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Imagine that a member of the bishopric telephones two ward members to ask them to say the opening and closing prayers in sacramentmeeting. Both members feel nervous. One has butterflies in their stomach about saying the prayer but thinks through what to say and goes through with it. The other has an overwhelming sense of dread accompanied by an elevated heart rate and hyperventilation and does not go to church that Sunday. One feels relief at being able to do something difficult. The other has other similar panic episodes over the next few months out of fear of being called on to pray and avoids going to church for quite a while.
This contrast highlights the fundamental difference between most people’s experience of anxiety and the experiences of people with anxiety disorders.
Different Experiences
Anxiety is a normal human emotion. Everyone experiences it. It is part of the “opposition in all things,” without which there would be no “happiness nor misery, neither sense nor insensibility” (2 Nephi 2:11).1 As such, this emotion serves us well. It is part of our emotional alarm system. It motivates us to prepare for important events. It causes us to protect ourselves when we feel threatened. It enhances performance. It helps us make thoughtful decisions, solve problems, and prepare for challenges. It reveals what we care about.
On the other hand, there are also anxiety disorders. These interfere with our alarm system and its many benefits and are characterized by persistent, overwhelming, uncontrollable anxiety that impedes normal functioning. They include social anxiety; phobias; panic attacks; repetitive, intrusive, objectionable thoughts, impulses, and images; and are often accompanied by a host of physical symptoms and extreme avoidance behavior.
Many among us suffer from such disorders. Therefore, it’s important that we understand these disorders so that we can offer appropriate support and help.
How Anxiety Disorders Develop
In addition to extreme avoidance of anxiety-filled situations, several human traits come together in a “perfect storm” to create debilitating anxiety: biological vulnerability to anxiety, coupled with stress; worry; distorted perception and thinking; perfectionism; excessive niceness; and unresolved regrets.
Biological Vulnerability to Anxiety, Coupled with Excessive Stress
We inherit from our parents our physical and emotional makeup, including vulnerability to certain illnesses. Just as some families are vulnerable to high blood pressure or diabetes, some are also vulnerable to certain emotional disorders.
Vulnerability by itself will not cause an anxiety disorder. However, when it is coupled with long-term, unresolved stress, a person may develop such a disorder. Understanding this can help us know, for instance, that some people may need to take medication to manage body chemistry when they have high levels of constant anxiety.
Excessive Worry
Worry comes when we feel we are highly vulnerable to some threat and also feel we have little power to do anything about it. Like anxiety, worry can be very helpful. However, when it is excessive, persistent, and unchecked over a long period of time, it can evolve into an anxiety disorder.
Distorted Perception and Thinking
People who suffer from anxiety disorders have distorted perceptions and thoughts. Perception begins with what we experience through our five senses and then includes the meaning we give to our experience. This filtered perception accumulates over time. However, it is often false when not guided by the truth.
Anxiety disorders distort thinking. For instance, fear that a dog might bite you could be very rational in a given situation. However, thinking that you should not go outside because a dog might attack you is irrational.
A theory that counselors use to teach people how to change distorted perception and thinking states that our emotions are the result of events and experiences filtered through how we perceive and think. The simple formula of this theory is A+B=C: The key to our emotions (C) is perception (B) of an event (A) rather than the event itself. We know this because two people can experience the same thing but feel very differently about it.
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If you can replace irrational thoughts and beliefs with more rational, comforting ones, your anxiety will drop and become more normal.
Excessive Perfectionism
Perfectionism can be functional and helpful when used as a tool to improve and grow. However, two common irrational beliefs that create anxiety are “People will look down on me if I make a mistake” and “I’m less worthwhile when I fail.” These beliefs limit our use of mistakes to teach us (see Ether 12:27; D&C 1:25, 27) and ignore the fact that we have great worth as sons and daughters of God (see D&C 18:10).
Unhealthy perfectionism causes people to hold themselves to standards they don’t hold others to. It causes procrastination. It takes the joy out of trying new things. For example, if people’s friends invite them to go bowling, they may fear what their friends will think if they bowl poorly. Of course, they themselves would not look down on friends who bowl poorly, but they do not see how irrational their thinking has become.
The Lord commanded us to be perfect (see Matthew 5:48), but He also said that if we draw close to Him, He will show us our weakness (see Ether 12:27). There appears to be a conflict between these two concepts unless you understand that perfection (completeness, wholeness) is an eternal condition that comes through the Savior’s Atonement “on conditions of repentance” (Alma 42:13). We don’t make ourselves perfect; Jesus Christ does. We just do our best and keep repenting when we fall short, relying on His grace to make weak things strong.
If we don’t resolve the distorted thinking common to perfectionism, we become the slaves rather than the masters of our high standards, and we become vulnerable to extreme anxiety.