A cold flash, like the strange, icy feeling after a burn, runs through his body with every breath. He feels his heart racing. It feels like it is counting down to the moment when it will explode—or, mercifully, to the moment when he will turn his pillow to the cooler side, and finally fall asleep.

He eventually succeeds. His train of thought is broken and tied off in a dozen places, following an unknown but welcome calm. It is a sign that sleep is coming. Sleep is coming, after four hours of sitting in the dark, calculating catastrophic probabilities about work failure, smouldering family conflicts, the destruction of his marriage due to financial problems, his mistakes and his inability to overcome them, and the possibility that not even God will come to his rescue this time. He falls asleep without even contemplating the concern his mind has reserved for his nightmares: what if the doctor was wrong, and that mole on his child’s back is actually malignant?

This script repeats itself night after night, in his apartment on the sixth floor of a building with 159 other apartments, in a neighbourhood of a formerly communist city with 1.8 million inhabitants, in a country where a little over 19.5 million souls yearn for a carefree life, but do not have it. National statistics that map out the anxieties of Romanians show that 51.8% of them fear for the health of their family members. This concerns Romanians even more than rising prices (50.1% of Romanians are afraid of this) or an increase in taxes and dues (50%). Money is a chief concern: 46.6% of Romanians are afraid that their family income might decrease. About as many (46.5%) are afraid that they will get sick, and, if this happens, that they will not have money for the treatment or to find the medication they need (32.9%).

The web of worry

Which of these concerns are normal and which are manifested irrationally, in the absence of any real danger to justify them? Which fall into the sphere of mental disorders? We do not have exact statistics for Romania. We only know that 20% of the population suffers from a mental illness, that two million Romanians suffer from depression, and that depression may sometimes occur as a result of anxiety not being treated, becoming an unresolved constant.

In richer countries, with robust financing for mental health policies, statistical information is more in-depth. In the US, for instance, it is well known that anxiety disorders are the most widespread mental illness, affecting around 40 million adults over the age of 18. At a federal level, this number translates to 18.1% of the population. Considering that the American economy cannot be compared with the Romanian economy, and that people suffering from anxiety are three to five times more likely to go to the doctor or be hospitalized than people who do not suffer from this illness, it is disconcerting that only 36.9% of Americans with anxiety receive adequate treatment.[1]

In Great Britain, the data shows that approximately 5% of the population suffers from generalised anxiety—a permanent and overwhelming state of concern regarding a wide range of situations. The illness is especially encountered in 35-39 year old adults, who, in the most productive period of their lives, are forced to put up with continuous concerns, a lack of focus and rest, insomnia, dizziness and palpitations, and, as a result of all this, work problems or an inability to maintain healthy relationships.[2]

Fear: sensitive to culture

Statistics from only three countries are surely not enough to build a global picture. However, people who have attempted to put together such a picture, like Canadian psychiatrist Ian R. Dowbiggin, have sufficient grounds to affirm that “anxiety disorders constitute the most prevalent mental health problem around the globe, afflicting millions of people.”[3] Dowbiggin published his study in 2009, eight years before the Mental Health Division of the World Health Organization[4] produced its transnational survey on the same subject.

Although they notice the high prevalence of social anxiety[5], both research initiatives are representative of two opposite data interpretation currents. Dowbiggin believes anxiety has always been a component of the human condition (mention of different facets of anxiety dates back to antiquity) but that the alarming growth of the incidence of anxiety after the Second World War is a result of social and cultural tendencies which turned anxiety into a psychiatric diagnosis. “By the early 21st century, a perfect storm of social, medical, and biological circumstances” summed up as “the impact of SHRM, the pharmaceutical revolution, and the culture of victimization” produced a cultural arena in which equating fear with illness became normal.

In a titanic synthesis, Dowbiggin manages to support, with historical arguments, every element of this confluence of factors, and concludes that the anxiety epidemic which developed societies are confronted with today is a result of the way in which societies interpret experiences. He gives solid references for the way in which recovering money from health insurance state institutions has stimulated the proliferation of psychotropic drugs (those that affect the psyche), and how the development of drugs has in turn influenced the differentiation of diagnoses. Dowbiggin believes that the growing appetite of Westernised societies for conspiracies, against the backdrop of certain dramatic events (terrorism, economic inequality, and political uncertainty), has contributed to the generalisation of the idea that anxiety is a reasonable response to environmental challenges.

A World Health Organization study from 2017 starts off from the hypothesis that this evaluation is erroneous. The group of researchers involved suggested that, if anxiety were a Western cultural invention, then in other countries with different cultures and economic situations one should be able to notice a lower incidence of the illness. In fact, at the time of the survey there was no conclusive transnational data, because previous studies had been too limited. And, of course, anxiety is an umbrella term, covering various illnesses. Therefore, research on social anxiety could only be conducted in 28 countries with different cultural and economic backgrounds. In the end, despite its monumental dimensions, the WHO study could not refute Dowbiggin’s hypothesis, because data has shown that the inhabitants of different countries really do suffer from social anxiety in different proportions. The poorer a country is, and the more collectivistic (Eastern) its culture is, the lower the incidence of social anxiety. The causes of these differences have not yet been elucidated.

Researchers have concluded that the subject requires further research. Although they do not explicitly agree with Dowbiggin, their results implicitly show that his conclusion is at least reasonable. For instance, the WHO study infers that the lower prevalence of social anxiety in eastern societies is a result of their collectivistic culture, and that the low income of people in poor countries drives them to create social support networks which protect them from anxiety better than money protects the members of richer but more individualistic societies.

However, until researchers reach a consensus regarding the causes, it is enough to keep in mind that the cultural environment we live in has the power to predispose us to a lower or higher degree of anxiety.

Religion as therapy

Christianity enters the discussion on anxiety through a special door. Numerous psychological studies have shown that religion is extremely useful in dealing with difficult emotions in general—not just anxiety. A healthy religious life contributes to one’s general well-being. When a believer follows a diet which encourages moderation and abstention from the consumption of harmful products (alcohol, tobacco, caffeine) they are making healthy choices. However, practicing religion is also linked to a lower incidence of depression and anxiety, a more grounded sense of purpose, and a healthy commitment to and involvement in social relationships.

Psychologist Kenneth Pargament, who for decades has conducted research at the intersection of religion and mental health, is the creator of one of the most well-known methods of measuring the efficiency of religion in providing mental health assistance to an individual: the RCOPE scale. Pargament, an emeritus psychology professor at Bowling Green State University in Ohio, has concluded that religion can help people to discover they are stronger (more adapted) after a stressful or traumatic event than they were before. However, not just any kind of religious approach to life brings benefits. People who have a negative image of God, who see God predominantly as a punitive force, experience stronger feelings of depression, anxiety, paranoia, obsession, and compulsive behaviour.

God’s image and His relationship to man, however, as reflected in the Bible, is a profoundly positive one. Countless biblical passages mention the ways in which God “comes and showers his righteousness”[6] on a humanity trapped on a carousel of suffering and sin. Sometimes these fragments are pedagogical, when they warn that riches (the symbol of a comfortable life) will destroy man’s desire to live in communion with God. Other times, biblical passages are explicit invitations to trust the God who loves supremely and who has supreme power. Still others are examples of the way in which this trust can and must be cultivated despite circumstances which seem to point to an opposite reality.

As a cultural phenomenon, Christianity has had an unparalleled ability to spread certain fundamental truths throughout the world. These truths, once integrated into our value system, overwrite our attitudes and beliefs, regardless of the culture we belong to. The Christian from Africa might dress and worship differently to one in Western Europe, but he will believe the same fundamental truth: that God loves the entire world and does all He can in His omnipotence to save humans. Christianity can teach the Christian living in a collectivistic society that God’s approval is more important than community validation. The Christian living in a poor country may learn that inner riches shine in God’s eyes in a way that material wealth will never be able to shine in men’s eyes. Christianity can teach the Christian living in an individualistic society that a life lived for oneself is robbed of the satisfaction God has reserved, through His law, for those who love their neighbour.

Saving truths

Without committing the impudence of explicitly recommending itself as an anxiolytic drug, the Bible is a balm to the soul through the vision of life it describes. According to Christianity, man is vulnerable in the face of uncertainty only if he takes on tasks that exceed him—like trying to control the unknown. Christianity, however, teaches us that the locus of general control in life is always outside of man, and that this is a good thing. No matter how much we desire to feel like we are the masters of our own destiny, in reality, God is the only one who can control what is happening. And there is nothing degrading about this, because the God we depend on is a good and loving God.

Our fight to have absolute control is one against our own nature. Wherever we think our strength is coming from, we depend on Him, even if we do not accept this fact. This is why our efforts to be something other than we were created to be creates dissonance and anxiety. Accepting our God-dependent nature as created beings harmonises us with Him and with ourselves.

When we try to enter into communion with the One who created us, loves us, and wishes the best for us, we can see anxiety as an alarm system warning us that our life priorities might be out of order. Anxiety can be a sign that we are chasing goals which will not make us happy. Hopefully, we can stop in time to ask ourselves whether, in this case, they are still worth pursuing. It might also be a sign that our ideas of God are harmful, and that it might be high time to re-evaluate them in light of what Scripture teaches us.

This does not exclude the fact that anxiety often has biological causes, and its severity may require psychiatric or psychological treatment. However, in its milder forms, anxiety may be an indication that we need to rely more on God and less on ourselves. We need to look more at what He is like and less at what we are, or are not, like. We should calm our souls by remembering that He cares for us and that nothing in our future can take Him by surprise. Then our objective will be to become willing to face whatever may come, with Him at our side. Then, even spiritual anxiety is quietened. And the “peace that transcends all understanding”—transcending any five-year plan we might come up with during our sleepless nights—satisfies the heart’s thirst and restores our joy and vitality.

Alina Kartman is a senior editor at ST Network and Semnele timpului.

[1]„Anxiety and Depression Association of America, Facts & Statistics, adaa.org.”
[2]„Generalised anxiety disorder in adults, nhs.uk.”
[3]„Ian R. Dowbiggin, «High Anxieties: The Social Construction of Anxiety Disorders», in Canadian Journal of Psychiatry, 2009.”
[4]„D. J. Stein, et. al., «The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative», in BMC Medicine, 2017.”
[5]„One of the numerous manifestation forms of anxieties based on discomfort in and avoiding of social situations.”
[6]„See Hosea 10:12.”

„Anxiety and Depression Association of America, Facts & Statistics, adaa.org.”
„Generalised anxiety disorder in adults, nhs.uk.”
„Ian R. Dowbiggin, «High Anxieties: The Social Construction of Anxiety Disorders», in Canadian Journal of Psychiatry, 2009.”
„D. J. Stein, et. al., «The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative», in BMC Medicine, 2017.”
„One of the numerous manifestation forms of anxieties based on discomfort in and avoiding of social situations.”
„See Hosea 10:12.”