One of the more common questions we get asked when helping those with fear, worry, and anxiety is whether they should use anti-anxiety medication. At BCC, we often counsel those who have already been prescribed by a medical doctor and it is estimated that 8% percent of the US Population  takes some sort of anti-anxiety medicine. How should we think through the issues of anxiety medication?
You may have wondered about these questions that we hear frequently:
- Do anxiety medicines work effectively?
- What are the side effects?
- What is the relapse rate?
- Is there a more natural medicine approach?
- Is it sinful to try psychiatric medication?
- What else besides medication might relieve anxiety?
- Would EMDR help my anxiety?
- Would medical marijuana help with my anxiety?
When approaching the question of medication, we walk our counselees through three questions that help clarify whether anxiety medicines would be an appropriate choice. In the first half of this article, I am going to present the short answers to the three questions. In part two of this article, I will expand on my answers and give a fuller explanation.
A Few Important Disclaimers:
1. We don’t discuss specific medicine brands because psychiatric medicines are constantly changing or rebranding, and new medicines are being developed and marketed on a regular basis. We will discuss the major categories of medicine and how they work.
2. We don’t discuss your experience with anti-anxiety medication, because we readily admit that our counselors have counseled many who would say they benefited from anxiety medicine and others who say they saw little benefit or even worsening. Your experience might be normal to you, but it was only your experience, whether it was helpful or disappointing. We don’t assume that all people respond the same to medication or that all medicines obtain the same results for everyone.
3. Warning: If you are currently taking any psychiatric medicine, the only safe way to stop taking them is with your doctors help. At BCC, our counselors will insist you develop a plan with your doctor if you wish to discontinue medicines and we will stop counseling with those who disregard the advice of their doctors in weaning off medicines. You can cause physical harm to yourself by foolishly quitting medicines cold turkey. We often respond to those frustrated with their psychiatric medicines, “prove you can be responsible on them if you desire to come off them.” Listen to your doctor!
3 Questions: The Short Answer about Anti-Anxiety Medication
Is it wrong?
No, taking anti-anxiety medicines is not wrong because you are doing it to find relief and the ability to function at an improved level. This is a worthwhile goal and morally acceptable.
Is it helpful?
Sometimes it helps and sometimes it hurts. Pharmaceutical effectiveness studies, personal experiences, and more natural alternatives to medicine play into any comprehensive answer to that question. Furthermore, taking medicine might distract you from dealing with underlying struggles/emotions that would help you more long term than medicine.
Is it necessary?
Even though it may help you short-term, rarely is anti-anxiety medication advisable as a long-term approach to dealing with anxiety. Life may go better in the short term on meds but working through the underlying emotions with a wise counselor has repeatedly been demonstrated to be a better long-term approach to anxiety. Furthermore, from a spiritual perspective, God has given you many resources to battle effectively against anxiety. What we worry about reveals what our hearts love. God wants to rule in our hearts, for our good and his glory. Learning to think differently about our struggles, with God’s purposes in view, has a major impact on our anxious thinking.
3 Longer Answers about Anti-Anxiety Medication
How Anti-Anxiety Medication Works
There are several different classes of anti-anxiety medicine:
- Benzodiazepines for anxiety work by slowing down the nervous system essentially muting the intense feelings of anxiety.
- SSRIs, most commonly used for depression treatment are often used in longer-term anxiety and work by increasing serotonin available to the brain.
- Buspirone works by increasing serotonin to the brain.
- Beta-Blockers work by blocking norepinephrine, which is often produced in situations where anxiety is likely to be produced like flying or public speaking.
These are the four major categories of medicines that are used to treat anxiety, and all of them have side effects. Doing a simple web search on WebMD or helpguide.org can familiarize yourself with side effects and normal usage patterns of each of these categories. If you are considering medication, you would be smart to do some research with a trusted friend first.
It’s interesting to note that each of these types of medicine works to increase or decrease a normal biological process regarding how the body responds to fearful, worry, or anxious thought processes. God designed our bodies so that fearful thoughts are felt in our bodies and they produce a chemical reaction that energizes us. Many courageous acts are energized by responding to fearful thoughts. Most anti-anxiety medication works by slowing down the physical process that is biologically intended but excessively felt by some. Since anxiety often feels like rapid, out-of-control thinking, it’s no wonder that many seem to find relief with medical interventions to slow their rapid thinking and the body’s natural response of energy.
It is also interesting to note that nobody claims that medicine will actually change worried or anxious thought patterns. At best, they change the way the body responds to these thoughts. Medicine can change the way anxiety feels, but it can’t actually address the object of your fear. One of the things we all have to realize is that the Creator God designed our bodies to feel fear and for our bodies to respond with energy to put us into motion. Simply muting the intensity of those bodily reactions and feelings by medically suppressing the natural chemical reactions in otherwise healthy bodies doesn’t solve one’s anxious thought patterns. We don’t fear death, flying, relational confrontation, or financial struggles any less; it’s just these things don’t create the same physical response or intensity of anxious feelings any longer.
Question #1 – Is it Wrong?
It is not wrong to want to feel better or want the restless sleep, pounding chest, or profuse sweating to go away. Since anti-anxiety medication simply change the way anxiety feels, those who say that taking medicine to feel better is sinful, would have to apply that principle to virtually every medicine choice, even pain medicine. No doctor would responsibly do that, even though the questions surrounding the “opioid crisis” and similar critiques of psychiatric medicine have some uncanny similarities to promises of psychiatric medicine and are thought to accidentally create chemical dependency as well. 
Undoubtedly, alcohol, THC, or sugar consumption is also reported to make people feel better in the short term. Additionally, vigorous exercise, vacations, or sleeping in also lead to mood elevation and a more relaxed outlook on life. Feeling good is not really the issue. While it is not wrong to take medicine to feel better, it is naïve to think that medicine alone is the answer that brings those who worry to find significant progress and life change. From a Biblical perspective, psychiatric medicine is a Christian liberty issue, not one that should be condemned but one where loving pastoral caution is certainly warranted.
Question #2 – Is it Helpful?
Consider how many physicians view anti-anxiety medication: “They are also not a cure. In fact, there are many questions about their long-term effectiveness. According to the American Academy of Family Physicians, benzodiazepines lose their therapeutic anti-anxiety effect after 4 to 6 months of regular use. And a recent analysis reported in JAMA Psychiatry found that the effectiveness of SSRIs in treating anxiety has been overestimated, and in some cases is no better than placebo.” To say that the science of anti-anxiety medication is unsettled is certainly a fair statement.
Our BCC counselors’ experience with anti-anxiety medication would reflect the cautionary note from the physicians listed above. Without a doubt, you can find articles “for” or “against” anti-anxiety medication as helpful but there is not a certainty with their effectiveness and often-times studies have revealed that counseling alone performs better than medicine in treating anxiety disorders. However, all of our counselors have experienced counseling with someone so anxious that they seemed unable to be counseled without some medical intervention first, but this would not be typical. We all agree that “everyone needs counseling, a few need medicine.”
We have found that trusting medicine to solve anxiety can actually distract us from unpacking the deeper struggles that always seem to accompany severely anxious thinking. If God gave us anxious feelings as a reminder that he is in control, reminding us to trust him and worship him, then muting our anxious feelings to distract our anxious thoughts might actually be counterproductive to solving the root issues in the long run. If your goal is to feel, function, and cope better in the short term, meds may be helpful. However, addressing the underlying emotions and fearful thought patterns is still necessary for better long-term results. In addition, it is always helpful to address the spiritual component of our anxious thought patterns. We need to be reminded often of II Timothy 1:7 – “God did not give us a spirit of fear, but of power, love, and a sound mind.” If we believe that verse, we all have work to do in our anxious moments to better understand how God would have us live in light of the resources He has given us to feel, function, and cope more effectively with the trials He allows into our life.
Question # 3 – Is it Necessary?
To answer this question, we have to examine two key disciplines: science and doctrine. For instance, research about anxiety often describes how intense anxiety hurts the body/brain and affects our social/interpersonal relationships. Regarding doctrine, multiple scriptures detail various healthy responses to our anxiety. For instance, I Peter 5:7–9 reminds us of the importance of thinking through anxiety, that we need to draw near to God to have the strength to overcome the attacks of evil, and that we have the assurance of complete victory because of the finished work of Christ and his faithfulness to complete that work in us. I John 4:18 teaches about loving others as we ought rather than allowing fear to paralyze us. Jesus taught in Matthew 6 that worry does nothing to actually solve the problem we are feeling so anxious about anyway. Doctrine and science both make a claim to change our experience during anxiety, but which one is more powerful? Are they both necessary? What happens if you try medicine/physical remedies without doctrine or you try doctrine without medicine/physical remedies?
If living with perpetual fear, anxiety, and worry damages the body, relationships, and spiritual vitality, why would we not want a medicine that could stop this kind of damage?
While that is a good question, it is an incomplete one as well. If there were no other means to address anxiety besides medicine, it would be a more important question, but scientifically that is not the case. To prove this point, I want you to consider recent studies regarding the treatment of those with anxiety disorders. I have provided the links in the footnotes if you want to read each source further. You should know, too, that many seemingly contradictory studies surround the treatment of anxiety. It is not settled science at this point.
Strategies for Fighting Anxiety Well
Natural Strategies for Treating Anxiety (for science source study see footnotes)
- Regular exercise usually outperforms medicine as a treatment for anxiety.
- Regular sleep almost always outperforms medicine as a treatment for anxiety.
- Probiotic/Gut Health is an important health consideration affecting anxiety.
- Proper Nutrition/Diet is important to manage your anxiety.
- Herbal Supplements show promises in helping affecting anxiety.
Counseling Strategies for Treating Anxiety
- Counseling alone is a more effective treatment for anxiety than medicine. – Until recently, a combination of cognitive therapy and medication was thought to be the most effective treatment for these patients. The researchers’ results, which have just been published in the journal Psychotherapy and Psychosomatics, show that cognitive therapy on its own has a much better effect in the long term than just drugs or a combination of the two.
- Taking medicine alone is often counter-productive to lasting change. – “Patients often rely more on the medication and don’t place as much importance on therapy. They think it’s the drugs that will make them healthier, and they become dependent on something external rather than learning to regulate themselves. So the medication camouflages a very important patient discovery: that by learning effective techniques, they have the ability to handle their anxiety themselves,” says Nordahl.
- For Christians, effective counseling reminds us of resources in our faith to help us deal with the anxieties of life. – Paul Tripp describes the battle this way: “Defeating worry is not about hoping that tomorrow will be better. No, defeating worry is about being a good soldier in this deeper war for the heart. It is about fighting the temptation to attach the peace of your heart to things that, by their very nature are temporary and, therefore, are not organically designed to give you lasting peace (see Matt. 6:19). It is about daily feeding your soul on the promises and provisions of your heavenly Father. It is about taking special care before you name something a need. And it is about living for something bigger than you. It is about giving the love and concern of your heart to the King and His kingdom and fighting the instinct to construct a Lilliputian kingdom of your own. The kingdom of self will never give you rest because it does not have the capacity to satisfy the cravings of your heart.”
- If you want to win the battle with anxiety, engage in counseling that helps shape your heart, mind, and affections by understanding the mind of Christ. – My point is not that medicine will do you no good, but to help you realize that many aspects of how you deal with anxiety are a spiritual battle. The most effective therapies for anxiety are thought to be Cognitive Behavioral approaches. Biblical Counseling focuses on the same key areas but focuses the counseling on how your faith shapes and guides your thinking and actions. We are not content to leave your faith out of the equation of your healing and simply talk about behaviors and thoughts independent from God.
The decision to take anxiety meds or not is a personal choice, and these conversations need to be had primarily with your doctor. Contrary to the popular myth, Biblical Counselors are not opposed to all psychiatric medicine use, nor do we think that all problems can be cured by prayer, Bible study, and church attendance. However, we are skeptical about the ability of anxiety meds to overcome serious anxiety for the long-term, because the science that supports this skepticism is vast and credible. Further, we have seen that anxious thinking must be addressed for serious progress to be made and that anxiety is an opportunity for worship and trusting God despite our fears. Rather than condemning us in our fear, Jesus extends an invitation to trust him despite our fears and responding to this invitation changes lives.
 https://www.addictioncenter.com/benzodiazepines/xanax/ “Tolerance to Xanax develops quickly, requiring the user to take more of the drug to achieve the desired effects. Someone with a Xanax addiction may take up to 20 to 30 pills per day.”
 Dr. Lee Edmonds, ACBC 2019 Plenary Address
 The Norwegian University of Science and Technology (NTNU). “A cure for social anxiety disorders.” ScienceDaily. www.sciencedaily.com/releases/2016/12/161221090117.htm (accessed October 13, 2019).