Anxiety, Phobias, and PTSD – Part 1

“The Scream” by Edvard Munch (1893), National Gallery, Norway (Accession No. NG.M.00939), Source WebMuseum (PD)

God is our refuge and strength,
A very present help in trouble.
Therefore we will not fear,
Even though the earth be removed,
And though the mountains be carried into the midst of the sea
…” (Ps. 46: 1-2).

Most people have experienced anxiety, in one situation or another.

The death of a loved one, divorce, serious illness, job loss, and moving are recognized as major stressors [1].  Other anxiety producing occasions include public speaking (always a favorite), waiting on approval for a mortgage, meeting a girlfriend’s parents for the first time, and having the in-laws over for Thanksgiving.

Then, of course, there are a host of phobias.  As a general rule narrowly focused, phobias are no small matter for those suffering from them.  Phobias include the fear of heights, spiders, snakes, birds, tight spaces, bridges, flying, and blood [2].

Purpose of Anxiety

Anxiety is intended to alert us to potential danger, and prepare the body for it.

A part of the brain called the amygdala releases neuro-transmitters that initiate the so called “fight of flight” response, producing the sensations of anxiety [3].  The heart rate climbs; blood rushes to the muscles; the lungs work harder.  This process is largely autonomic.  We have, by design, very limited control.

For most, the panic associated with stressful situations quickly subsides.  Shallow breathing deepens and slows.  Rapid heartbeat subsides.

The audience does or does not throw tomatoes.  The in-laws smile or grimace – it’s sometimes hard to tell the difference – and swallow their turkey.  We eventually get the mortgage.

In short, the body figures out we are going to survive.

Anxiety Disorders

About 40 million Americans, however, suffer from anxiety disorders [4].  Severe anxiety, whatever form it takes, is debilitating and can be crippling.


The severe anxiety resulting from traumas such war, rape, or child abuse is better known as Post-Traumatic Stress Disorder (PTSD) [5].

Whatever its origin, PTSD can cause recurrent, powerful, panic attacks, with or without an identifiable trigger.  These attacks are typically accompanied by heart palpitations, chest pain, the sensation of being smothered, and a feeling of dread.  A panic attack can, also, be experienced as paralysis and overwhelming fear.

PTSD sufferers may, in addition, experience flashbacks (vivid and disturbing memories, re-experienced involuntarily).  I have discussed these elsewhere [6].


Severe anxiety may present as obsessive compulsive disorder (OCD).  Sufferers are forced to lock and relock their doors, or repeat some other activity, to alleviate their anxiety.  Rituals become a way for sufferers to “control” the environment.

C. Worry

Another version of severe anxiety is characterized by exaggerated worries, for instance, about our security or that of loved ones.  Symptoms may include problems with sleep and/or concentration, headaches, shortness of breath, nausea, body aches, even hot flashes.

This is the kind of gnawing anxiety that may cause sufferers to seek out fortune tellers and the like.

D. Social Anxiety

Severe anxiety may, also, present as social anxiety.  In social anxiety, intense self-consciousness can cause sufferers to limit personal interaction, leading to a life of isolation.  Abuse victims are all too familiar with this flawed coping strategy.

Associated Illness

Depression, eating disorders (anorexia, bulimia), or drug addiction can be associated with anxiety disorders.  These add another layer of complexity.


Part of what is painful about severe anxiety is the criticism we direct at ourselves.  Not only are abuse victims overcome during a panic attack, we savage ourselves for that perceived “defect”.

Equating anxiety with cowardice, we criticize ourselves for weakness in the face of what may seem harmless to others.

This criticism is groundless for three basic reasons:

  • First, the response to threat is engineered into our bodies. The “fight or flight” response is wired into us.
  • Second, severe anxiety may have a genetic component.
  • Third, chronic stress (such as the abuse to which victims were subjected) produces changes in brain chemistry over which we have no control.

Anxiety is not, in other words, a character defect on our part.  Severe anxiety is simply evidence of what we were forced to endure.

In effect, our bodies concluded long ago that the environment was so hostile it would be safer to remain constantly on alert.  Not such an irrational conclusion, when you come to think about it.

[1]  HealthStatus, “Top 5 Stressful Situations”,

[2]  Fear Of, “Phobia List – The Ultimate List of Phobias and Fears”,

[3]  CalmClinic, “How the Amygdala Affects Anxiety” by Ryan Rivera and Rachel Ramos,

[4], “Symptoms of Severe Anxiety Disorder” by Linda Ray, 8/16/13,

[5], “Situations that Cause Anxiety” by Chris Sherwood, 1/11/16,

[6]  See, Falling Knives, Part 1; Kidnapped by Boko Haram; War Wounds; and Breached Defenses

Healthy strategies for dealing with anxiety will be discussed next week, in the conclusion of this series



Filed under Child Abuse, Christianity, Emotional Abuse, Neglect, Physical Abuse, Religion, Sexual Abuse, Violence Against Women

34 responses to “Anxiety, Phobias, and PTSD – Part 1

  1. As usual, Anna you have given us an excellent illustration of the severe impact abuse whether as the effects of war, or the effects of war within the home to name two “anxiety producing occasions” can affect the individual. Sadly and infuriatingly, anxiety disorders are often treated by the medical profession and those who have been fortunate not to have experienced this as unimportant and a lesser cousin to actual physical disorders (such as cancer). Extreme anxiety (unlike understandable and transient anxiety – if you’re waiting for a mortgage approval) just like cancer is a severe health condition which deserves to be treated with understanding and compassion for those who through no fault of their own have been inflicted with this.

    • Thank you, Marie. I heartily agree that anxiety should be taken seriously. Even without complicating factors, anxiety can be crippling. Like its “cousin” depression, anxiety can limit our activities and rob us of the joy of living.

  2. Thank you for sharing.. I have been fighting social anxiety for years..The anti depressant Zoloft actually caused the anxiety.. so I do not use any meds. I have faith that Jesus can bring wholeness. 🙂

    • My heart goes out to you, Mary Ann. ❤ You make an important point. Anti-depressants, though they are helpful to many, can have severe adverse effects.

    • So have I Mary Ann. It’s interesting but clearly not desirable that meds have caused this. I hope you are able to overcome this as it is crippling and prevents you from enjoying life to the full. My own situation differs in that my social anxiety is rooted in domestic violence and the effects of that is to change who you are as a person, becoming withdrawn and lacking in self-esteem. I battle this daily, but with support it is not the “war” it threatens to be, but a “skirmish” as I choose to view it now. I empathise with and wish you well.

      • Thank you for the encouragement.. I am sorry for what you have been through.. after the bruises fade, the scars are left behind.. I am happy you chose the best Counselor and Physician 🙂

      • You are more than welcome. I love to encourage others and I’m really good at that even though I say so myself. 🙂 Out of the abuse has come a wellspring of compassion. I’m so glad that we have chosen the best Counsellor and Physician and HE doesn’t charge! 🙂

  3. i keep going back to the scripture at the head of your post. and my question is, where was your god during your assault? why didn’t he stop it? why did he allow it to begin? why did he create the person or persons that assaulted you? not such an omnipotent being i think

    • This is the issue with which all victims struggle. It is all the more painful — for me, at any rate — knowing He is not impotent. Here are the answers I have found.

      First, this is a broken world. We know that; we’ve lived it; we see it everyday on the news, and all around us. God does not promise He will shelter us from all possible harm. He promises to walk with us through the storm.

      Second, evil exists in the world because choice exists. God could easily have created beings forced to love Him. Think of what North Korea’s Kim Jong Un requires of his subjects: robotic adoration. Instead, God allows us all to choose: good v. evil, right v. wrong. Many choose evil. It was not God who abused you. It was another human being who chose to become a monster. That you are irate at such despicable acts, that you are distressed by injustice, whether done to you or others, is a reflection of God’s own anger and His pain at the harm done to His children.

      Third, instead of abandoning us here, leaving us in the blood and the muck, God took on a human nature in the Person of Jesus Christ. Not only did He come to this fallen world, He died on the cross for all our sakes then rose from the dead to restore our hope. Not only is there darkness now. There is light. God did not have to do that. But restoring the ruptured relationship with mankind — the relationship destroyed by abuse, lynchings, concentration camps, and the rest — mattered to Him.

      Fourth, our suffering is not pointless or incidental. There is a spiritual war going on — a war between the forces of good and the forces of evil. No one gets to sit it out. We all have to take sides. Abuse victims are some of the casualties. We are, also, some of the heroes. Our suffering mirrors Christ’s own. That same suffering is transmuted to endurance, and endurance to character. We are, in other words, changed. That can involve great loss. But we will have a great reward.

      No argument, regardless how persuasive, will convince you. For answers of your own, you must take your questions to God. Take your anger, take your outrage, take your sorrow, take your doubts there. As an incest survivor and a former atheist, that is my advice.

      I wish you well. ❤

    • It is easy for us as humans to question God’s role in abuse. I understand your anger, your rage, your questioning the omnipotence of God. Your rage and anger if you try to think about it, should be directed at the/your abuser. They assaulted you. They allowed it to begin. They created the opportunity to assault you. They are human. Humans are imperfect, some more than others. There are often valid reasons for abusers to abuse others [reasons related to the abuse they may, themselves, have suffered] – this does not however excuse the abuse.

      I cannot give you the answers to your question about God’s failure to rescue you when you were in need of safety. No-one can but God Himself. The author of this post has written it in order to illustrate, highlight and show compassion for those suffering anxiety which is undoubtedly one of the effects of abusive behaviour towards another. It’s an excellent post. She is a tremendous writer and advocate for the abused, but even with all her skills, she is not able to answer your question either. She too is human. Her compassionate response to your understandable rage is admirable. She could not have attempted to try to answer some of your questions without guidance from God who if you believe that He is a God of Love, has used Anna as a vessel in which to convey His message that you should come directly to Him for answers. Who am I you might ask? I was a battered child. I was sexually abused. I am an incest survivor. I too in moments of rage asked God why he didn’t rescue me. He reached out to me, told me how much He loves me, provides healing (slow yes, but evident too) and asked me to let others know that He knows our suffering, He is there for us if we believe and trust in Him. So I try to do His bidding through my blog. I would not have been able to do this without God’s help. Through blogging I have met many wonderful people who speak about their experiences and who want to reach out and help others. God is a great healer and networker, I think you’ll find if you follow Anna’s advice. Go forward in peace.

  4. I think of how my mom would say to me, “You’re such a worry-wart!”, her tone harsh and critical, rather than taking time and heart to comfort me–and I wish that little me could have shouted the truth, that she’d made me fear her and everything in my world from Day 1…

    • It is so sad to think of that “little you” without comfort, Delyn. As children, we do not always have the words to express our needs. The baby cries. But if her cries go unanswered, at a certain point, they stop. What is left for the child to deal with are those unresolved feelings of hurt and loss, longing and loneliness.

      Our challenge, as adults, is to unearth those feelings; to comfort the children that we were. Comfort does exist — both from God and others with more compassion or understanding than some of the adults who raised us.

      Poets like you, Delyn, have a special gift for this. You access and convey those feelings through your work, something not as easy for the rest of the world. More than that, you transmute that pain into beauty. It is a pleasure and a privilege to know you. ❤

      • Oh myyyy, Anna–your words have blessed my day to overflowing. Thank you so much–and truly, it’s an honor to know YOU! ❤ If your ears were burning recently, I was telling my cousin about you–lots of acclamation 🙂

      • I don’t deserve such praise, Delyn. Really. But it makes me happy that God has used me to bless you. 🙂

      • Sometimes I think our main job as Christians should be less about evangelism, and more about lifting people up out of the world’s mire–surely encouragement might lead to people accepting God’s grace through Jesus, or strengthening their belief in Him when it ebbs ❤

      • Christians in this country spend alot of time tearing down those with opposing beliefs (and one another). We should certainly defend our faith. That can involve speaking truth in love. But the emphasis should be on love.

        The most powerful witness, in my opinion, is the way we live out our faith. How do we respond to suffering, our own and that of others (whether or not they share our beliefs)?

        There are so many people in need — physical and spiritual. Do we reach out in love, as the Good Samaritan did? That does not require us to compromise our values. It does though require us to set self-righteousness aside. Our goal, after all, is to imitate Christ…not the Pharisees.

        Sorry, Delyn. I carry my soapbox with me. ❤

      • Anna, I’m glad you carry your soapbox with you–more and more I’m doing the same 🙂 I hope my comment wasn’t misinterpreted–I’m in complete agreement with defending our Faith and speaking the Truth in Love ❤ I feel that my gift is "encouragement"…and maybe I have other gifts unrealized yet 🙂 After last Sunday's post, a couple people suggested I have a bit of the pastor/preacher in me… 🙂

      • It would not surprise me. 🙂

  5. My Dear Anna, In India, I find that many, many people have grounds for PTSD. Ill treatment in the family, sexual abuse, particularly the ‘rape culture,’ acid throwings, etc, leave their mark, though our military men are either taught to handle their stresses better, or just go berserk and shoot off half a dozen of their comrades.

    Having said that, in India, there are very few psychiatrists, and people do not think of going even to psychologists or counsellors, in numbers anyway.

    So what happens is that people just carry on, Stressed, for Sure, but just pulling on, and people don’t even notice these things.

    Maybe the Lesson that Life CAN be Lived. Just like that.

    This is not to decry the Excellent work You are doing, but overall, the West Does make too much of its Illnesses, and, it must be said, at least India makes too little of it.

    Maybe it reflects in the Medal tallies at the Olympics and Our Poor performance in Sports in general!

    There, go ahead and make Head and Tail of that! 🙂

    Love and Regards.

    • I always value your insights, Swami. 🙂 It is a profound observation that the pain of abuse and sexual violence is expressed in many ways. It impacts society directly and indirectly, just as the after effects of slavery continue to impact society. We see evidence of the sin nature of mankind everywhere. Not until the Savior returns will that truly change.

      Love and Regards,

      A. ❤

      • Thank You, my Dear Anna! Your Views and Your comments are Profound as well! Thank You.

        Yes, for this world of sin, MARANATHA seems to be the Only last word. Maranatha, Come, O Christ the Lord. And Come Quickly, Please.

        Love and Regards to You and Yours. 🙂

  6. This was awesome insight. Thank you, Anna!!


    • Thank you, David. You are too kind. I hope that that the information is of some help to others. As you wrote recently, “I often am in tears (as now) at the thought of what He poured into me actually making a difference.”


  7. Thank you so much for making that additional point [in brackets] in my response to nowamfoundatlast, Anna. It is always helpful to clarify a point and you have done that beautifully. So beautifully, in fact, that I had almost considered I had written it myself. It was you wasn’t it? 🙂 x

    • My remark. I apologize for inserting myself. I was concerned readers might mistakenly infer you were suggesting fault on the part of victims. Knowing you as I do, it was clear to me you would never imply such a thing.

      • Dear Anna, you were absolutely right to clarify the point. I don’t want to hear another word about apologies. 🙂 I should really have been a little more careful in my wording. So good of you to have picked up on the implications.

  8. Shattered in Him

    All of the above. Wow. Some of this is so hard to read, because it describes me. But, I am also able to feel so much less alone.

    • Truly, I feel for you. ❤ Isolation is terribly painful, and all too common w/ abuse victims. Of course, anxiety is not confined to abuse victims. The most prevalent mental health issue in the United States, severe anxiety in one form or another impacts some 40 million adults, only a small percentage of whom seek treatment. Reaching out is the first step.

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