, 2018.
[12] Harvard Health Publishing. “Generalized Anxiety Disorder.” Harvard Health Blog. Accessed December 01, 2018.
[13] MacArthur, John. Anxious for Nothing : God’s Cure for the Cares of Your Soul. Vol. 3rd ed, David C. Cook, 2012.
[14] Generalized Anxiety Disorder. Mayo Clinic.
[15] Jay Adams, The Christian Counselor’s Manual, 416.
[16] Jay Adams, The Christian Counselor’s Manual, 416.
[17] John MacArthur, Anxious for Nothing, chapter 2.
The Encyclopedia of Biblical Counseling 