Missionary Care

Missions and Mental Health Resources from Ron and Bonnie Koteskey

What Missionaries Ought to Know About Anxiety

by Dr. Ronald Koteskey

download this as a pdf file in the format of a 2 sided tri-fold brochure for printing and distribution to others

anxiety1You have been worrying more than usual lately. You used to worry only about such things as the unstable political situation or the safety of your children, but lately you seem to be anxious about everything. You even worry about such things as car repairs and having enough money for retirement. Sometimes your hands get cold and clammy, and you are beginning to have trouble sleeping. You begin to wonder such things as these: Is my anxiety serious? Can I have anxiety if I am really committed to Christ? What causes anxiety? Will I ever get over it? What can I do to prevent and get rid of it? Let’s consider some of these questions.

How serious is my anxiety?

Everyone has some anxiety. For some it is anticipating speaking to a crowd. For others it is when meeting new people. For still others it is about being in a different culture. Usually this uneasiness is rather mild and does not last long. However, if it does not go away and becomes intense, you may have an anxiety disorder. To have a generalized anxiety disorder you must have the following:

  • Excessive worry about many things more days than not for at least six months.
  • Difficulty controlling the worrying

At least three of the following:

  • Feeling "keyed up" or "on edge"
  • Easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbances

These symptoms must be bad enough to distress you or impair your daily functioning and not be caused by drugs, hormonal imbalance, or other physical factors. However, even if you do not meet these criteria for an anxiety disorder, the material in this brochure may still help you and make your life more pleasant and make you more effective at work and in your relationships with others.

Can committed missionaries have anxiety?

The first missionary, Paul, certainly did: "When I could stand it no longer, I sent to find out about your faith. I was afraid that in some way the tempter might have tempted you and our efforts might have been useless" (1 Thessalonians 5:5 NIV). Paul had only been able to teach the scriptures for three weeks (Acts 17:2-3) before he was driven out of town, and he was concerned that the church would not last. The word for "stand it no longer" means "to cover, or conceal" (like a roof). Paul is saying that when he could conceal it no longer, he sent Timothy back to find out how they were doing (1 Thessalonians 5:1-2).

Paul had the same feelings about the Philippian church, the one he had started just before the church in Thessalonica. Paul wrote, "I think it necessary to send back to you Epaphroditus ….so that when you see him again you may be glad and I may have less anxiety" (Philippians 2:25-28 NIV).

This was a general feeling for Paul as a missionary. After a long list of stressful events, he wrote, "Besides everything else, I face daily the pressure of my concern for all the churches (2 Corinthians 11:28 NIV).

What does the Bible say about anxiety?

Although the Bible has much to say about anxiety, the King James Version never uses the words "worry" or "anxiety," so use a modern translation. Solomon wrote, "An anxious heart weighs a man down, but a kind word cheers him up" (Proverbs 12.25). Jesus also warned us that in the last days we must "Be careful, or your heart will be weighed down with…the anxieties of life" (Luke 21:34). Anxiety often results in depression, and both of these are most unpleasant emotions that distress us.

Not only is anxiety unpleasant, but it also has negative consequences in our lives. In explaining the parable of the sower Jesus pointed out, "The worries of this life and the deceitfulness of wealth choke it (the word), making it unfruitful" (Matthew 13:22). Wealth may not be a problem in the lives of missionaries, but the worries of life may well make them unfruitful. We will consider other things the Bible says about anxiety later.

Will I ever get over anxiety?

Some people report feeling anxious all their lives, others just for several months or years. Stress often makes anxiety worse. You can control the level of your anxiety, but you must remember that some anxiety is a normal part of life, and you have to deal with it as it arises, perhaps on a daily basis.

What causes anxiety?

The list of things that can cause anxiety is nearly endless. Sometimes the cause is rather specific, such as the fear of a specific illness like malaria. Other times you may feel anxious and have no idea why. Here are some common causes among missionaries.

  1. MK education
  2. Health concerns
  3. Political instability and terrorism
  4. Transitions and separations
  5. Poor communication from headquarters
  6. Not knowing what is culturally appropriate
  7. Anything seen as out of your control
  8. Unpredictability, not knowing what is going to happen
  9. Lack of information about friends in sending country
  10. Etc. etc.

What can I do about anxiety?

The most important thing is to do something; do not just wait for it to go away. Notice that Paul did something about his concern for the Thessalonians. He sent Timothy to strengthen and encourage them. After that he wrote them letters. He did the same thing with the Philippians. When you pinpoint the cause of your anxiety, do something about it. For the causes mentioned above, you might do the following.

  1. Ask to serve on the school board
  2. Carefully wash and cook food and avoid mosquitoes
  3. Use routes that avoid dangerous spots
  4. Get closure on one part of your life and fully enter the next phase
  5. Contact headquarters and ask
  6. Plead ignorance and ask what to do
  7. Look for what is under your control even when nothing seems to be
  8. Learn about whatever is unpredictable. That makes it more predictable
  9. Contact friends in sending country
  10. Etc. etc.

All of the above will decrease your anxiety, but probably not completely erase it. The Bible tells us to take the remaining anxieties to God. Paul, who sent Epaphroditus to see the Philippians to reduce his anxiety, also told them, "Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God" (Philippians 4:6 NIV). Then God’s peace could come into their thoughts and feelings.

Peter also acknowledged that we will have anxiety, and told us, "Cast all your anxiety on him because he cares for you" (1 Peter 5:6). The writer of Ecclesiastes said, "So then, banish anxiety from your heart" (Ecclesiastes 11:10).

Sometimes, however, even after putting our worries on God the physiological responses that are a part of anxiety still occur. Learning relaxation techniques such as the following can decrease these responses.

  • Deep, relaxed breathing
  • Tensing and relaxing muscles
  • Shrugging and rotating your shoulders

Who can I see for help?

If self-help does not work, the kind of treatment you receive depends on whom you see for help.

  • Pastor. Missionaries, like other Christians, often think their feelings of anxiety and worry have a spiritual basis, indicating a lack of faith. Such feelings may, and a "spiritual check-up" with your pastor is a good place to begin. If this works, fine. But if it does not, then it is good to see a mental health professional.
  • Psychologist/Counselor. Anxiety may be caused by your way of thinking about things. A psychologist or other counselor may be able help you change your way of thinking, and such cognitive therapy may be an effective treatment for anxiety.
  • Psychiatrist. Drugs, hormonal imbalance or other physical factors can cause anxiety. A psychiatrist is in the best position to evaluate such symptoms. A psychiatrist may also prescribe a minor tranquilizer to reduce intense anxiety temporarily so that you can learn to deal with it effectively.

Can I prevent anxiety?

anxiety2You can decrease anxiety by trying to take measures to prevent problems, but such actions seldom completely prevent anxiety. Let us look at the example of Paul and the Thessalonians. He noted that he had tried to prepare them for the problems he knew were coming, "In fact, when we were with you we kept telling you that we would be persecuted. And it turned out that way, as you well know" (3:4). Thus Paul tried to anticipate problems, and he took steps to prevent the church from falling away. However, he still was not sure, and he sent Timothy to find out how they were doing. Even after Timothy’s encouragement and glowing report, Paul still said, "Night and day we pray earnestly that we may see you again and supply what is lacking in your faith" (3:10). He seemed still to have some anxiety about their faith, but it was no longer at the point where he could not stand it.

You can use your anxiety as a motivation to do something about the problem, which will often lower your anxiety. This will be less distressing and make you more fruitful.

Ronald Koteskey
Member Care Consultant
GO International

About the Author



Ron and Bonnie Koteskey are Member Care Consultants with Go International.

They have provided member care for missionaries since 1997.