Missionary Care

Missions and Mental Health Resources from Ron and Bonnie Koteskey

Stewardship of Self for Christian Workers: Anxiety

By Ron Koteskey & Marty Seitz

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After all that Jesus said about not worrying in Luke 12 and all that Paul wrote to the Philippians about not being anxious (4:6), one would think that Christian workers certainly would not suffer from anxiety. However, such is not the case as evidenced by Paul himself.

Paul wrote, "When I could stand it no longer, I sent to find out about your faith. I was afraid that in some way the tempter might have tempted you and our efforts might have been useless" (1 Thessalonians 3:5 NIV). He sent Timothy back to find out how they were doing.

Paul also wrote, "I think it necessary to send back to you Epaphroditus … so that when you see him again you may be glad and I may have less anxiety" (Philippians 2:25-28 NIV).

After a long list of stressful events, he also wrote, "Besides everything else, I face daily the pressure of my concern for all the churches (2 Corinthians 11:28 NIV). Paul clearly had some "concerns," "fears," and "anxieties," so Christians may experience these emotions, but we are not to continue in worry. We can do something to alleviate these emotions.

How do I know if I have an anxiety disorder?

Although some fear and anxiety are a normal part of life and Christians are given ways to respond to them (Philippians 4:6), sometimes fears and anxieties become overwhelming, interfering with a person's life. The person may find no obvious cause and neither may friends or family. These anxiety disorders can take a variety of forms.

  • If you have worried about things excessively during most days over the past six months and those worries keep you from focusing on what you are doing because you are on edge, tense, irritable, unable to concentrate, and have problems sleeping, you may have generalized anxiety disorder.
  • If more than once you have had spells when for no reason you suddenly felt extremely anxious, frightened, uncomfortable, or uneasy even in situations when most people would not feel that way and you had a continuing fear that another attack would occur, you may have a panic disorder.
  • If during the last month you have had a fear of something that most people would not find frightening to the extent that you avoid those things and it disrupts your normal functioning or is distressing to you, you may have a phobic disorder.
  • During the past month if you have been bothered by repeated thoughts or impulses that were unwanted, distasteful, or distressing and you could not get rid of them but had to carry them out, you may have an obsessive-compulsive disorder.
  • If you have witnessed or experienced a traumatic event that included or threatened death or serious injury and you have re-experienced the event in a distressing way so that you avoid things that remind you of it and your reactions interfere with your normal activities, you may have a stress disorder.

Although it will not give a "professional diagnosis" of the anxiety disorders, questionnaires at the following web site will help you determine if you may need to see a mental health professional:www.mentalhealth.com/fr71.html.

What can I do if I have an anxiety disorder?

To ensure that a change will not be detrimental to existing medical conditions or treatments, Ideally one ought to consult a medical professional before making any significant lifestyle change.

  • A good first step is to get a medical checkup if you have not had one recently. Sometimes physical problems or prescriptions you are taking may mimic the effects of an anxiety disorder, and treating that medical problem or changing the prescription may reduce the anxiety. Also, you may have a specific ailment that a medical approach might help.
  • Be careful what you are saying to yourself. Monitor what you are thinking about because those thoughts may be creating the anxiety. Paul told us to think about things that are true, noble, right, pure, lovely, admirable, excellent, or praiseworthy (Philippians 4:8). If you are thinking about other kinds of things without developing strategies to solve the problems causing the worries, tell yourself, "Stop!" and change your thinking to the calm, hopeful, and optimistic things Paul described.
  • Do some relaxation exercises to help reduce the anxiety. Any or all of the following may help:
    • Stretching. While sitting as relaxed as you can, curl your toes to tense those muscles in your feet and relax them. Then raise your toes against the tops of your shoes to tense those muscles in your feet and relax them. Then move up to your ankles and do the same thing. Then to the knees and so on up through your whole body, learning to tense and relax every muscle group.
    • Breathing. Deep breathing using your abdomen (rather than your chest) helps you relax. To make sure you are "belly breathing" lie on your back and place a book on your belly. Slowly inhale through your nose for about five seconds gradually filling your abdomen, and the book should rise. Then slowly exhale through nose and mouth for about five seconds, and the book should fall. Once you have learned how to do it, you can do it sitting, standing, or lying down any time to relax.
    • Imagine one of your favorite places (remember Paul's advice to the Philippians) and perhaps think about being there alone or with your favorite companions. While "there," imagine doing one of your favorite activities or enjoying one of your favorite things, including all of the sights, sounds, smells, and other sensations.
  • Do some soothing, calming, relaxing activities, such as the following:
    • Listen to some of your favorite calming music.
    • Smell some soothing fragrances, such as burning a vanilla or lavender candle, assuming you are not allergic.
    • Listen to running water, wind in the pines, or waves lapping the shore. These are available on tapes, CDs, or on sound generating machines.
  • Pray specifically about the situations causing your anxiety.
  • Ask others to pray about those difficult situations for you and with you.
  • If you wish to try herbal supplements, Kava Kava may help reduce anxiety, and Valerian (root) may help induce sleep if your anxiety is interfering with sleep.
  • If some problem is causing you to worry, take steps to solve the problem.
    • Think of the best thing that could happen and what would cause that outcome. Come up with "Plan A" to work toward that outcome.
    • Think of the worst thing that could happen and what would cause that outcome. Come up with "Plan B" to cope with that outcome.
  • If your difficulty is in social relationships in which you need to confront someone about a problem, note how God confronted the churches in Chapters 2 and 3 of Revelation, telling the truth in love.
    • First, he affirmed them, said something positive about each of them. (Your good deeds, your faith, your perseverance, etc.)
    • Second, he confronted them about the problem. (Yet, I hold this against you … Nevertheless, I have a few things against you.)
    • Third, he specified the consequences. (If you do not repent, I will …Repent, therefore! Otherwise I will …)
    • Fourth, he reaffirmed them. (To him who overcomes, I will give …)
    • Make a plan deciding how you will word your affirmation, your confrontation, the consequences, and your reaffirmation of the other person.
  • If a specific object or situation produces anxiety in you, take steps to gradually reduce that anxiety by facing it.
    • First, make a list of the things that arouse the most to the least fear. For example, if you are afraid of dogs, think of the most feared situation with a dog, then the next most feared situation with a dog, and so forth down to one that would cause no fear.
    • Second, practice the relaxation exercises described earlier so that you can relax whenever you want to.
    • Third, imagine the least feared thing. If you have any anxiety, practice relaxing until you can think about it and still be relaxed. Keep doing this with things that are a little more frightening each time (over the days ahead) until you can think of even the most frightening without becoming overly anxious.
    • Even better than imagining them is to actually encounter them in real life if that is possible. Practice getting closer and closer to the feared object or situation. For example, keep playing with a little puppy until you are not anxious. Then do the same thing with larger and larger gentle dogs until the fear is gone.
  • If you cannot seem to stop thinking about something, try the following steps:
    • Recognize that it may be a disorder.
    • Relabel the problem as due to an obsessive-compulsive disorder.
    • Refocus on something other than the obsession.
  • If you feel compelled to repeat some act, gradually delay carrying out the action for longer and longer periods of time. For example, if you feel compelled to wash your hands because of your fear of the germs on them, first delay washing them one minute, then delay washing them two minutes, then five minutes, etc. Using relaxation to deal with anxiety, gradually lengthen the time until you no longer feel you have to do it.
  • If you keep re-experiencing a traumatic event, try actually writing down a complete description of everything that happened, just as if you were giving a testimony in court. Write down not only what happened objectively but also write every thought, feeling, and image you have of that time. Then reread it often (several times a day if possible), imagining everything that happened each time. Invite Christ into that image, especially at the point in which the scene is the worst, at the point of your greatest need or weakness. This will not necessarily erase the scene, but it often takes the emotional sting out of it.
  • Read some good books on the subject of anxiety such as The Anxiety & Phobia Workbook by Edmond J. Bourne, Brain Lock: Free Yourself from Obsessive-Compulsive Behavior by Jeffrey Schwartz, Don't Panic: Taking Control of Anxiety Attacks by Reid Wilson, or I Can't Get over It: A Handbook for Trauma Survivors by Aphrodite Matsakis.
  • Find information about anxiety on the Internet at sites such as the one maintained by the National Library of Medicine at www.nlm.nih.gov/medlineplus/anxiety.html or http://mentalhelp.net/disorders/. These web sites have numerous links to reliable information about anxiety. (Remember that the domains .gov and .edu tend to be the most reliable.)

About the Author



Ron and Bonnie Koteskey are Member Care Consultants with Go International.

They have provided member care for missionaries since 1997.