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Breaking Up With Anxiety — With Dr. Amanda Porter

Many Christians question whether anxiety is a sin and wonder why it often persists despite prayer and faith. Today’s guest helps us understand anxiety as a natural, biological emotion that can help free us from shame and stigmas and help us move forward and receive help. Dr. Amanda Porter is an author, psychiatric nurse practitioner, and anxiety sufferer who has lived at the intersection of mental health and faith for many years. As one of the 40 million adults in the U.S. who struggle with anxiety, Dr. Porter shares a message of hope that feelings of anxiety can be managed through our thoughts, behaviors, and actions and with professional help when needed. If you have grown weary in your search for relief, may this conversation help you push forward, trust God, and find greater healing and freedom.

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Breaking Up With Anxiety — With Dr. Amanda Porter

I want to ask you a question. Would you consider yourself a worrier or an anxious person? Did you know that anxiety is the most common mental illness diagnosis? We have a lot to be concerned about in this broken world. We face the threat of illness, loss of loved ones, broken dreams, tragedy, and natural disasters. Let’s be honest. It can be so terrifying at times. Look at the last few years, but here we are. We are still breathing. We can all experience anxiety to some degree in our lives.

Through the power of God, renewed thinking, and professional help when needed, we can have hope and live victoriously. Our guest is one of the 40 million adults in the US who struggle with anxiety. She’s also a psychiatric nurse practitioner with triple board certifications in internal medicine, psychiatry, and mental health addiction. Amanda Porter has been living at the intersection of mental health and faith for many years. She is a writer and a speaker.

She practices at the nationally renowned Lindner Center of HOPE in Mason, Ohio. She serves as a clinical preceptor and teaches community classes on mental health, faith and anxiety. Amanda lives outside Cincinnati. She is the author of the new devotional, Dear Anxiety, Let’s Break Up: 40 Devotions to Conquer Worry and Anxiety. Amanda, welcome to our community here at the show. How are you?

I am so great. Thank you for having me, Allie.

I love that through your new book, you offer education, encouragement, and spiritual counsel to those of us who battle anxieties. First, what is anxiety? We hear the term used all the time throughout our days and conversations, “I’m anxious about this.” What is anxiety? What does the spectrum from mild to severe symptoms look like?

I talk a lot about this in the book. One of my big motivations for writing the book was I wanted to educate. A lot of people throw around the word anxiety and might not even understand exactly what it is. From a clinical standpoint, I would define anxiety as the feeling of fear, worry or dread. Above all else, anxiety is an emotion. It’s a universal human experience. We are all wired up with emotions. This is the way that God created us. Anxiety is one of those emotions.

Interestingly, I try to coach my patients on this. I like to define anxiety as data. Anxiety gives us information about our surroundings, and whether we are or are not in some sort of true danger. Ultimately, because anxiety is an emotion, it drives our behavior, decisions and relationships. That’s why it’s ultra-important for all of us to get a handle on our emotional regulation and keep anxiety to a degree that is manageable.

WOMA Dr. Amanda Porter | Anxiety

Anxiety: Anxiety is an emotion that drives our behavior, decisions, and relationships. And that’s why we all need to get a handle on our emotional regulation and keep anxiety to the degree that it’s manageable.

We’re humans. This is the way God has wired us up. A certain amount of anxiety is completely normal. We were all instilled with this fight or flight system or response. Feeling anxious is normal but there does come a day for some people, myself included, when anxiety crosses a line. It’s no longer a normative type of anxiety. It then becomes disordered anxiety to the degree where your anxiety is affecting your ability to function.

It’s so incapacitating for some people. They are so overwhelmed with their anxiety. They can’t get out of bed. They stop sleeping. It affects their relationships and ability to hold down a job. They cannot care for themselves. Some people even to a very extreme degree might have suicidal thinking with their anxiety. There is a spectrum there. The bottom line is anxiety is a normal thing for all humans. It’s very treatable for people who are willing to speak up and get help.

Thank you so much for bringing clarity to that. I love how you say that it’s an emotion and it can provide us with data. That’s informative. Can you speak to the interplay of anxiety and depression, and how they can often go hand in hand? Some people deal with both simultaneously, or maybe anxiety comes first, followed by depression. I know that’s my story. Can you speak into that a little bit for us?

I always like to say that anxiety and depression are two sides of the same coin. It’s very rarely that a person is going to experience one without the other. What I typically see happen in practice is that anxiety comes first. Maybe it is normative anxiety. Maybe it is situational anxiety that evolves into something long-lasting and chronic. As a result, the person feels completely burdened and overwhelmed. That leads to depression. It’s this feeling of helplessness and hopelessness, “Things are never going to change and get any better. What’s wrong with me? Why can’t I deal with this?” All these things come to a head and result in some depressive episodes. It’s super common.

I appreciate this quote in your book. You say, “It’s okay to be overwhelmed, angry or despondent. We are humans with human emotions. We are all doing the best we can. It’s okay to have big feelings. It’s good to bring those feelings to God. He can handle our feelings of anger, sadness and anxiety. He does not judge us or sort us into categories of good or bad based on our emotions. However turbulent our emotions may be, they do not cause Him to love us any less. His love for us is unchanging.” One thing I appreciate that you write about in your book is reminding us that anxiety is not a sin. Just as joy, which is also an emotion, is not a sin. Can you talk a little bit more about that?

It’s always amazing to me how positive emotions like joy, happiness or love get labeled as good emotions. Other things like anger, anxiety or envy get labeled as bad emotions. I don’t see where along the line things got separated into these labels or headings of good and bad. Emotions are emotions. God has instilled all of these within us. We all have the capability to play any of these emotions at any time. There’s no good emotion and no bad emotion.

What we choose to do with those emotions can lead to acting out in some way. That can lead to some poor decision-making, which certainly can lead to some sinful activity. The emotion in and of itself is not a sin. There is a lot of toxic theology out there that preaches that anxiety is a sin. Another big reason that I wanted to write this book was to speak to that tension that Christians, in particular, feel when they’re dealing with their out-of-control emotions where their anxiety is off the charts.

From a clinical standpoint, anxiety is the feeling of fear, worry, or dread, and anxiety is above all else and emotion. It's a universal human experience. Click To Tweet

Oftentimes, a Christian will turn to their faith community for help. We’re taught to lean on one another. What I see happen a lot in practice is somebody who’s investing and participating in their faith community and struggling with their anxiety goes to someone for help. They are met with things like, “You need to pray more, believe harder or have more faith.”

It is important to pray, immerse yourself in scripture, and have a lot of faith, but that’s such a reductionist way of treating someone’s anxiety disorder. That’s just one small piece of the puzzle. We should in no way be over-spiritualizing mental health concerns. That will ultimately only result in heaping shame, blame and guilt on this person who’s already struggling. I could not disagree more with this statement that anxiety is a sin. According to me, it is not.

I appreciate how authentic and honest you are about your struggle with anxiety. I imagine for some people, it could be tempting. Once you have the degree and the practice, you bury your experiences in the past and do not open up about them. There’s something so special about being a wounded healer. Will you share with us a bit about your own battle with anxiety? How have you seen God in the ether?

I started struggling with anxiety right after I started having kids. My oldest is seventeen. I am no stranger to dealing with this anxiety disorder. I used to think that once I got into this particular line of work, I shouldn’t be talking a lot about my personal struggles with anxiety. I’m supposed to be the expert or the person that people come to for answers. I’m supposed to have my life together.

I felt like it was going to take away from my credibility if I were to be honest with some of my struggles. I kept it inside. I didn’t speak about this thing publicly for a very long time up until a few years ago when I started teaching some workshops through my church. I started sharing these vulnerable parts of myself. I am met with nothing but gratitude, kindness and graciousness.

Now I understand that rather than my anxiety disorder taking away from my credibility, it gives me a little more credibility. People are very interested in hearing from someone who has walked what they have walked through and has come out on the other side of it. It has been a pretty cool thing to witness all of the grace and kindness that I’ve experienced along the way.

Thank you for sharing. I’m always grateful for people who are authentic. It doesn’t mean that we have to share every detail of our struggle. We can have wisdom about what we share and who we share it with. It does give you more credibility. I have spoken a lot about my experiences with depression. One thing I haven’t shared much is my experience with anxiety that preceded my major depressive episode at the age of eighteen. It was terrible.

WOMA Dr. Amanda Porter | Anxiety

Anxiety: A certain amount of anxiety is completely normal. But there does come a day when anxiety crosses a line for some people, and it’s no longer a normative type of anxiety. It then becomes disordered anxiety.

It was the spring of my senior year. I was trying to do big things. I got this hostess job at this popular restaurant. I wanted to be a waitress so I can make money and save it for college. Anxiety came on me. It was terrifying and debilitating. I had trouble breathing. I was so forgetful at work. I got a lot of social anxiety. I remember sitting in my car and being like, “What is wrong with me? I’m falling apart.” It was terrifying and awful. Unfortunately, major depression followed that bout with anxiety.

In college too, I started getting these unexplained panic attacks as I was falling asleep. College is so much stress. You’re under a lot of stress. It’s a new environment. There’s so much going on. My brother was in the military on a submarine in the middle of the ocean. I had all of these things I was worried about. I thought I was dying as this would come on to me. My body couldn’t move. I couldn’t breathe. I remember waking up crying and going to my resident advisor, “I don’t know what’s wrong with me.”

I want to speak to anyone who is suffering from moderate to severe anxiety. Remember that this isn’t your fault. It’s not because you’re not a strong enough Christian or you don’t have enough Bible verses memorized. There’s a physiology to our brain. It’s okay to ask for help, to reach out, and to remember that you’re not the only one. Remember that anxiety is the most common mental health condition. What do you want to say to someone who may believe that medication for anxiety is unnecessary? Can you speak to that?

It’s a big decision to take medication for your anxiety. It’s an even bigger decision when you’re a Christian and you’re deciding to take medication for your anxiety because this goes back to that toxic theology that we were talking about before. Somewhere along the lines, it was drilled into us Christians that if we take a medication, that means that we must not be trusting God fully for our healing. I see medication as one tool in the toolbox or one thing that God has put on this Earth that he has created for us to enable us to gain further control over anxiety.

I take medication. Lots of members of my family take medication. It works well. I’m always reminded of the story in the Book of John, Chapter 4 where Jesus is healing the blind man. He heals this man in a very interesting way. He uses a tool. Instead of speaking this man’s healing into existence, which we all know that he’s capable of doing, he chose to instead bend down to the ground, gather a little bit of dirt in the palm of his hand, and spit into it. He mixes it up and makes this muddy paste.

We have all heard this story. He places this paste on the man’s eyes and says, “You are healed.” This is how he chooses to heal this man. He uses this tool. In modern times, I see medication as being the tool that Christ has given us to help us heal from our anxiety. It’s one tool in the toolbox. There are lots of different treatment modalities out there. Medication doesn’t work for everybody, but it does work for a lot of people if they’re able and willing to give it a chance.

When we begin to understand anxiety for what it is as a natural biological emotion, how does this help free us from shame and dispel stigmas? What should we remember about our emotions?

Anxiety is normal for all humans. And it’s very treatable for people willing to speak up and get help. Click To Tweet

We can cement it in our minds that anxiety is a normative process and a universal human experience. They can talk about it and share it with others. This goes back to being willing to take a risk and be vulnerable with somebody else. The things that we keep inside and don’t share with others, their power builds over time. All of these thoughts that I chose to withhold over time had so much power over me.

It was only when I chose to be vulnerable and share my struggles and my thoughts with the people around me that I felt like I was the one in control. I had the power. If somebody is willing to put themselves out there and admit that they are struggling with anxiety to someone that they love and trust, chances are that person is then going to say, “Me too. I struggled with that as well.” That’s something that the two of you can work on together.

Anytime we can bring things into the light. You have to have wisdom about who you’re sharing things with.

Check your boundaries on that. Don’t go sharing with everybody.

Maybe don’t announce everything in a social media post. Be intentional about who you’re sharing with and where you’re sharing. When someone opens up about their story, it takes the shame away and makes us feel less alone. There’s so much healing in the light. If you’re reading and you feel like anxiety is becoming a problem in your life, it’s becoming harder to function, and maybe you’ve been trying so hard to press forward day by day and things aren’t changing, and you haven’t shared this with anyone, we want to encourage you to think and pray about who you can share this with, and to know that it is brave to open up and seek professional help. You are strong for doing that.

I want to encourage that. You said, “Medication is a tool.” I agree. It has been a tool that God helped heal me in my life and help me thrive even though I have a mental health diagnosis. It’s one of the tools. Even for me in my life, I use many tools. Let’s talk about more of these tools in the toolbox. What are some practices that help ease anxiety? What has helped you most personally?

For me, medication has probably been the most helpful tool in combination with some therapy. If any of your readers are thinking, “I have had it with this anxiety. I’m finally going to get this under control,” the two biggest things to work on are going to be self-care and therapy. To be very clear, when I say self-care, I mean getting back to the basics. It’s things like making sure that you’re hydrating well, feeding yourself well, getting enough sleep, and getting in some body work every day.

WOMA Dr. Amanda Porter | Anxiety

Anxiety: Anxiety and depression are two sides of the same coin. So very rarely is a person going to experience one without the other. And what I typically see happen in practice is that anxiety just comes first.

The next tier of self-care would be things like developing a practice of gratitude, working on your self-compassion, developing a mindfulness practice, setting those boundaries or limits, making sure you have structure to your day, and incorporating some soul work into your daily life. It boils down to self-care and therapy. These things certainly can be done on your own, but if you have a qualified and compassionate therapist who can help you along this journey, then you’re going to reach your goal much faster than if you try to do it alone.

Can you talk for a moment about social media and anxiety?

That’s something that I talk a lot about in the book in this context of checking your input. A lot of us are inundated, not just from social media, but from a lot of different sources. We’re inundated with images, comparisons, ideas and notions that everyone else has the best life and we’re the only ones who are struggling. There is plenty to get envious over.

There are plenty of materials to work with in terms of playing that comparison game or comparing yourself to someone else on Instagram, Pinterest or whatever your favorite site might be. While I do acknowledge that social media has its time and place, some pretty firm boundaries should be set around how often you use it and when and where you use it. I like to use this metaphor when I’m talking about social media. Social media is like wildfire.

If you use it correctly and responsibly, you can use wildfire to cook yourself a warm meal. However, if you’re using social media in a reckless or irresponsible way, wildfire will burn your house down. I like to remind myself of that metaphor whenever I find myself doom scrolling or comparing myself on Instagram. I need to tighten things up and check my input. What am I feeding my heart, my mind, and my soul with these images? It’s something to think about.

Having healthy boundaries can protect our minds and well-being. I’ve realized me being more of a sensitive person to input and things like news and social media. I have decided to live with stricter boundaries probably than the average person with social media. It has protected me. It’s protecting my well-being. If you’re sensing that social media is contributing to your anxiety, there are a couple of things you can try. Maybe take a fast for a week or 30 days if you want to have a more balanced relationship with it.

One thing I do is I don’t keep social media apps on my phone. If I need to post something, I’ll download that app from the App Store. It takes five seconds. I’ll post and delete it. On my computer, I’ll engage with friends and comment on their photos. It keeps me from endlessly scrolling, going into the explore section, and looking at the lives of strangers that have everything that I don’t have. God can give us wisdom. I love that verse. It says, “Ask for wisdom and God will give it to you generously.”

It's okay to be overwhelmed, angry, or despondent. We are humans with human emotions, and we are all doing our best. It's okay to have big feelings, and bringing those feelings to God. God is good. He can handle our feelings of anger, sadness, and… Click To Tweet

We can’t even apply that to our relationship with social media. God give me wisdom with this because it’s not going away. It’s a huge part of our culture. It’s the way we connect with people and stay in touch with friends. We don’t have to use it the way the majority of people use it. We don’t have to be on it five hours a day. Thank you so much for offering that input. I love your analogy of the wildfire. We have talked a little bit about social media here. What are some other anxiety-provoking things in our world? What are some other steps we can take to minimize them in our lives?

Relationships are a big source of anxiety for a lot of people. Maybe it’s relationships with your peers, coworkers, parents or kids. For me, kids are a big stressor. The older my kids get, the less influence I have over them, and the more I feel like I’m losing control. I find that my level of anxiety will rise as my sense of control decreases. Those two things are inversely related.

Far and away, relationships are hugely anxiety-provoking for a lot of people. One thing that I found for me to help deal with relationships, in general, is working on my communication skills, learning how to express myself very clearly and calmly, and then learning how to be a good listener. It’s part of the human experience. We all are walking around with these cognitive distortions. We don’t even realize it.

We all have this lens that we’re looking at the world through and interpreting the world through. We assume that everyone else is equipped with the same lens that we are but they’re not. It’s easy to get offended, upset or frustrated with somebody, but the reality is that we all think, behave and communicate differently. It’s important to have that practice of learning how to be a good and clear communicator.

I want to ask you about something called CBT or Cognitive Behavioral Therapy. We know that verse in the Bible, “Be transformed by the renewing of your mind.” Science backs this verse up because neuroplasticity or the changing of our neural pathways is a real thing. We can create new neural pathways. You’re the expert. You can speak into that a little more than I can.

Have you seen Cognitive Behavioral Therapy to be helpful for people and give them practical ways to change the way that they think? What triggered that question is when you said distortions. Cognitive Behavioral Therapy identifies ten major cognitive distortions. I don’t want to walk away from this conversation without talking about the power of renewing our minds, and what that does for us to fight anxiety and depression.

It’s interesting you bring up that verse. I have a few tattoos, I’ll be honest. I have a small symbol tattooed on the back of my neck that represents the word transform because of this verse in Romans and because I know how valuable and essential it is. When you move through this world, you have to have the right lens that you’re interpreting things through. We need to understand the way that God sees us and the world, and bring that perspective to ourselves.

WOMA Dr. Amanda Porter | Anxiety

Anxiety: We all can play any of these emotions at any time. There’s no good emotion and no bad emotion. Now what we choose to do with those emotions that can lead to acting out in some way. But the emotion in and of itself is not the sin.

CBT is one of the most used forms of therapy. CBT stands for Cognitive Behavioral Therapy. The premise behind this is that if you change the way you think, then you will change the way that you feel. If you are struggling with a certain trigger or a stressor, if you are able to shift the way that you think or your perspective on this, then you will change the way that you feel. In turn, your anxiety levels would decrease. CBT is a great treatment modality.

It can be tricky sometimes because you often don’t see results very quickly with CBT. It takes a lot of inner work and investment of time. It also takes a great therapist. Finding a great therapist can be hard. With CBT, results are sometimes slow going or slow coming for people. Another effective tool is DBT. DBT stands for Dialectical Behavioral Therapy. That’s a little bit different from CBT. With DBT, you are equipped with skills that you can use at the moment when you’re feeling very overwhelmed.

These are on-the-spot things that you can utilize at the moment when you’re feeling like you’re spinning into some shame spiral, or some panic attack is coming on and you feel like you’re losing control. You can try some of these DBT skills. These are things like mindfulness and learning good communication. It has been a useful tool for me. Those are the two primary treatment modalities and therapies. There are dozens more to choose from, but CBT and DBT are going to be the most accessible for most people.

Thank you for sharing. I want to share something I use in my life. It’s a scripture meditation app. It’s called Abide. I get a subscription. It’s maybe $50 for the year. I got a notice. I’ve done 230 meditations in the last few years. It helps me. There are all kinds of topics if you’re looking for another tangible thing or resource to help you. Amanda, I want to close by asking you this question we ask all of our guests. If you could go back and give your younger self some words of wisdom, how old would she be and what would you say to her?

A difficult time of life for me was when my kids were small. My kids are much older now. Those days are very far behind me. I have a 17-year-old son and a 13-year-old daughter. When they’re very young, it’s easy to feel like you’re drowning. When you’re in the trenches of young motherhood, it’s easy to feel overwhelmed. You feel like you’re alone and you’re the only one struggling. It’s hard to reach out and ask for help.

If I had to give myself a piece of advice, I would go back to my early to mid-twenties and say to myself, “It’s not always going to be like this.” Sometimes when we’re in the thick of things and we’re feeling an emotion so strongly, it’s also easy to buy into the lie that things are never going to change, but that is a lie. That’s not the truth. I would remind myself way back then to the 25-year-old Amanda that it’s not always going to be this way.

Thank you so much for sharing. Amanda, congratulations again. Friends, if you want to get a copy of Amanda’s book, I highly recommend it. I’ve been enjoying reading through it. For anyone who does battle anxiety, this is a great resource. The title is Dear Anxiety, Let’s Break Up: 40 Devotions to Conquer Worry and Anxiety. Amanda, thank you so much for being with us.

It’s my pleasure, Allie. This is fun.

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About Dr. Amanda Porter

WOMA Dr. Amanda Porter | AnxietyAs a mental health expert, an anxiety sufferer, and a pastor’s wife, Amanda Porter has been living at the intersection of mental health and faith for many years. She is a writer, speaker, and psychiatric nurse practitioner with triple-board certifications in internal medicine, psychiatry/mental health, and addiction. Amanda practices at the nationally renowned Lindner Center of HOPE in Mason, Ohio. She volunteers as a clinical preceptor and teaches community classes on mental health, faith, and anxiety. Amanda lives outside Cincinnati with her husband, Joe, two kids, a dog named Marley, and a cat, Izzy.