Anxious America: How to Faithfully Respond to the Mental Health Crisis

This article was written by Jeff Haanen and was originally published by The Reformed Journal. Reposted with author's permission.

I shut my laptop abruptly late one afternoon. I realized I was holding my breath. My neck and scalp were tingling and my shoulders were tight. I put my hand over my chest and felt my heart racing. It was just an unpleasant email, I thought. Why am I feeling like this? I stood up from the kitchen table, only to feel dizzy. I sat down again, just to breathe.

It was early 2022. For months I had been experiencing increased anxiety, often making work and family responsibilities hard to manage. Tensions in my extended family and at work, mixed with intense cultural polarization, caused me to honestly ask myself two questions: Is there something wrong with me? And am I the only one feeling like this?

After some digging, I came to learn that anxiety and challenges around mental health may be one of the most universal human experiences of the past several years. The CDC reported in July 2022 that 28.8% of Americans report symptoms of anxiety disorder; for 18-29 year olds, it’s a staggering 42.9%. In December 2021, the Surgeon General warned of a growing youth mental health crisis.  And today, nearly one-quarter of Americans over age 18 are medicated for anxiety, depression or ADHD. No wonder President Biden called for a national response to the growing mental health crisis in his 2022 State of the Union Address.  

The pandemic didn’t create a global mental health crisis, but it did make it worse. “I believe we saw the exacerbation of mental health issues during the pandemic,” says Marvin Williams, 57, the lead pastor of Trinity Church in Lansing, Michigan. Williams, a Black pastor in a predominately White church (“which carries its own anxieties,” he says), believes the convergence of the pandemic, political division, and growing issues around race created a perfect storm. “Those three things coming together at the same time revealed even more of what was under the hood,” says Williams. Globally, the World Health Organization found the pandemic sparked a 25% increase in anxiety and depression. 

Chronic anxiety is increasingly commonplace and even severe mental health issues have been on the rise for years. In the last two decades, suicide rates have risen 30%, and in 2020, 1.2 million Americans attempted suicide. Princeton researchers Angus Deaton and Anne Case found that “deaths of despair” - death by drug overdose, suicide, and alcoholism - have risen sharply, particularly for working class communities.  For the first time in the modern era, even before the pandemic, life expectancy rates started to decline. 

So what’s causing the growing mental health crisis? Many point to a loneliness epidemic. NPR reports 60% of Americans are lonely, which the pandemic perpetuated when workplaces and schools were shut down, impacting a generation of young people.  The inability to gather during COVID led to fewer in-person relationships, sapping people’s resilience to stress.

Many also point to heightened social tensions in the past two years. “In our culture we’ve seen increasing political and social polarization, increasing awareness of sexual assault and racial violence and inequity, and we’ve had two very polarizing election cycles,” says Warren Kinghorn, a psychiatrist and co-director of the Theology, Medicine and Culture program at Duke University. “Our experience has been that mental health clinicians are in high demand, especially since the pandemic.” Kinghorn notes colleges and universities are reporting a significant increase in demand for student mental health services.

Others point to another plague for young people: the rise of social media and smartphones. Not only has social media led to growing political division due to an inability to effectively communicate, but studies have also found that overuse of smartphones actually warps teenage brains, causing anxiety, depression, impulse control problems, and sleep disorders. Dr. Jean Twenge, author of the best-selling book iGen, has found that this generation of teens, when compared to teens in the 1970s, are less likely to go out with peers, more likely to say they feel left out or lonely, and more likely to report they don’t enjoy life. These rates went up markedly since 2012 - the first year smartphones hit the market.

It may still be that something is wrong with me. But if the statistics are right, I’m certainly not alone.

The church has been responding to mental health issues since its inception. The ancient Romans thought mental illness was caused by divine punishment, evil spirits, or an imbalance of the humors. Treatments ranged from philosophizing to bloodletting. Yet, noting Jesus’ compassion for the Gerasene demoniac (Mark 5:1-20, Matthew 8:28-34, Luke 8:26-39), early church fathers innovated in devising new methods of care for the poor and mentally ill. 

In 370, St. Basil opened a ptochotropeion, a hospital intended to serve the poor, indigent, and ill. In contrast to Greek hospitals of the time, who would only serve those who could pay, Basil offered care to all, founding what historians believe to be the first public hospital. 

The Medieval Church continued to innovate ways to serve the mentally ill. The 7th-Century Irish Saint Dymphna inspired the town of Geel, located in modern Belgium, to pioneer de-institutionalized care for the mentally ill, where patients would interact with townspeople during the daytime and sleep at the hospital at night. 

A century later, Father Joan Gilabert Jofré (1350-1417) was on his way to the Cathedral in Valencia for the first Sunday in Lent.  When he saw two men brutally attacking a “madman,” he rescued the victim, took him back to his convent, and preached a sermon about establishing an institution to care for the mentally ill. Afterwards, eleven patrons gathered to found arguably the first psychiatric care institution in Europe.

Indeed, anxiety and depression have been present throughout church history, including the 20th century. We’ve always had reasons to worry, whether they be the anthrax scare, 9/11, school shootings or the cultural turmoil of previous generations, like the Vietnam War or the Cuban Missile Crisis. Mental Health Awareness Month wasn’t founded in 2020; it has been observed in the US every May since 1949. “Cast your anxiety on him because he cares for you” is a comfort and mandate for all generations (1 Peter 5:7). 

And yet, something does seem different today. 

Many in the modern world experience unprecedented levels of wealth and physical comfort, but report being deeply unhappy - actually at the highest rate in the last 70 years, reports Gallup. The speed of technology and rapid cultural fragmentation are undoubtedly influencing us, especially young people. And the lines between mental illness and everyday experience seem to be blurring for millions. 

Can the church offer unique insight today for those battling anxiety, depression, and mental illness? Here’s what I’m learning from the best pastors, business leaders, psychiatrists, counselors, and spiritual directors addressing America’s mental health crisis.

“You have to name it to tame it,” says Steve Cuss, author of Managing Leadership Anxiety and Australian-born pastor, speaker and writer. Cuss’ journey as a hospital chaplain sparked an enduring interest in helping people notice and address anxiety. He helps people reduce anxiety by noticing how it shows up in everyday life and controlling “reactivity,” or the impulse to overreact when our bodies are in a fight-or-flight state. 

“Anxiety shrinks the power of the gospel because it presents a false gospel - one of self-reliance rather than reliance on God,” says Cuss. Anxiety may be universal, but he says learning to notice it in yourself and others is a first step toward becoming calm, aware, and present. 

A growing number of pastors have latched onto the concept of “non-anxious presence” to combat anxiety. Christian leaders like John Mark Comer, Mark Sayers, and Todd Bolsinger have all latched onto the idea in sermons and books. The term was popularized amongst clergy by the late Edwin Friedmann, a rabbi, family systems theorist, and author of books like A Failure of Nerve and Generation to Generation.  

One pathway to non-anxious presence is what the late Murray Bowen, the founder of family systems theory and professor of psychiatry at Georgetown University, called the “well-differentiated self.” The key is to strike the right balance between independence and connectedness, and thereby avoid becoming enmeshed with others or, conversely, emotionally cut off.

The well-differentiated leader, according to Friedman, is “someone who can be separate while still remaining connected, and therefore can maintain a modifying, non-anxious, and sometimes challenging presence.” The first step in addressing anxiety is found in taking responsibility for your own personal presence, and diffusing anxiety both internally as well as between others.

John Swinton, a Scottish theologian and minister specializing in faith and disability, believes the church offers a unique message from the broader culture. There’s a difference, he says, between inclusion and belonging. Inclusion, says Swinton, is just a technical requirement to not exclude, sustained by law and policy. “But to belong,” Swinton says, “you have to be missed. To belong you have to have a space where, when you’re not there, people long for you.” Churches offer this sense of family and connectedness that is often missed in secular culture. 

As stigma about sharing mental health challenges decreases, especially among Millennials and Gen Z, the number of church-focused resources on faith and mental health increases. Mental Health Grace Alliance, Fresh Hope for Mental Health, Pathways to Promise, and Kay Warren’s The Gospel and Mental Health all offer churches practical congregational-focused resources.  Sanctuary Mental Health Ministries offers a complete course for churches on topics such as mental health, stigma, recovery, companionship, caregiving, self-care and reflection. 

“Everyone is struggling with anxiety,” says Trisha Taylor, a psychotherapist and co-author of The Leader’s Journey: Answering the Call to Personal and Congregational Transformation. Taylor and her ministry partner Jim Herrington help congregational leaders increase their emotional intelligence and navigate conflict. She also encourages all Christians to normalize conversations about mental health. 

“First, let’s just talk about it. Second, we need to make a point to understand how emotions work. We need to learn from them rather than try to eliminate our negative emotions,” says Taylor, who believes that chronic anxiety is one major factor for why pastors leave their jobs. “Finally, anxiety is physiological. It’s our body’s natural response to stress. We often need to start by getting help for our bodies.”

For every 400 adults sitting in a congregation, on average 112 of them are struggling with chronic anxiety and 88 have symptoms of depressive disorder. For churches wondering how to restore community after the pandemic, here’s a place to start.

“In my way of thinking, the most important kind of medicine we can practice is the kind of medicine for those who otherwise wouldn’t otherwise receive care,” says Abraham Nussbaum, a professor of psychiatry at the University of Colorado School of Medicine who also works at Denver Health, a public safety net hospital. But because mental health services are often not covered by insurance - or are arbitrarily limited by most insurance plans – those who receive mental health care are predominantly wealthy and white. “This is a long-standing social disaster,” says Nussbaum.  

One solution to improve access to mental health care is the growing number of options provided through the workplace. 

It’s becoming more common for employers to offer mental health support to their employees as a workplace benefit. For example, workplace chaplaincy has been a life-line for many blue collar employees. Corporate Chaplains of America serves over 500,000 people and their families nationwide. Marketplace Chaplains employs 2,025 chaplains who serve at 5,461 locations and touch nearly 1.3 million employees, family members and patients. 

There are also a growing number of tech tools and communities available.  Stephen Hays, the founder of What If Ventures, a mental health venture capital firm, had an encounter with Jesus that freed him from a lifestyle of addiction. Today he invests in companies that move people from mental illness to mental wellness to mental performance. 

His research has found that the mental health ecosystem is vast. Companies such as Calm, Headspace, Mindstrong, and Pear Therapeutics have reached substantial size. Types of companies include digital therapeutics, telehealth, business-to-business benefit providers, peer-to-peer platforms, non-tech businesses, measurement and testing companies, and companies focusing on mental health, wellness and sleep.

Some Christian companies, such as Abide, a biblical medication and sleep App, have reached millions of people, as have devotional apps like Pray.com. Others are just launching into the space between mental health and soul care. William Norvell, a former partner at Sovereign's Capital, recently launched Paraclete, “The World’s First Soulcare Platform for the Workplace.” Norvell, who has also struggled with addiction, says, “In seasons of life where I had community I was always able to find pockets of light creeping into the darkness.” Paraclete offers businesses “on-demand, confidential conversations” through coaches who help employees with spiritual and emotional needs.

Whereas government leaders have focused largely on equitable access to public services and preventing more severe cases of mental health like suicide, workplaces are often becoming a primary place to advocate for and receive mental health care.

“It’s impossible to be spiritually mature by remaining emotionally immature.” This punchy subtitle comes from Pete Scazzero’s best-selling book Emotionally Healthy Spirituality. Scazzero, his protege Rich Villodas, author of The Deeply Formed Life, and a host of others are sounding the bell to dissolve the barriers between emotional and spiritual health. 

Brian Gray, the VP of Formation at Denver Institute for Faith & Work believes that growing anxiety calls for a deeper daily spirituality based on the classic spiritual disciplines. “It was the wise man who put Jesus’ words into practice that built his life on the rock,” referencing the Sermon on the Mount and Jesus’ call to practice, not just doctrine. Because work is a major source of anxiety for most people, a part of Gray’s work is forming leaders to live out the spiritual disciplines at work, further dissolving the barriers between daily life, emotional health and spiritual vibrancy. 

Others are drawing on medieval traditions like Ignatian spirituality to address anxiety and mental health issues that church leaders face. Patti Pierce, a former staff member at Menlo Church (formerly Menlo Presbyterian Church) started a nine-month program called SoulCare after seeing several colleagues fall to sexual temptation. The program, which introduces ministry leaders to practices on interior freedom, paying attention to the movements of the soul, and living a “with God” life, has spread to Orange County and Denver, under the name the Praxis. “I found that the movements of the Ignatian exercises, which are based in the life of Jesus,” says Pierce, “really helped people experience Jesus, not just have cognitive information about him.”

The renaissance of spiritual formation, led in the past generation by leading figures like Richard Foster and Dallas Willard, addressed the growing evangelical desire for a deeper spiritual life past preaching and singing on Sunday. Today, those threads are being rediscovered as a lifeline for those searching for more enduring answers than what popular psychology and self-help books can provide alone. 

Our hearts and souls, our emotions and our spiritual lives, are woven together and need to be addressed together. “Ignoring our emotions is turning our backs on reality,” says Scazzero. “Listening to our emotions ushers us into reality. And reality is where we meet God.”

In an age of increased anxiety and depression, where mental health struggles seem to be an almost universal experience, Christ uniquely offers the world neither distraction nor temporary remedies, but everlasting good news: “Peace I leave with you; my peace I give you. I do not give as the world gives. Do not let your hearts be troubled or afraid,”(John 14:27).  As a result, I believe the church's unique contribution lies at the intersection between therapy and spiritual formation, mental health resources and the life of God.

The church also uniquely offers an anchor for a tormented soul. “The deepest truth of who you are is that you are known and loved by God,” says Kinghorn to those struggling with chronic anxiety or mental illness. “And nothing about your situation can possibly change that.” 

As I think about my own anxiety, I still experience the tingling neck, racing heart, and shortness of breath. Honestly, it still feels like there’s something wrong with me. 

But I’m learning not to avoid it and flee. Instead, I try to exercise, do meaningful work, be patient with others, and open up to friends. I’m leaning into the slow disciplines of naming my feelings, practicing welcoming prayer, and seeking community. And when I need help, I now just ask for it. 

As I do, I’m reminded of a central truth of the historic Christian faith: we are not alone.