Anxiety Therapy: The ‘It Wasn’t THAT Awful!’ List

Psychiatric diagnoses don’t always identify the big issues that get in our way, and that’s unfortunate. Nearly 40 years, five diagnoses, and 22 different medications into my treatment, no one had yet labeled “anxiety” as a challenge I could confront and overcome. Once I could name anxiety as a challenge, I found hope in discovering ways to overcome it, and joy in this newfound area of resilience.

It was my first manicurist — a professional I engaged sometime after I turned 60 — who told me I was not just anxious but SERIOUSLY anxious. More anxious than anyone he had ever served.

“It’s exhausting to work on you!” he said. “You have the tensest hands I’ve ever touched!”

Can you imagine a person who is so anxious that her hands are too tense to relax under a professional massage? Can you imagine that she, perhaps, might not know what it is to not feel anxious? Her mental health professionals haven’t identified anxiety as an issue because she herself doesn’t even experience it. And if well-meaning Christian friends urged her

“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God” (Phil. 4:6)

— well, that just seemed irrelevant. Anxiety wasn’t among her five diagnoses.

Once my manicurist had named it, I could recognize that I become seriously anxious about things that might seem really easy to you. Things like:

  • Will my store “rewards” app really download my $7.15 in rewards when I ‘m checking out?
  • Will I survive calling someone I don’t know well to invite them to get together?
  • Can I successfully work through a challenge I’m having with new software?

One thing that has helped was posting a list where I see it regularly of things that turned out less terribly than I expected.

I’m sure that seems a bit goofy, and maybe oversimplified as a way to deal with chronic anxiety. Over a couple of months, the list of items that “weren’t THAT awful!” grew longer and longer!

My anxiety didn’t grow less. But my confidence that I would successfully overcome anxiety-producing hurdles grew larger. I also found a new partner in facing challenges as a nine-month “Retreat in Everyday Life” trained me to know that Jesus and the Holy Spirit are right alongside me all the time to offer guidance, help, and support in my challenges.

Eventually, I even started a new list: “It wasn’t awful AT ALL.”

There’s a lot of hope to be found in the experience of overcoming difficulties. This is just one strategy that has helped me find resilience as I deal with my anxiety. What has worked for you?

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Have a Hopeful Day Every Day in 2023!

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You’ve probably got lots of resolutions that you intend will challenge you and spur you on to good works in 2023. And if you’re like most of us, around January 17 you’ll start to run out of steam for self-improvement. By February 2, your resolutions will be history. But your sense of disappointment with yourself will continue to color your days for all the rest of the year, undermining your sense of hope in the future.

So let me offer a resolution that requires almost no effort to implement and will cast hope and good cheer over every day of 2023. It’s something I discovered late in 2022, and has had remarkable results in my life. It’s Pig’s Day Predictor and it will help you have a FABULOUS day every day.

Pig is a cheerful little character in Stephan Pastis’ “Pearls Before Swine” comic. For Pig, any day that includes chocolate, cheese, and enough sleep is a GREAT day. And he starts each day in hopeful anticipation of what is to come:

Pearls Before Swine, Nov. 20, 2022, Stephan Pastis

Unlike Pig, I’m not an optimist by nature. I’m closer to Rat. Some call him cynical or pessimistic. I tend to think of him as a realist, and I’m a big fan of reality. Optimists get some great stuff done, but so do pessimists. As they say:

The optimist invented the airplane; the pessimist invented the parachute.

But what optimists have going for them is that their hopefulness makes it easier for them to enjoy what they’re doing. And while I’d love to continue inventing the parachutes that pessimists appreciate and optimists eventually do need, I’d really like to have some fun while I’m doing it.

Thus the Day Predictor.

Every day, I choose one of the little slips from my Day Predictor jar and tape it to my calendar.

What a FANTASTIC! December I had!

The word I find each morning both encourages me to observe whatever is GREAT! or GOD-FILLED or JOYFUL! in the day, and also to avoid anything I can possibly avoid that isn’t THE BEST! or MAGNIFICENT or EXCEPTIONAL! So given the choice on Dec. 9 between two holiday events — one where I’d see people who have lately treated me badly and another where I’d see people I always enjoy — I chose in hope of having a TREMENDOUS evening. And I did.

People who read the Bible will recognize this as a fun way to remind ourselves daily of something we learn there:

Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable — if anything is excellent or praiseworthy — think about such things. (Phil. 4:8)

For your daily reminder to hope for a STUPENDOUS day every day of 2023, download your own Day Predictor here. And enjoy a hopeful 2023.

In Carlene Hill Byron’s Not Quite Fine: Mental Health, Faith and Showing Up for One Another, you’ll learn how to nurture the hope, meaning, belonging, value and purpose that are foundational to good mental health for everyone. Available where good books are sold.

When Church Makes You Feel Guilty for Getting Help

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Some people who read this blog feel really guilty that they are seeking help outside of church for their mental health struggles. They keep being told: “Pray more! Read the Bible more! Claim your healing!” People at church tell them that looking to a professional counselor, a doctor, or a medicine is to deny the power of God.

You already feel bad, and now your church is “guilting” you for seeking help. Image by Gerd Altmann from Pixabay

Two Terrible Options

So they feel like they have to choose between two terrible options: feeling like crap because they feel like crap or feeling like crap because they’ve been smeared with guilt for getting help from any source other than God.

Now, I totally agree that God heals, including mental health problems, and that prayer and Bible reading are good things. But here are some things I’ve seen that tell me those solutions are often not all that’s required.

Three Alternative Examples

I know someone who helped to plant a church – who was his pastor’s prayer partner for years – who left that church because people kept telling him he should trust God and stop taking the psychiatric medications that helped control his schizophrenic psychoses. That God had told them he’d been healed.

My own life was stuffed with a gray fog of despair, so full that I could barely see what was outside of me, until doctors finally prescribed the right antidepressant. Within a few weeks, I discovered the scent of clover as it rose from sun-warmed grass. Clover always had a scent, but I had never been able to smell past the thick insulation of sorrow that jammed up every possibility of perception.

Clover always had a scent, but the first time I noticed it was after an antidepressant cleared the fog of sadness that filled my life. Image by Annette Meyer from Pixabay

In the Bible, when the young Timothy was overwhelmed by trying to lead a church of older people who disrespected him, the Apostle Paul’s recommendation wasn’t to pray more – it was to drink some wine “because of your stomach” (1 Tim 5:23). Those who drink wine know it’s too acidic to benefit an upset stomach unless the stomach is upset by stress. In that case, wine can calm what’s causing the acid stomach. So Paul appears to have prescribed his own times’ psychiatric medicine for Timothy’s anxiety.

Choose Help and God, Not Guilt

Be like Timothy, and me, and the church planter. Don’t neglect God. Don’t abandon the community of faith (although you may need to seek a new one). But do seek help where it’s offered, and do assess the value of all kinds of help that are available.

Those who read me often know that my experience of 40 years of treatment have made me a careful user of psychiatric medicines. I wish I’d been more careful earlier in my life. I generally encourage you to be careful also. Medicine can’t remedy an imbalanced lifestyle or disordered heart. Long-term use of psychiatric medicine often masks difficulties instead of remedying them. If you find yourself — as I was –being prescribed one medicine after another in the attempt to resolve your issues, it’s entirely possible that your issues aren’t mostly based in your biochemistry.

But it is also true that sometimes the right medicine can clear enough fog to help you see the imbalances in your way of life, and move enough barriers to afford the energy to find remedies.

May you move guilt-free toward answers that support you in the life God made you to live.

Wanting to Die Doesn’t Need to Be Fatal

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During Suicide Prevention Awareness Month, please remember: Wanting to die doesn’t need to be fatal. If you need help to bring that to mind, call the National Suicide Lifeline at 988 or text 741741 to talk with helpful people.

When I was 23 years old, I was in a very rough patch. It wasn’t unfamiliar: I wanted to die, and I’d wanted to die many, many times before. Wanting to die was part of my normal day. I’d do something stupid; I’d want to die. I’d do something embarrassing; I’d want to die. I had always resisted those suicide impulses. Generally, I was able to treat my suicidal ideation in the same way Martin Luther encouraged people to manage temptations: I let the dangerous ideas keep flying overhead like birds, but refused them nesting space in my head.

Wanting to die was part of my normal day. Still, I had always resisted those suicide impulses.

What made this day particularly tough was that I wanted to die even though I seemed to be en route to the life I wanted. I was just 23 years old and earning more than my father’s lifetime peak income. I was working for a daily newspaper, living in a big historic house surrounded with three generations of friends. Dinner was shared on a table big enough for 12, in a dark-paneled dining room with an elaborately carved Victorian mantel that rose to the ceiling. What our kitchen lacked in cabinets, it made up in a butler’s pantry, with oak doors on the lower cabinets and sliding glass doors framed in oak above. We hosted contradances in the gas-lit ballroom of our home, with live music performed by a roommate’s traditional band.

And still, on that October evening, I wanted to die.

I sat in my car at the curb in the early evening twilight. Warm lamplight poured from the parlor and kitchen windows.  I knew that if I could make it to the door, three kids would wrap their arms around my knees the moment I got into the house. Still, I was still unable to move from the seat of my VW.

The voice I knew to be God told me, “Plant bulbs.”

That made no sense to me.

I told the voice, “Huh?”

And God replied, “If you don’t have a reason to live till spring, plant bulbs.”

You probably wonder how I decided that a voice making such a silly proposition was the voice of God. I have been fortunate to have enjoyed outstanding training in listening for God. My training began in a Quaker meeting in Durham, Maine, a tiny town founded before the Revolution that has yet to outgrow its farming roots. You enter the brick meetinghouse through one of two door arches set side by side in a corner of the building. When the building was constructed nearly 200 years ago, these were the separate entrances for men and women. Like many churches of its day, the Meeting seated men and women separately. Unlike other churches of its day, the Meeting did not limit public proclamation to men. This caused no end of headaches for the Puritan leadership of the Massachusetts Bay Colony (of which Maine was originally a part). They eventually felt a need to create an example of one particularly outspoken female Quaker preacher, first burning a hole through her tongue with a red hot poker, then, when she still was not silenced, publicly hanging her.

That is the kind of lesson in hearing God that contemporary Quakers cling to: God often speaks in ways that require people to act outside of cultural norms. Quakers are proud of their adherence to a doctrine of peace and nonviolence, proud that they recognized God’s call to free slaves almost two centuries before the larger British and American cultures acknowledged it. Quakers take pride in their long-standing quiet leadership in the arenas of sustainability and simple living.

Thanks to time with Quakers, I was prepared to hear and recognize God’s voice. And I also knew it was wisest to follow it.

Wanting to die — even on thousands of days — doesn’t need to be fatal.

So, as peculiar as the guidance seemed, I obeyed. I dug in about a hundred bulbs over the next two weeks. I lived till spring. They bloomed. I kept planting bulbs and landscapes and gardens at the homes of family and friends. When I first moved back to Maine, I was living in my childhood home, where I maintained blackberry canes and blueberry bushes and a huge trellis covered with Concord grapes, as well as the now-overgrown gardens my mother developed after I provided her some plants and sketches.

But if I look for a spiritual bulb I planted that is bearing fruit, it’s a little brochure. Google tells me it’s been circulating for a decade through denominational mental health ministry trainings, Mental Health Sunday sermons, and other people’s blogs. In that brochure, I suggest ways congregations can address mental health ministry needs and I “come out” as a person with a bipolar diagnosis.

Who wants to make their life about a diagnosis?

Many Christians cling to this life. I cling to the promises that keep me alive.

People who hear I have a bipolar diagnosis use words like “inspiring” and “courageous” and “persevering” to describe me. I find those words frustrating. I have the same choice each day as everyone who claims Christ as Lord: live for Christ or die spiritually. The only difference is that for me, the idea of dying is more imminent than for most Christians. Most Christians cling to this life. I cling to the promises that keep me alive.

Wanting to die isn’t the end of the world.  A person like me can want to die on thousands of days (more than 7,000 by my best recent estimate) and still continue to live.

In this world, we do have trouble. And in this world, God has created good works for us to walk into.

Choose life. Do good. Love God.

And if you have a chance, plant bulbs. Give yourself another reason to look forward to spring.

As Science Sees It: Spiritual Focus Protects Mental Health

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Lisa Miller, a psychologist on faculty at Teachers College, Columbia University, talked with the Wall Street Journal about what her research is discovering about the mental health benefits of spiritual practices.

“Strong spiritual awareness protects against despair, addiction, depression, and even suicidality.” Lisa Miller, psychologist, Columbia University, in @wsj

“Hundreds of scientific peer-reviewed articles have found that a strong spiritual awareness protects against the most prevalent forms of inner suffering: the diseases of despair, addiction, depression, and even suicidality,” she told the Journal. “The data has also shown that character strengths and virtues such as optimism, grit, commitment and forgiveness go hand-in-hand with strong spiritual awareness.”

Even more strikingly, she said, spiritual growth is dependent on experiencing difficulties.

“There are specific life challenges that help us develop spiritually. If someone dies. If someone gets ill. A divorce. The birth of a child.”

Read more in the Wall Street Journal.

Miller’s newest book is The Awakened Brain: The New Science of Spirituality and Our Quest for an Inspired Life. Among her research of interest: Barton, Y., Miller, L., Wickmaratne, P., Weissman, M. (2013).  Religious Attendance and Social Adjustment as Protective Against Depression: A Ten-Year Prospective Study.  Journal of Affective Disorders, (1), 53-57. “Conclusions: Frequent religious attendance may protect against major depression, independent from the effects of social adjustment.”

“Frequent religious attendance may protect against major depression.” Conclusion from actual scientific research, published in the Journal of Affective Disorders. 2013

Reimagine Mental Health: Treat Causes, Not Crises

While a massive advocacy campaign begins this week to gain funding for even more mental health crisis services, I wonder: why we would keep building a system that’s so clearly failing people in crisis?

This week, a wide coalition of national organizations is encouraging us to Reimagine how we support people in emotional crisis. They recommend expanding the current crisis call and text systems, establishing local crisis teams for in-person response to callers, and creating new crisis stabilization settings to replace mental health crisis trips to emergency rooms.

This week’s efforts are the speartip of a nationwide lobbying campaign that’s being piggybacked on next July’s rollout of the 988 national mental health crisis phone number. 988 would work similarly to 911. The difference is that mental health crisis services are less widely dispersed than other emergency supports.

man talking on phone
Crisis call and text services give access to trained volunteers or staff anywhere, anytime. (In the US, call 800-273-8255, or text HOME to 741741)

If you call the National Suicide Prevention Lifeline today (800-273-8255), you may be switched to a nearby call center or you may talk to someone hundreds of miles away. That’s fine because training for lifeline volunteers is pretty consistent nationwide.

Crisis line volunteers let you know, by their words and their presence, that you’re not alone. They listen with compassion. Try to make sure you’re not planning to kill yourself today. Encourage you to think about any person that you could connect with. And then they’ll help you think of something you might do after you get off the phone, because seeing a possible future is part of the definition of hope, even if that future is as simple as tea and toast and a purring kitty.

The lifeline systems work. I know from experience. A person in a crisis needs reminding that she’s not alone (she belongs), she is important enough to be heard (she has value), her life matters – even if right now it’s just to the cat who wants to be fed (she lives with meaning and purpose), and that there is a future beyond this dark moment (she can hope). When she gets those five things, she can usually live to another day.

The US Suicide Rate Keeps Rising.
What We’re Doing Isn’t Working.

The coalition wants to make sure that we have more crisis services to prevent more suicide deaths. The question is: Will more crisis services help? Here’s the most important thing to know about US suicide deaths in the last 20 years:

The US suicide rate rose one-third from 1999-2017.

The global suicide rate dropped by a third in roughly the same time.

In 20 years, the US suicide rate has risen by a third while the global rate has dropped by a third. Whatever we’re doing to prevent suicide in the US is almost exactly wrong.

It would seem that whatever we’re doing to prevent suicide in the US is almost exactly wrong. So why would we choose to REIMAGINE mental health supports by providing more of almost exactly the same – more services to intervene at crisis moments instead of more community supports that would avert crises?

To be clear, in the US we provide significantly more ongoing mental health services today than we did in 1999. Almost 1 in 5 of us receives professional mental health care; 1 in 6 takes psychiatric medications. And still our rates of mental health crisis and attributed deaths – by suicide and also by drug overdose – have risen.

Global Suicide Rates are Dropping.
Could We Learn from What’s Working Elsewhere?

While our rate of these “deaths by despair” continues to rise, the global suicide rate has been dropping, in part because other nations take seriously people’s own explanations for their distress. Japan changed its laws so creditors couldn’t collect on life insurance policies after a suicide. Collection agencies had been quite literally hounding debtors to death. Zimbabwe, short on professional therapists, trained a small army of “grandmothers on benches” to listen to those who had no one else’s ear.

When people long for a decent job or good friends, what is more likely to help: a weekly hour with a costly therapist, expensive psychiatric medicines, or a good job and good friends?

We, too, could listen to the cries of the hearts around us to create change. When people long for a decent job or good friends, what is more likely to help: a weekly hour with a costly therapist, expensive psychiatric medicines, or a good job and good friends? In our work and relationships, we find meaning, belonging, purpose, value and hope. We may find them in union halls or community businesses, in faith communities or neighborhood associations, in the bar or the park where we “always” go.

Not Quite Fine book

We find our mental health and proactively avert mental health crises as we live with and for one another. That is how we best “reimagine” mental health supports.

Read more about the mental health benefits of meaning, purpose, belonging, value and hope in Not Quite Fine: Mental Health, Faith and Showing Up for One Another, now available on Herald Press.