We all know people in our lives who have experienced or are currently experiencing anxiety and depression. They might be people we see in passing, our coworkers, friends, or family. It could be your own brothers or sisters in Christ. And of course, even we ourselves may have gone through it at some point in our life—or maybe we are experiencing this type of problem ourselves at this very moment.

Anxiety and depression are complex medical conditions that I want to briefly define so we can understand and recognize the symptoms in ourselves or others. There are different types of anxiety and depression, and of course, the severity of each condition can vary.

But before we dive into these mental health conditions, I’d like to share a bit about my past.

It’s the summer of 2014, and I had just graduated high school. I had met a girl in my statistics class, came to like her, and asked her out. I still remember how giddy, happy, and excited I felt when she said yes. The smile would not leave my face, and all my friends knew something good had just happened to me. We were so young then, with so much to learn and experience.

Back then, I was so sure of myself. I believed myself to be righteous—that I always tried to do the right thing, and that I always tried to be a good person. I believed she was one of the sweetest people I ever knew. I felt so fortunate. Even at this young age, I was not one to date “just to date”—I intended to marry her.

We had several happy years together, but then things weren’t the same after a few years. Four, then five years passed, but we were stagnant in our relationship. I made the difficult decision to end the relationship with her in the spring of 2020.

I was made very aware of all the troubling things done while in this relationship with her and I realized how young, stupid, and foolish I had been. In reality, I was incapable of loving her properly because I hardly even loved myself. I had no self-esteem. I didn’t deserve love. I hated myself. I don’t think I ever hated myself more than during that summer.

Right after this, the world went into lockdown for COVID. As an extrovert, that time was especially hard for me. A very special person for the past quarter of my life was no longer there with me. For years I held onto guilt and feelings of unworthiness. Time, therapy, friends, family—they helped, but I felt like I could never really be happy with myself anymore. I was isolated, alone, and in despair.

I always wanted to be a good person. I really did. But I was always letting people (and myself) down because I was just a sinful, useless person.

Do you think this experience is describing some form of anxiety or depression? What do you think helped me? If you knew this version of me back then, would you have said or done something?

The American Psychological Association defines anxiety as “an emotion characterized by apprehension and somatic symptoms of tension in which an individual anticipates impending danger, catastrophe, or misfortune. The body often mobilizes itself to meet the perceived threat: Muscles become tense, breathing is faster, and the heart beats more rapidly. Anxiety may be distinguished from fear both conceptually and physiologically, although the two terms are often used interchangeably. Anxiety is considered a future-oriented, long-acting response broadly focused on a diffuse threat, whereas fear is an appropriate, present-oriented, and short-lived response to a clearly identifiable and specific threat.”1

Why is it a problem? It interferes with daily activities—our schoolwork, our jobs, even our relationship with God. It is not a small, occasional worry or fear that simply “goes away.” According to the National Institute of Mental Health (NIH), about 31% of US adults experience an anxiety disorder at some time in their lives. 2

Listed below are different types of anxieties that people may suffer from from most common to least common:3

1. A specific phobia, which is an intense fear of (or aversion to) a specific object or situation. Examples might include spiders, snakes, needles, heights, or blood. Risk factors include exposure to traumatic events involving the specific object or situation, or a history of anxiety or mental disorder in biological relatives.

2. Social anxiety disorder, which is an intense, disproportionate, and persistent fear of being watched and judged by others leading one to avoid social situations whenever possible.

3. Panic disorder – frequent, unexpected attacks characterized by sudden waves of fear or discomfort or a sense of losing control even when there is no clear danger or trigger. It involves physical symptoms that feel like a heart attack (trembling, tingling, rapid heart rate; trouble breathing), and should have 1+ months of persistent concern of panic attacks or significant behavioral changes to avoid such attacks.

4. Generalized anxiety disorder (GAD) is defined by the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) as meeting all the following criteria:4

●     Excessive anxiety/worry most days of the week for > 6 months

●     Difficulty controlling worry

●     Presence of 3 or more of the following (1 in children)

Restlessness

Fatigue

Difficulty concentrating

Irritable

Muscle tension

Sleep disturbance

●     Not attributed to another anxiety or somatic symptom disorder

●     Significant distress/impairment

●     Symptoms not induced by a substance or other medical condition

Certain over-the-counter medications or herbal medications, especially if used improperly, can contribute to anxiety. Examples include pseudoephedrine (produces stimulating effects due to constriction of blood vessels) and St. John’s Wort (a plant used to treat anxiety/depression, but can also cause anxiety or restlessness due to its effect on brain neurotransmitters). Caffeine and alcohol are known to contribute as well.

What are some suggested treatments for anxiety? Getting adequate sleep and exercise can help. Less commonly considered is having a healthier diet, with a plant-based diet being the ideal diet. Why is this? Being the original diet that God intended for us, it has superior tryptophan uptake compared to an omnivore diet. Tryptophan is an amino acid required for conversion to 5-HTP, serotonin, and melatonin in the brain. Animal protein introduces more amino acids which will compete with tryptophan’s entry into the brain, thereby reducing its uptake. Support groups or psychotherapy (counseling) are also highly encouraged. And if nothing else, it is vital to find one good friend or family member whom you trust to lean on. Be brave enough to admit you need help and ask for it. There is no shame in it.

Although not ideal due to risks of side effects and addiction, in some cases anxiety may require medication. In such situations, we strongly recommend consulting qualified Christian healthcare professionals who can guide you toward the most appropriate treatment while giving priority to natural remedies and lifestyle changes (such as regular physical activity, a balanced diet, sufficient sleep, sunlight exposure, and trust in God). These professionals can help weigh options carefully, always favoring non-pharmacological approaches first to avoid potential complications like gastrointestinal distress, nausea, weight changes, headache, worsening anxiety or depression, thoughts of suicide, rebound symptoms upon withdrawal, or high addiction risk.

The DSM-V defines Major Depressive Disorder (MDD) in the following way:

> 5 of the following most days for at least 2 weeks, 1 of which must be the first 2 criteria in bold.

●     Depressed mood

●     Loss of interest or pleasure

●     Weight changes

●     Sleep changes

●     Psychomotor agitation or retardation

●     Fatigue or reduction in energy

●     Feelings of worthlessness or guilt

●     Decreased concentration or indecisiveness

●     Suicidal ideation or attempt

Depression causes significant distress and interferes with functioning.

Traditionally, MDD is treated by a combination of pharmacologic therapies (various classes of antidepressants) as well as non-pharmacologic therapies. We’re going to dive a bit more into the non-pharmacologic therapies, as they’re more natural and practical gifts from God.

The first secret to treating MDD is simply to enjoy the great outdoors as much as you can! There are numerous health benefits. Fresh air purifies the blood, invigorates the brain, clears the mind, benefits our gut (improves digestion), purifies the liver, improves the innate immune system, and much more.5

Being around “green spaces” increases serotonin levels in the brain and reduces stress. Gardening is a highly encouraged activity—not only do you get exercise, but research shows it improves mood and self-esteem while reducing anxiety and depression. The sunshine also has numerous health benefits, such as better sleep, weight loss, improved immunity, and emotional well-being. It is recommended to get 15–30 minutes at least 3 times a week.5

Have you ever gone outside after a nice rainstorm or been to a waterfall and breathed the air in deeply? If so, you’re benefiting from negative ions in the air, which are known to improve learning and concentration by providing more oxygen to the brain. They also reduce anxiety and improve mood.5

To get the full benefits of breathing, we want to avoid apical breathing. This is shallow breathing which uses only the upper part of the chest, and not the diaphragm (the major muscle of respiration below the lungs). Unfortunately, more people work indoors these days, sitting with poor posture and breathing shallow breaths.

We want to focus on deep, diaphragmatic breathing. You can either lie down or sit up, with good posture. Place one hand above your belly button and the other on your chest. Breathe in slowly and deeply through your nose, for about 3–5 seconds, hold it for a few seconds, then exhale slowly through your mouth, for about 3–5 seconds, feeling your stomach contract without your chest moving. You should be taking about 4–6 breaths/minute. Feel free to try it now!

Do this for 5 minutes 3 times a day, and do this at least 3 times a week, but preferably daily.

This kind of breathing allows enough time for gas exchange, for air to fill the entirety of our lungs, and for sufficient oxygen to enter our blood. It activates the parasympathetic nervous system (responsible for “rest and digest”). As blood vessels dilate and relax the heart, the heart rate is slowed, blood pressure is decreased, and cortisol levels (a stress hormone) are decreased, allowing you to manage stress better. This, in turn, boosts your immunity. (The stress response being lowered “deactivates” the sympathetic nervous system.) You are able to focus better. With more oxygen in the brain, cognitive function and mental clarity are enhanced. Other benefits include management of chronic pain, digestion, irritable bowel syndrome, depression, anxiety, and sleep disorders.6

For general health, the recommendations from the American College of Sports Medicine are at least 150 minutes of moderate-intensity physical activity a week, and an additional 2 days of muscle-strengthening activity working all major muscle groups. Exercise has a plethora of health benefits, including mental health. Scientific studies show improved remission rates from depression (that is, people no longer meeting MDD criteria) with exercise. It lowers stress and anxiety and improves mood.7 How does it do all this?

Exercise causes the release of the following neurotransmitters (chemical messengers that carry messages between nerve cells in your brain and throughout your body. Firstly, serotonin, which regulates mood, digestion, sleep, wound healing, and more. A lack of serotonin plays a role in various mental health conditions. Ironically, a lack of serotonin means the brain cannot make as much melatonin, leading to worse sleep. Sleep disturbances accompany most cases of major depression. Then there’s dopamine, which regulates memory, movement, mood, and attention. Another neurotransmitter released is endorphins, which relieve pain and stress.8, 9

Suicide is not a mental health disorder, but is often a result of mental illness. The Cleveland Clinic lists the following as some warning signs of suicide: talking openly about suicide; sleeping pattern changes; feeling trapped; mood changes; social withdrawal; reckless behavior; not finding joy; sudden calmness; writing a note. If you notice these signs in yourself, or someone else, reach out for help without hesitation! You can also contact a local suicide prevention hotline. In the United States, dial 988. For numbers in other countries, visit https://www.iasp.info/visitors/ or search for “suicide hotline [your country]”. You could save someone’s life, or your own.

It is true that God wants us to fully trust Him and His promises. It’s true that He is the great Comforter. But it is also not wrong to get help from a Christlike brother or sister, especially at our lowest moments when we are unable to think clearly. Anxiety, depression, and thoughts of suicide can be all-consuming.

Why would someone contemplate suicide? Often, they lack acceptance by friends, family, or themselves. They may have been exposed to another’s death by suicide. They have access to lethal means (with guns being the leading method of suicide). They may have a psychiatric disorder, substance use disorder, or other serious health condition.10

If you suspect someone is contemplating ending their life, ask, “Are you contemplating suicide?” This will not typically increase the individual’s likelihood to commit suicide. Rather, you’re tackling the problem head-on and identifying if immediate supportive care is needed. Listen to them, without judgment. Stay in touch with them after the crisis, showing you truly care of their wellbeing.11

Finally, remind them that there is somebody who cares about them—a partner, friend, or family member. The most powerful thing that you can do for them is to remind them that God cares about them. Whether they are Christian or not may influence which verses or topics you want to share, but regardless of their religion, these verses could change their life.

For those paralyzed in fear:Isaiah 41:10 – "Fear thou not; for I am with thee: be not dismayed; for I am thy God: I will strengthen thee; yea, I will help thee; yea, I will uphold thee with the right hand of my righteousness."

For those doubting God’s plan for them: Jeremiah 29:11 – "For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end."

For those lacking peace:Isaiah 26:3, 4 – "Thou wilt keep him in perfect peace, whose mind is stayed on thee: because he trusteth in thee. Trust ye in the Lord for ever: for in the Lord Jehovah is everlasting strength."

For those feeling weary:Isaiah 40:31 ­– "But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint."

For those who cannot understand why they’re suffering:Proverbs 3:5, 6 – "Trust in the Lord with all thine heart; and lean not unto thine own understanding. In all thy ways acknowledge him, and he shall direct thy paths."

For the brokenhearted and afflicted:Psalms 34:17–20 – "The righteous cry, and the Lord heareth, and delivereth them out of all their troubles. The Lord is nigh unto them that are of a broken heart; and saveth such as be of a contrite spirit. Many are the afflictions of the righteous: but the Lord delivereth him out of them all. He keepeth all his bones: not one of them is broken."

The book of Psalms is useful for anyone suffering from anxiety, particularly Psalms 23, 61, and 91.

We must realize that our life is God’s, not our own. It is not in God’s plan for us to take our life. Remember that we are God’s temple. 1 Corinthians 3:16, 17 says, “Know ye not that ye are the temple of God, and that the Spirit of God dwelleth in you? If any man defile the temple of God, him shall God destroy; for the temple of God is holy, which temple ye are.” It continues in 1 Corinthians 16:9, “What? know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own?” We must also consider the sixth commandment. Exodus 20:13 says, “Thou shalt not kill.”

Suicide is never acceptable. However, only God knows the heart and the full circumstances of each person. We cannot make a final judgment about anyone’s eternal destiny. Our loving Saviour is full of mercy and compassion, and we can trust Him completely with the souls of those who have suffered greatly. The important question for us today is this: if we are struggling, will we reach out for help now while there is still hope?

To put things in perspective, I investigated the statistics on suicides in the US. What I found was shocking. In 2022, it was the 11th leading cause of death overall in the US (nearly 50,000 deaths). That’s about 137 deaths a day, or 1 death every 10.5 minutes. It was the 2nd leading cause of death among individuals 10–14 and 25–34, indicating that the young are especially vulnerable. There were nearly twice as many suicides (49,476) as homicides (24,849) in the US, with the prevalence being 4x higher in males than females (22.9 per 100,000 vs 5.9 per 100,000).

In 2023, 2% of adults 18–25 attempted suicide. That’s 1 in 50 people that you see!!

Truly, we live in a sin-sick world.

It’s easy to FEEL alone, like God’s presence is withdrawn. This is a deception from the enemy of our souls. We know from the prophet Jeremiah that “The heart is deceitful above all things, and desperately wicked: who can know it?” (Jeremiah 17:9). This is why religion based on feeling is incredibly dangerous. It must be based on faith, and faith alone. It takes constant connection and communion with Christ. We have to place our trust in Him, even when things appear bleak for us here on earth.

Hebrews 13:5, 6 says to, “be content with such things as ye have: for he hath said, I will never leave thee, nor forsake thee.” So we can confidently say, “The Lord is my helper, and I will not fear what man shall do unto me” (Hebrews 13:6).

No matter our socioeconomic or religious background, we have to look out for each other. And most importantly, people must come to know the love, peace, and comfort that Christ brings. That means we need to pour out the love of the Lord upon others. This is our God-given duty. I pray that we may be able to fulfill it.—To be continued.