The Bible and Anxiety

Anxiety is a common human emotion characterized by feelings of worry about the future. Paul tells us not to worry about anything, and Peter says to “Cast all your anxiety on him because he cares for you” (1 Pe. 5:7). The Bible acknowledges anxiety because it's a common human reaction.

The psalms are so relatable because the writers are honest, raw, and vulnerable about their struggles. Since David wrote 75 of the 150 collected psalms, he seems like an old, trusted friend. We know a lot of David's life-story, from the moment he appeared on the Judean hillside with five stones and a sling to his final breath, curled up on his death bed. So, we know both what David did (because of the historical books) and how he felt (because of the psalms).

Prior to assuming the throne, David was chased across the countryside by a jealous King Saul, who tried to kill him six or seven times. David fled for his life, hiding out in caves, on mountains, and even living with his mortal enemies the Philistines for a time. During this 5-7 year period of running for his life, David experienced overwhelming anxiety. He tells us about this in the psalms, specifically in Ps. 6.13, 22, 35,38, 55, 59, 69, 109, and 143.

He writes,

"My soul is in deep anguish…
I am worn out from my groaning.
All night long I flood my bed with weeping
and drench my couch with tears.
My eyes grow weak with sorrow;
they fail because of all my foes” (6:3, 6-7).

And again,

“My heart is in anguish within me;
the terrors of death have fallen on me.
Fear and trembling have beset me;
horror has overwhelmed me” (55:4-5).

Anxiety is a common human emotion characterized by feelings of unease, worry, and apprehension. The Bible has a lot to say about it. Jesus tells us, “do not worry” (Matt.6:25). Peter encourages Christians to “Cast all your anxiety on him because he cares for you” (1 Pe. 5:7). And everyone knows Paul’s words to the Philippian church: “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God” (Phil. 4:6). Do you ever wonder why the Bible addresses anxiety and worry? Because it's a common human reaction to the unknown future.

Anxiety is a normal response to the unknown, but excessive and persistent feelings of anxiety interfere with daily life. Everyone experiences anxiety on some level—even Paul (2 Cor.11:28), who told the Philippians not to do it. Some may be more prone to becoming anxious than others, but no one is immune to it. The big question is when does worry develop into a pattern of overwhelming anxiety?

Manageable anxiety should be distinguished from mental illness. For example, everyone worries about life, stress, health, finances, children, and so on. The Bible speaks to these occasions many different times. This is not a sign of mental illness. People suffering with anxiety disorder worry excessively, so much that it can become debilitating.

Think of a spectrum. On one end is nervousness and concern, but it’s manageable. On the other extreme is outright fear and a panic attack. As anxiety moves along the spectrum it becomes more difficult to manage and interferes with our ability to perform daily tasks.

From a clinical perspective, the person who continues in this overwhelmed state for more than six months might be diagnosed with anxiety disorder. There are many types of anxiety disorders. One of the most common is called generalized anxiety disorder. Here are the criteria:

Excessive anxiety and worry occurring most days of the week for at least six months that is accompanied by at least three of the following symptoms:
Restlessness or feeling keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep problems (difficulty falling asleep, staying asleep, or restless sleep)

Based upon David’s own words, it is reasonable to conclude he experienced an anxiety disorder as he ran for his life during these 4-7 years. Let’s walk through the symptoms and compare them with his experience.

Excessive anxiety
His anxiety was beyond the normal amount of worry we usually face and—given the number of psalms in which he expresses it—certainly occurred most of the day and for more than six months. He refers to the length of his struggle many times. For example, he wrote, "I am bowed down and brought very low; all day long I go about mourning” (38:6) and "How long must I wrestle with my thoughts and day after day have sorrow in my heart" (13:2)? In Psalm 22 he complains to God, "My God, I cry out by day, but you do not answer, by night, but I find no rest" (v.2).

“My heart is in anguish within me; the terrors of death have fallen on me. Fear and trembling have beset me; horror has overwhelmed me” (55:4-5). It’s difficult to read these ten psalms without feeling his fear and anxiety. (See also, 13:2; 22:2; 69:1-2, 20; 109:9, 7, 22) The frequency with which it appears reveals it was foremost on his mind and had—oftentimes—become consuming.

Restlessness and the feeling of being “on edge”
David spoke often about his heart. “My heart pounds, my strength fails me…” (35:10) and “My heart is in anguish within me; the terrors of death have fallen on me” (55:4; cf. 109:22; 143:4). David was constantly on edge. He pleaded for God to bring relief. “How long, Lord, will you look on? Rescue me from their ravages, my precious life from these lions” (35:17). “Why are you so far from saving me, so far from my cries of anguish” (22:1)?

We might add to these symptoms a hint of paranoia. David was under an intense social microscope and strongly believed eyes were always watching him. “They sneer at me and say, “Aha! Aha” (35:21)! “Those who sit at the gate mock me, and I am the song of the drunkards” (69:10-12). “Those who want to kill me set their traps, those who would harm me talk of my ruin; all day long they scheme and lie” (38:12).

Physical weakness
David experienced fatigue, heart palpitations, and other physical effects of mental anguish. “I am worn out from my groaning” (6:6). “All my bones are out of joint. My heart has turned to wax; it has melted within me. My mouth is dried up like a potsherd, and my tongue sticks to the roof of my mouth…” (22:14-15). “My heart is in anguish within me” (55:4). “There is no health in my body; there is no soundness in my bones,” he finally admits (38:3). We can safely assume David experienced no small amount of chronic fatigue during this time.

Difficulty managing thoughts
“How long must I wrestle with my thoughts” (13:2)? “My thoughts trouble me and I am distraught because of what my enemy is saying, because of the threats of the wicked; for they bring down suffering on me and assail me in their anger” (55:2-3).

Trouble sleeping, either falling asleep, staying asleep, or being restless while sleeping
“All night long I flood my bed with weeping and drench my couch with tears” (6:6). “My God, I cry out by day, but you do not answer, by night, but I find no rest” (22:2). “Evening, morning and noon I cry out in distress” (55:17).

Irritability and/or aggression
David was certainly frustrated and irritable because of his foes. This come out in his writing, “Let death take my enemies by surprise; let them go down alive to the realm of the dead” (55:15). Psalm 109 describes perhaps his lowest point of aggression. “May his children be fatherless and his wife a widow. May his children be wandering beggars; may they be driven from their ruined homes. May a creditor seize all he has; may strangers plunder the fruits of his labor. May no one extend kindness to him or take pity on his fatherless children…May their sins always remain before the Lord, that he may blot out their name from the earth” (vv.9-15).

David's fleeing from Saul is an extreme example, but that is the point. There is a difference between normal anxiety levels and overwhelming anxiety. We all experience anxiety and worry about a lot of things, but it doesn't prevent us from carrying out our daily activities. When it does reach that threshold, however, it becomes more than worry. It might become an anxiety disorder that interferes with daily life and makes you want to be like David: run away into hiding and escape.