By Tim Lane


Everyone worries. Some of us more than others. Reports show that nearly 20% of people

living in the US struggle with anxiety. That means that approximately 65 million people experience worry that impacts their daily lives and relationships in profound ways.

In 2008, American physicians wrote more than 50 million prescriptions for specifically anti-anxiety medications and more than 150 million for antidepressants, many of which were used for anxiety-related conditions.



So why do so many of us struggle with anxiety? That question has been at the center of much debate. The pendulum has swung from one extreme to the other throughout history. Some have thought that worry is purely a physiological issue while others have concluded that it is purely spiritual. Alan Horwitz states this in his book, Anxiety: A Short History:

Between the fourth and sixteenth centuries, religious, magical, and folkloric views of anxiety and other mental conditions largely displaced empirically-based Hippocratic and Galenic conceptions in Western societies. While the latter beliefs persisted within medicine through the medieval period, medical knowledge itself was overridden by ecclesiastical structures. Over the course of the seventeenth century, however, anxiety was once again increasingly likely to be viewed within a medical, as opposed to spiritual, framework. Within medicine, the influences of humoral pathology, which had dominated medical thinking since Hippocratic times, gradually waned. By the end of the eighteenth century, while humoral conceptions remained popular theories of temperaments in the general culture, medicine preferred physiological accounts to explain how mental disturbances resulted from malfunctioning nervous systems (p. 54).


While Horowitz’s view of the church may be oversimplified, we still must ask: what causes anxiety? Does the Bible provide categories that enable us to avoid the swinging pendulum between faith and science? I believe it does.


The historic Christian categories of World, Flesh and Devil are entirely capable of providing a robust understanding of people and their problems, allowing us to avoid simplistic reductionism on either end of the spectrum. We don’t have to engage in either/or thinking and conclude that anxiety is either purely physiological or only spiritual. This means that we can learn from the best insights that modern science has to offer along with the rich truths of Scripture which remind us that God is able to meet us in our struggles with worry.



The category of “world” is everything outside of the heart. These are the external shaping influences that we experience as human beings made in God’s image. It is the person’s situation; their context. To minimize the impact someone’s circumstances has on a person is to be sub-biblical. The God of Scripture takes our situation seriously. This is a place where we can learn most from modern scientific research:


  • Brain: we all have brains that determine our personalities and pre-dispose us to a host of struggles. All of us are constitutionally wired differently. Our brains are also impacted by the fall of humanity. We are all broken at some level and exhibit various mental strengths and frailties.
  • Body: we have bodies that have strengths and weaknesses. They too are broken in different ways and impact how we respond to difficulty.
  • Event and Relational History: we have good and bad things that have happened to us along with people who have blessed us or hurt us.
  • Political/Cultural/Socio-economic Context: we exist in a context that impacts the degree to which we may struggle with worry.
  • Gender: our gender plays a role in how we struggle with worry.
  • Religious Upbringing: the beliefs that shaped us growing up influence our struggle with worry.
  • Age: the longer we live, the more grief and loss we experience. This can make us wiser or more prone to anxiety.
  • Race/Ethnicity: whether we are the majority or minority culture in a given context will also shape the way we experience anxiety.


This list is not exhaustive. You may be able to think of other external shaping influences. Each one can be nuanced to fit every person who has ever lived. No two people are alike.

While we take all of this seriously, it is important to note something interesting about the struggle with anxiety. While appreciating one’s context, changing one’s context does not guarantee that you will live a worry free life.


Once again, Alan Horwitz states this in his book, Anxiety: A Short History:

Modern developed societies are the safest, healthiest, and most prosperous that have ever existed so we might expect that their citizens would have low levels of anxiousness….

Nevertheless, surveys inform us that the public reports more anxiety disorders now than in the past. These studies indicate that anxiety is the single most common class of mental illness; almost one in five people has had an anxiety disorder during the past year and more than a quarter of the population experienced one at some point in their lives (p. 143).


Certainly there is nothing wrong with changing your circumstances if you are in danger, but situational change does not mean you will be anxiety free. There is a need for more.




This category factors in the reality that we were created by God to worship and trust in him in the midst of our circumstances, no matter what they are. This is where the Bible focuses most of its attention. It does so, not because it is simplistic, but because it offers something that no other theory of change offers; a personal, loving, redeeming God who becomes a human being, lives, dies and has risen from the dead to give us new life, wisdom and power to live in relationship with him! The Bible does not minimize the category of “world” at all. Yet it does call us to depend upon and trust in God in the midst of our joys and sorrows.



This category is factored into the Biblical worldview because it recognizes that evil is real and personal. While most attention is focused on the other two categories, the Bible does clearly state that we have one who is opposed to God’s people and he seeks to tempt and accuse those who follow Christ. In Ephesians 6:10-20, the apostle Paul gives clear instruction on how to fight the schemes of the Evil One. When this category is improperly over-emphasized, it can lead people to look for demons in every pathology. When it is improperly under-emphasized, it can lead people to miss the real battle that part and parcel of the Christian life.


Modern psychology and psychiatry attempt to capture the multi-layeredness of people and their problems by talking about the bio/psycho/socio/cultural aspects of causation. The Biblical worldview allows us to take those categories seriously along with painting an even fuller, more nuanced picture. Whether the church has always represented this level of nuance is something to debate, but the Scriptures are clear.



One of the most relevant aspects of understanding these three categories is to fully appreciate the multi-layered nature of anxiety. When we do this, we can understand why some people may struggle more than others. The more layers that are involved, the greater the struggle and the harder it may be to change.


If you struggle with severe anxiety, this can help you calibrate your expectations and not live under a cloud of shame because of your struggle.


If you are someone who is helping someone who struggles deeply, these categories can move you to greater empathy and compassion. They can also help you see that, even in the midst of a struggle with anxiety, the living, redeeming God wants to meet you in your troubles and comfort you and walk with you.


Copyright © 2016 Timothy S. Lane