Is Anxiety a Sin?

Bob: Do you know somebody who wrestles with high levels of anxiety? Is it right to tell that person, “You just need to believe what it says in Philippians 4: ‘Be anxious for nothing…’”?—or is it that too simplistic? That’s a question we asked Matthew Stanford.

Matthew: You know, I don’t think it’s too simplistic; because that’s God’s Word, and that’s what it says. I think the question we have to ask our self is: “What does Paul mean when he says, ‘Do not be anxious...’? Was he talking about OCD? Was he talking about generalizing anxiety disorder?—or panic disorder?” No! He’s talking to normal-functioning Christians; and they’re really worried that they’re not actually going to be able to maintain their faith or that God’s not going to be faithful to them. Really, I think that’s the difference there. Paul is talking about the worry of God not being faithful.

This is FamilyLife Today for Wednesday June 27^th. Our host is Dennis Rainey, and I'm Bob Lepine. We need to think clearly about issues related to mental illnesses and about how the Bible speaks to those issues.

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We’ll get some clarity from Matthew Stanford today. Stay with us.

And welcome to FamilyLife Today. Thanks for joining us. I hope some families are getting some encouragement/some enlightenment from the conversation we are having this week; because we know that mental health issues—well, it’s like a grenade going off inside a family.

Dennis: Yes; when it goes off, it leaves debris and wounded humans in the process. We have a guest with us today who’s written a book called Grace for the Afflicted. This is really a book for both those who have mental and emotional disorders but, also, the families and spouses that are impacted.

Bob: Yes; in fact, the moms and the dads—or the husbands and wives, who are in families with folks with disorders—they are the ones who are going to benefit the most from reading this book.

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Dennis: Right; and Dr. Matthew Stanford joins us again on FamilyLife Today. Matthew, welcome back.

Matthew: Great to be here.

Dennis: He is the CEO of the Hope and Healing Center and Institute in Houston, Texas. He and his wife Julie have been married since 1990—have four children. He has a long history of clinical studies and teaching at Baylor Medical Center in Houston.

We’ve talked about depression; we’ve talked about suicide; learning disorders or not being able to sit still; kids who are being over-prescribed. You say that the issue of anxiety is also one of the top emotional disorders in our country.

Matthew: Yes; behind depression, anxiety is your second most common mental health problem that people in the population encounter——that’s a number of disorders—that’s everything from generalize anxiety disorder, which is kind of a varying anxiety that kind of moves from thing to thing— 

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—you might be worried about physical health and then you might be worrying about your job—I mean, worrying at a level that causes you to not be functional. You begin to have panic attacks, which are kind of an overwhelming physiological response, where your heart pounds and you sweat; you feel like you’re having a heart attack. It’s not just worry; it’s an overwhelming sense of anxiety that causes you not to function—that’s generalizing anxiety disorder.

It might be something like an adjustment disorder; or a separation anxiety, where children are separated from their parents or separated from a situation—again, they have that overwhelming anxiety; or panic disorder, where you have recurrent panic attacks over and over; or obsessive compulsive disorder, where you have obsessions and compulsive obsessions, or kind of odd thoughts that you have—like, for instance, you might think that: “Something bad is going to happen if I don’t count all the ceiling tiles…”—I had a student, when I was at the University of New Orleans—he would count all the ceiling tiles over, and over, and over; because he was afraid something bad would happen if he didn’t do that. Again, it’s a compulsion that you have to do it; because, if you don’t do it, you become so anxious that you’re not able to function.

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Bob: So somebody who says they’re OCD—I remember, when my son was in high school, he liked to keep his room straight / keep his clothes in order. One of his classmates said “Well, you’re OCD!” He started to think: “Maybe I am. Maybe I need to see a doctor about OCD, because I do like things in order. If they are not in order, it bothers me; it troubles me.”

I’m just thinking: “You just need to relax a little bit. That’s nothing to be anxious about.” It was not causing him to lose sleep at night. How do we know, as parents, whether our son needs to see a child psychiatrist or whether he just needs to relax a little bit?

Matthew: I think the terms, “depression” and “OCD” are the two psychological terms that we use the most cheaply. Let’s say your child is a real neatnik. They come home; and you’ve put a pile of unfolded clothing of theirs, that you’ve washed, on their bed.

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Well, how do they handle that situation? Do they go, “Mom, you know I don’t like this,” and then they fold them and put them away. Well, that’s not OCD. If they walk in and absolutely fall apart—they are unable to move beyond it; they completely just kind of fall into a puddle on the floor—there’s emotion / there’s a panic attack—that’s more like a disorder.

As I mentioned earlier, I had a student, when I was at the University of New Orleans, who—he had OCD. One of his obsessive thoughts was that something bad was going to happen. A compulsion that he had—that he thought would offset that was—he would count the ceiling tiles in the classroom when he would come into class. The problem is that, once he counted them once he was concerned that he had not counted them correctly; and if he didn’t count them correctly, something bad was going to happen. So the entire class he would sit and count them over, and over, and over again. He was failing all his classes. You couldn’t just say, “Stop counting the ceiling tiles”; because, if you did that, he would have a panic attack; because he was so worried—see, that’s the difference.

Being neat—that’s not a problem.

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It’s when that neatness causes you not to be functional within what I think of as the three domains: at your job, at school, or with relationships.

Bob: So if somebody is counting ceiling tiles, what you’re saying is: “There’s something in their brain that’s not working the way it’s supposed to be working, and we can help with medication and therapy to fix that.”

Matthew: Absolutely. Basically, all mental illness is either a reduction in some normal behavior or thought process, or over-production—in OCD, it’s an over-production. We also have normal levels of worry. God gave us a system in our body that has a stress response. You all have had tests and you got a little anxious; that was a good thing, because it made you study more. In things like that, there are good aspects to anxiety—that’s a God-given thing to be anxious.

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But with OCD, the frontal lobe of your brain is so over-active that you are over-attending to things. You get caught in this loop that you cannot get out of—you may be concerned something bad is going to happen; and it is not possible for you to go through a set of mental information and say: “No, no, no; that’s okay. I really know it’s not going to happen,”—or to count the ceiling tiles one time and say: “Okay; I’ve counted them. There are 47; everything is good,”—no; you go: “No, no; I might be wrong.” You’re trapped in that loop.

The medication that’s given for OCD, and the therapeutic treatment that’s given, you’re actually able to help yourself get out of that loop; and you don’t get caught in that loop over and over again.

Bob: When you brought up anxiety, the first thing that comes to mind for me is Philippians, Chapter 4—it says: “Be anxious for nothing; in everything, through prayer and supplication, make your requests known to God; and the peace of God, which passes understanding, will keep you in Christ.” I’m thinking: “There it is—the Bible gives us a response for anxiety: pray and God will give peace. Is that too simplistic?”

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Matthew: You know, I don’t think it’s too simplistic; because that’s God’s Word, and that’s what it says. I think the question we have to ask our self is: “What does Paul mean when he says, ‘Do not be anxious for anything’? Was he talking about OCD? Was he talking about generalize anxiety disorder?—or panic disorder?”

No! He’s talking to normal-functioning Christians at the time that were questioning their role in the world / questioning God’s role in their lives; because they were suffering persecution. They are seeing a secular, pagan society around them; and they’re really worried that they’re not actually going to be able to maintain their faith or that God’s going to be faithful to them. So, really, that’s what Paul is talking about; he’s not talking about anxiety disorders.

Dennis: In the Psalms, we read a lot of emotional declarations by David. Some of them, he sounds depressed; others, he sounds like maybe he had a problem with anxiety—he said, “His anxiety was multiplied before Him.” Did he suffer, do you think, from emotional disorders?

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Matthew: What’s nice about David is, we don’t only have historical narrative about him, we have his own actual writings about what he’s thinking and feeling. You’re right; the majority of his Psalms are laments. He talks regularly about depressive symptoms and anxiety. Depression and anxiety go, hand in hand. It’s rare to find a client, who has major depressive disorder and doesn’t have an anxiety issue also—or has an anxiety issue and doesn’t have depression on top of it.

I do think David struggled with depression, particularly in the latter half of his reign. In fact, I think it even brings to light some of the—and you can send all of your upset email to me. You don’t have to send them to them when I tell you this. [Laughter] I think, in some of the stories we look at, we kind of wonder: “Why did this happen?” “Why did that happen?” I’ll give you this one, for instance. When it says that “In a time when kings went out to wage war, David stayed home,” it also talks about, at that exact same time, he was having trouble sleeping; so he’s wandering around the top of the palace. That’s when he saw Bathsheba.

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When I look at that—and I think about all the other things that I’ve seen in the context of him describing his depression/anxiety—I see a man that was struggling to reign. He couldn’t go out and do what he was supposed to do, as king. Insomnia is a very common symptom of depression—and so is adopting negative coping strategies, such as promiscuity or substance abuse—things like that—to try to deal with the negative feelings associated with depression. Maybe that helps us understand why he did what he did.

It doesn’t make him not culpable—he’s absolutely culpable for any sin that he committed—but maybe it helps us understand why, in the time when kings went out to war, David stayed home—it gives no explanation for that. Again, I think he has a lot of descriptions of depressive and anxiety symptoms.

The most important part, I think, that can be learned from that in the Scriptures, is this—

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—that in a time, when there was actually no understanding of depression / no treatment for it, when David was at his darkest and lowest moments, you see, in those Psalms—where he describes all this kind of paranoia, and darkness, and anxiety, and fear—and then he says this: “…but this I hold onto…”—he holds onto the promises of God. That’s what moves him forward, and gives him hope, and allows him to move on to the next day. I think that’s a powerful message for us all—that is that that hope is the foundation for change that we still have today. It’s a hope that we should connect all of our clients, and those who struggle with these problems, to.

Dennis: Speak to parents, who may have a teenage son or daughter / maybe an adult child, who is demonstrating a mental disorder; perhaps anxiety/depression. What would you coach them to do? At what point would you encourage them to seek, perhaps, medical help?—a prescribed drug to deal with it?

Matthew: A parent knows their child better than anyone else. If a teacher comes to you—or a Sunday school teacher or a coach—and says, “I think there’s something going on with your child,”—I would definitely look into that.

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But a parent knows their child better than anyone else, because you’re with them more often.

I think, secondly, you do not want to jump to the conclusion that there’s something wrong with your child just because your child may have displayed a wrong behavior or someone thought they weren’t feeling something the way they should have been feeling it.

Thirdly, you do not want to ever give someone a psychiatric medication that alters their brain chemistry unless they have the illness of that medication is expected to treat.

This is what I would say, first and foremost—If someone comes to you or you think your child is struggling with something—because, as I said, they are affected in one of those three areas—in their work, in their school, in their relationships. Something is causing them not to be able to function normally in one of those three arenas.

The first place I would start is with a physical—physical with blood work—because there are a lot of physical illnesses that can look like psychiatric illnesses. A thyroid issue in a teenage girl can look just like anxiety, so I would go and get a physical.

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If nothing came of that, I would then ask my pediatrician or physician if they can give a referral to a child psychologist—if it’s a teenager or a child. Then I would go to that individual and say that I would like my child assessed to determine what’s going on.

One of the misconceptions about psychology and psychiatry is that we kind of like just walk into a room and kind of guess what the problem is. We have assessments / we have tests to be able to determine what’s going on. You can go to a child psychologist. In fact, one of the things I say is: “If you were in a town or you’re near a university that has a doctoral program in psychology, or even a Master’s level psychology, you’re likely to get a psychological assessment done on your child or teen at a reduced rate, much like if you go to a medical school; because students are doing it under supervision.

Get an assessment; it’s a report. It usually takes several hours for the assessment. Sometimes, you have to come back multiple times; but it will give you a definitive set of diagnoses and recommendations. You then can take those recommendations to a mental health care provider and then begin to move forward with treatment.

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It’s a process; it’s not just a kind of jump in, feet first, and you get medication, whether the person needs it or not. Get an assessment, and then you can move forward from there.

Dennis: What I heard you saying, clearly, to parents: “Don’t check your brain at the door. You know your child better than anybody. Don’t get caught up in over-prescribing / over-assessing a behavior issue that [the child] just needs time to grow up and grow out of the phase.”

Matthew: Absolutely! There’s a lot of variability in children. If you have more than one child, you know there is a lot of variability in children. Some children are more mature than others; some are less mature. We have to know our children—be attentive to your child / find out what’s going on with them every day. Just because a teacher said one thing or somebody on the bus said something, don’t jump to the conclusion that they have a disorder. Your child may have just done something wrong, and then you can help them through that in a restorative way. It’s also possible they are just a little less mature right now.

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I would have to go through a lot of steps before I would want to give my child a psychiatric medication. I would want to try everything else I could. When I say that, I mean everything else that is a reasonable treatment—some type of psychotherapeutic intervention perhaps or behavior modification.

The problem with giving children and adolescents psychiatric medication is that their brains are in full-development phase and, now, you are bathing their brain with medication during this heavy development. Children are not just little adults; they are different. These things manifest differently in them, and they need to be treated differently. We need to be very careful with medications in children. I’m not saying it isn’t effective; I’m just saying you want to make sure it’s the right thing to do.

Bob: Well, let me ask you about that; because a lot of teenagers are bathing their brains in narcotics and drugs. They are experimenting—they’re smoking weed, or they’re taking molly, or something that their friends recommend to them. You mentioned there’s a relationship between addictions and psychiatric behaviors.

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Any parent—who knows their child is taking drugs or doing drugs, recreationally, with their friends—is concerned about that. Should they wonder if there is some underlying psychological issue or psychiatric issue too?

Matthew: Yes; I think you do have to be concerned. In about half of individuals, with a substance abuse problem, you also find underlying mental health problems; so an undiagnosed bipolar, or depression, or something. The person is using substances as a negative coping strategy to deal or self-medicate with the issue. I think most of our treatment, unfortunately, is focused solely on the addiction; so you don’t get a dual-diagnoses approach, where the addiction and the other problem are treated. That’s where we have a lot of really kind of incomplete treatment.

If you have a teen that’s using, I think, again, don’t lose your head. You know, If your teen smoked marijuana one time—yes, that’s a bad thing; and you need to take it into account—but that’s not an addiction. You don’t need to try to drive off and run your child down to the addiction treatment center because you found out he did that one time.

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But you need to find out how much is being used, how often it is being used, what’s being used. I think you do need to connect with a mental health care provider, because a mental health care provider can provide you with expertise that you don’t have. Think about it this way—if you brought your loved one to me and you said, “Dr. Stanford, can you help us understand if our son has an addiction problem?” This may be the only person you’ve ever interacted with that you thought had an addiction problem. I’ve interacted with hundreds and hundreds. I have a little better sense than you do; plus, there’s assessments that we can do and things like that. It’s more than us just taking their word for it whether they are or not.

It’s the same thing with cancer, or some kind of pancreatic problem, or something like that—you go to somebody that has a little bit more context and they help you figure it out. You want to bring in some providers and you want to make sure that it’s not significant. If it is a significant issue, then you want to go down a route of trying to determine, as you mentioned: “Is there something else going on? Is it just an addiction issue, or is there some underlying issue?”

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For instance, in teens, the most common mental health issue diagnosed in teens is anxiety issues. That can manifest itself in really some pretty significant conduct problems, because the child is acting out. One of the things you have to understand is—the expectations we have for our children today are so extreme. There’s a guy, who has been following anxiety levels in children for, probably, since the ‘40s. What he finds is, today—that the anxiety level in teens today are the same of what you would find in psychiatric patients in the ‘40s and the ‘50s. The expectations we have on our children are really unrealistic, and it’s crushing them.

Where are we seeing our highest increase in mental health problems?—adolescents. Where are we seeing our highest increase in suicides?—adolescents. We really need to step back and we need to say:

What is the most important thing for our teen? Is the most important thing that we make sure they are in the top ten percent of their class so they can get into a certain college?

or

Is it more important that they have value and worth in who they are in Christ?

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Is it super important that they get an “A” in this class?

or

If they are really trying their hardest, and they get a “C,” is that the school’s fault?—or is that just, maybe, my son—that’s the best he can do, because we do vary in our levels of intelligence.

I think we need to step back, as parents—and I have to remind myself of this, all the time, myself—and we have to say: “What is most important? The most important thing is that my children recognize that they are loved by God, and that they have an opportunity to be in relationship with Him forever.” All the other stuff is gravy. And yes; if a mental health problem comes along, that’s still true; but I’m going to pursue the process of getting them better. I don’t want to just jump to conclusions.

And remember, as a final thing—medication is no magic bullet. It does not cure mental health problems; it only minimizes symptoms. You need a broader, more holistic approach to care. You want to try to minimize the amount of medication you use. Just like anything, you want to try other options as well.

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Dennis: There’s one last thing I want to ask you about and that’s pornography. Teenagers—anxiety, growing up and becoming a young man/a young lady—lots of emotions / lots of temptations. What do parents need to be on the lookout for and what can they do, simply?—because we’re about out of time here.

Matthew: I think, number one, pornography is such an issue now; it’s almost uncommon to find someone who hasn’t been exposed to it, as a teenager. Girls are on the up-rise. Again, you have to engage and find out what the extent of the use it:

Did they just look at it a few times, because their friends are looking at it?

or

Do they have a draw to it, where they are doing it regularly?

How is it affecting their relationships? How is it affecting their perceptions of women and things like that?

I think you really have to get in there and ask. Again, pornography is a very common negative coping strategy to deal with depression/anxiety. When people don’t feel well, they try to find things that will make them feel better.

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Why is your child looking at pornography? Is it a sex issue?—is it a maturation issue?—or is it a mental health issue?

Dennis: And that is where being a parent, and providing the love and the spiritual guidance—and I might say: “Be on the lookout for great small groups, led by adults in your church, for young people. They need other adults speaking into their lives, spiritually, in the midst of community.”

Matthew, I want to thank you for your work, and all that you are doing there, and specifically for your book, Grace for the Afflicted. I think this is going to be a great book for a lot parents and, also, for a lot of families, who are dealing with family members struggling with mental health issues.

Bob: Of course, we’ve got the book in our FamilyLife Today Resource Center. You can order it from us, online, at FamilyLifeToday.com; or you can call 1-800-FL-TODAY. Again, the title of the book is Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness.

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The author is Matthew Stanford. Go to FamilyLifeToday.com for more information about ordering the book, or call 1-800-FL-TODAY. If you want to find out more about what Matthew is doing in Houston, and about the Hope and Healing Center, go to FamilyLifeToday.com. We have a link available there as well.

We have heard from a lot of listeners this week, who have been greatly helped by our conversations on these subjects, and who have already contacted us, Matthew, to get a copy of your book. I think—about these kinds of discussions and these kinds of conversations—people often feel lonely and isolated and like there’s no place to turn when they’re facing issues like this. Everybody goes and Google^®s something. You never know what you’re getting when you just Google something and get random results. But I’ve been encouraged by the people, who have gotten in touch with us to say: “Thank you for having these kinds of conversations.

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“Thank you for the help it has provided for our family, just to hear these issues acknowledged and talked about.”

Matthew, I’ve appreciated the coaching for those of us, who may not be dealing with this first-hand, but we know friends or people at church who are—how we can be more compassionate and more understanding about what they are going through.

Here, at FamilyLife^®, our goal is to provide practical biblical help and hope for your marriage and your family. We are able to accomplish that goal, because we have partners who make this possible. We have monthly Legacy Partners; and we have regular listeners who will, from time to time, make a donation to help advance this work. We are grateful for those of you who do partner with us.

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Now, tomorrow, our colleague, Ron Deal, is going to join us. We’re going to do a little check-up. We’ve got some friends, Robbie and Sabrina McDonald, who are in a blended family. We’re going to find out how their blended family journey is going. They’ve been here before, and we’re just keeping tabs on the challenges they’re facing, through the years, in creating a healthy blended family. I hope you tune in for that.

I want to thank our engineer today, Keith Lynch, along with our entire broadcast production team. On behalf of our host, Dennis Rainey, I'm Bob Lepine. We will see you back tomorrow for another edition of FamilyLife Today.

FamilyLife Today is a production of FamilyLife of Little Rock, Arkansas; a Cru^® Ministry.

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