Is Hearing Voices a Spiritual Issue? A Christian Perspective on Psychosis and Mental Health

Because I work as a Psychiatrist, some people think that a trip to see me is not complete without the archetypal question, “Do you hear voices?” However, though I do usually cover this area at some point, that question itself is next to useless.

Some people will run a mile – especially if they actually suffer from something like OCD and just FEAR they are going mad. Others will have voices which for them are quite normal – about 1% of the UK population chronically hear voices and are not ill at all. And the group who you might think I am interested in (those with Schizophrenia) do not all hear voices and I am interested in far more than just hearing a voice.

 
Causes for Voice Hearing

Normality: Hearing voices or complex noises can be a normal experience and people live otherwise healthy lives. If it gets bad, the Hearing Voices Network have a helpful website with links to books and self-help groups all around the country. This resource can also be useful for some of the people who hear voices for the reasons listed below.

Split-Mind: The literal meaning of the word schizophrenia is ‘split brain’ but this is a misnomer – this is not what is happening in schizophrenia. But there are people whose mind is ‘split’ who hear voices. This may have occurred as a result of awful trauma when they were young such as sexual abuse – and our natural defence mechanism is to split off that awful memory into a hidden part of the brain. This is what can happen in Dissociation or Dissociative Identify Disorder. However, humans don’t do well with hiding things away, and the hidden bit tries to get out – some times as flashbacks, but sometimes as a voice saying nasty things like “You are dirty/horrible/useless.”

Low self-esteem: When our mood is chronically lowered, not typically due to depression which is episodic, but due to low self-worth; we can begin to hear a voice that resonates with our mood. This is less of a voice and more like an audible conscious stream of negative and critical comments: “You are useless. You are fat. I can see why no-one wants to be your friend…”.

Substance Misuse: If you use alcohol heavily, or other street drugs like amphetamines that stimulate dopamine, you will be likely to hear voices. In chronic alcohol use, the voice is similar to in low self-esteem above. In amphetamine intoxication it can be anything from hearing vague sounds to full-blown psychosis where all manner of things are believed. 

Severe mental illness: People with schizophrenia will experience all kinds of voices. General voice hearing is common, but psychiatrists are particularly interested in three types of voice: two or more people talking about you, a voice commentating on your actions, or hearing your own thoughts read out aloud. These voices are strongly suggesting of schizophrenia rather than other causes. Voices are also sometimes heard in other severe mental illnesses such as bipolar affective disorder, advanced dementia or very severe depression.

A word about schizophrenia

It is worth emphasising that most people with schizophrenia can receive effective treatment and support - but this only occurs if they are enabled to see help and not driven away by stigma.  Sadly, people have a negative image of schizophrenia – largely thanks to films like ‘One Flew Over the Cuckoo’s Nest’ and ‘Me, Myself and Irene’. The first is woefully out of date and even then inaccurate, the second is about multiple personality disorder and psychopathy – things completely unrelated to schizophrenia. Also, Christians can need reminding that Schizophrenia is NOT demon possession – most of the cases of demon possession in the Bible are completely unlike Schizophrenia and even the ‘Gerasene Demoniac’ in Mark 5 is pretty far off the mark.

Schizophrenia affects 1% of the population at some point in their lives and treatment can last for several years. This means that there are lots of people on treatment and you would never know – anymore that you could tell a person with diabetes was on insulin. People with Schizophrenia (and please lets call them this, not ‘schizophrenics’ or ‘nutters’) are more likely to get hit themselves rather than hit you – they are not typically violent, especially when well. In fact, in my experience, I have typically found them to be amazing and resourceful people who have to live with a severe illness that affects something very close to their core. Perhaps you or I would do well to meditate on this before we jump to any conclusions.

When Life Feels Too Much: What Is Overwhelm and How Can You Manage It?

Overwhelm. Nobody likes it, but if we’re honest we’ve probably all experienced it. Overwhelm can hit us predictably, when we’re juggling many responsibilities and stresses at the same time - or strike out of the blue when something happens and triggers a powerful emotion. It floods our mind and paralyses our thinking, triggering powerful emotions and difficult thoughts that trigger yet more emotion. At its worst it can leave us afraid we might break with what we are carrying, or feeling like we can’t carry on. And overwhelm is often behind those moments we act out of character, lash out or do something we later regret or wish we could change. 

What is Overwhelm?

Overwhelm is pretty much exactly what it sounds like - your brain triggering an alert that it has too much to deal with in any one moment. Your mind’s capacity isn’t limitless - whether that is attention capacity (how many things can you juggle or focus on at the same time), cognitive capacity (how much can you problem solve, decide or analyse at once), emotional capacity (how much difficult stuff can you process whilst still carrying on relatively normally) or just plain energy (your brain gets tired just like your body).

Even your brain needs a break sometimes!

Going under…

As well as the practical limits to how much you can hold in your head, all the things going on around you make demands on your brain - and that triggers your physiological stress system because they need you to respond. Life doesn’t have to be distressing to be stressful. Times when you are juggling lots, or are very busy raises your baseline stress level as your brain coordinates all the things you need to keep your mind on.

We can think of the level in our physiological stress system as a bit like the water level in a pool. When the baseline is around our ankles everything is fine. The little challenges of everyday life are like waves - and if the water level is low a wave is no problem at all. But we all have a limit - when the water gets up to our neck. When stress gets that high, we start to feel at the edge of ourselves. You might notice physical symptoms like palpitations, your breathing getting faster or headaches. Your thinking changes as your brain starts to try to get you to move yourself to somewhere quieter and less demanding so that you don’t go under. You might notice thoughts like ‘I need to get out of here’ or ‘I can’t cope with this’ as a result.

Feeling Triggered

Of course sometimes it IS that we’re experiencing things that are emotional or distressing. And it doesn’t have to be in the present. Sometimes things going on NOW remind us of things in the past, and they trigger something I call echo emotions - emotions linked to the past event, but experienced as if it were happening in the present.

Emotions like anger or anxiety operate on the same physiological system - remember the old ‘fight or flight’ description of this system? This means something triggering a background emotional flare raises the level on the whole system. And on top of that, when we are close to overwhelm it changes how we experience our emotional reactions to the more ordinary things of life. If your baseline is low, your emotions feel relatively stable. But the higher your stress level the more near to the surface your emotions feel - and the more easily triggered. So you might find yourself reacting disproportionately to little things, or having to deal with yourself being much more emotional than usual.
 

Hijack

When you become close to overwhelm several things happen as your brain seeks to resolve the situation and calm things down. Firstly, as your brain is more under pressure, it has to change the way it makes decisions and processes information. You have two systems in your brain - a slow, analytical processing system that uses your rational problem-solving brain, and a fast, instinctive system, which uses your emotional brain. The fast system makes much less demand on your brain, so if your head is already full you use this one much more. When we are in overwhelm our ability to analyse and rationalise is turned right down. This makes us more likely to react and get ourselves out of the situation - but it means our minds take short cuts. 

The way this is experienced is that your thinking becomes very binary - one thing or another. Your mind simplifies the world as if it were black and white. Everything is either good or bad, success or failure, people are either for you or against you. Of course this isn’t true - things are rarely that simple. And when you feel bombarded and vulnerable you are more likely to assume the negative in each case. Which adds to your feeling of overwhelm.

Secondly, alongside this change in how you analyse and understand the world around us, your brain tries to get you to bail- to change your circumstances to reduce the demand. It does this with a powerful emotional reaction most people describe as a sense of rising panic or urgency, a need to get out or do something now. That, combined with the difficulties of thinking rationally, can leave us feeling powerless and hopeless, fuelling impulsive or desperate actions. And, as our overwhelmed brains seek quiet and calm, any kind of demand becomes hard. So talking to people, rooms full of noise, things that would normal feel perfectly reasonable - even demands from people or things you love - suddenly feel too much as you crave peace and escape.

The combination of all of this means that when we hit overwhelm things can feel very negative, and like there are no solutions or options except escape. It is important to remember that feeling like this is a symptom of overwhelm and not reality. Things are rarely, therefore, as bad as they feel. The likelihood is when you can find a calmer space and your thinking brain can kick back in things will feel less bleak. When you are overwhelmed the most important thing is to reduce demand, and to keep yourself safe in the meantime, and try to avoid reacting in ways you might regret or cannot be undone later.
 

Causes of overwhelm

Of course, everyone is unique and something one person finds overwhelming might not bother another at all. But here are some classic causes, together with tips for how to deal with them:

1. Demand, responsibility and busy seasons.

This one’s simple - the more stuff you are trying to figure out, keep going or hold in your head, the more demand on your brain. Think about when you go to the supermarket to get a list of things - and you haven’t written them down. You have to keep reciting them to yourself to keep them in your active memory. When life gets busy it is a bit like that but on a grand scale - and it is surprisingly stressful. This is why writing things down can help - it gets things out of your head and allows your mind to relax a little. 

If thoughts wake you up at the moment or keep you awake try keeping a notepad by your bed so you can write down things you need to remember or get out of your head. Or proactively do this - before you go to bed try to brainstorm things you need to do or remember the next day. It may help your mind switch off.  

2. Change

One cause of overwhelm we often overlook is change. Routine and rhythm tell your mind what to expect. It is calming and is a surprising source of our sense of security and normality. Anything which causes change triggers stress and negative emotion as your brain tries to alert you to the change, and direct attentional capacity towards processing what this means. 

3. Information barrage

One major source of overwhelm we are all exposed to is the potential for constant negative or anxiety-provoking information. Having the news on continually, or reading things on Facebook may feel like a way to manage anxiety, but is actually very triggering for your mind, requiring it to constantly process, analyse and manage difficult information. 

Try to limit how and when you access these spaces. Set boundaries around when and how you use social media and check-in. Help yourself by not allowing it to dictate your day, and avoid the temptation to keep checking.

4. Trauma 

Trauma comes in many forms, from the most obvious - traumatic, sudden or disturbing experiences but also through grief and loss. Sometimes experiences are traumatic because they challenge important foundations to our lives - anchor people, places or even beliefs that we build out life around. Particularly if change is sudden or unexpected, your mind literally needs to reformat and work out what this means. That additional work to process and understand what has happened and the implications creates extra demand and may make you feel very overwhelmed. 

Remember that trauma takes time to process. In the early stages, overwhelm may mean you need to take time out and rest, or withdraw to a safe space. Be kind to yourself. Limit who you see and what you do for a while until things settle. But remember even in the next stage of starting to figure out what this means and deal with what has happened, your mind will be working overtime. Make sure you create spaces to take time out and find release and relief from all the mental work.

Kate Middleton

What Causes Postnatal Depression – and How Can It Be Treated?

What is postnatal depression?

Postnatal depression is very common, affecting at least one in 10 women after they have had a baby. The main symptoms of postnatal depression are similar to clinical depression, including low mood, loss of enjoyment and problems with sleep and appetite. Many women with postnatal depression also experience feelings of severe anxiety about their baby or their ability as a mum and, in addition, they may feel very disconnected from their baby. These symptoms can be particularly hard for new mums as they feel that they ought to be incredibly happy at this time in their life.

Some women experience depression and anxiety symptoms during pregnancy: this is called antenatal depression. 

What causes postnatal depression?

Antenatal and postnatal depression can be caused by the dramatic hormonal changes during pregnancy and childbirth. Difficult life circumstances, such as bereavement or the breakdown of a relationship during pregnancy or the postnatal period, can also trigger depression. For most women, it’s likely that hormonal factors, genetic factors (if her own mother suffered from depression or mental illness) and the transition of having a new baby in the family all combine to trigger depression. Mums who have experienced trauma in their own childhoods are at particularly high risk of depression during or after pregnancy. It’s really important not to assume that they are simply ‘not coping’ with the transition to motherhood, as for most mums the triggers for depression are much more complex. 

Can postnatal depression be treated?

It can be difficult for women with postnatal depression to seek help, as they may feel very guilty or ashamed that they are ‘not coping’ with being a new mum. However, antenatal and postnatal depression rarely go away without specialist treatment from health professionals.

Many mums benefit from medication, including antidepressants. GPs can advise them which medications are safe to take during pregnancy and breastfeeding. It’s important to support mums who need to take medication, as for many women it can feel like a difficult decision.

Talking therapies are also very helpful, especially if they have experienced trauma or are going through difficult life events. 

What is postpartum psychosis?

Postpartum psychosis is a severe mental illness triggered by childbirth. It affects around 1-2 in 1000 mums, but those who have bipolar disorder are at much higher risk. Symptoms of postpartum psychosis usually begin in the first week after a baby is born, and can get worse very rapidly. Mums with postpartum psychosis may become very energetic, confused or paranoid. They often experience symptoms of psychosis, including hallucinations (seeing or hearing things that are not there) or delusions (believing things that are not real).

Postpartum psychosis is a psychiatric emergency and women affected will need to be treated (almost always with medication) in hospital – ideally in a specialist Mother & Baby Unit. 

What about faith?

Many mums feel that being a Christian should automatically make them a brilliant, happy mother. Suffering from postnatal mental illness can make women feel incredibly guilty, and it can be difficult for them to know that they are unconditionally loved. It can also be harder as a Christian to own up to suffering from postnatal or antenatal depression, or to deal with negative thoughts or feelings, including feeling guilty, helpless or hopeless. Many mums feel that they are a failure as a mother. The Bible and faith can offer encouragement, God’s love and the hope of a better future.

Women with postpartum psychosis often find that they have intensely ‘spiritual’ beliefs during their delusions which turn out not to be true – and during recovery this can really shake their faith, as they try to sort out what is real again in their beliefs. Some mums who didn’t have a faith before find that these ‘spiritual’ experiences lead them to explore faith.

Being part of a community like a local church is very helpful. Because of tiredness, the demands of a new baby and feelings of shame, postnatal illness can make it harder to attend services or meet up with friends. Churches can help by making sure everyone feels valued, no matter what they can give in return. Regular phone calls and sensitive spiritual support could really assist someone’s recovery. Don’t be afraid to offer to visit mums while they are in psychiatric hospital. Churches can also support them in getting to talking therapy appointments by offering childcare, and lifts if they don’t have a car. Practical support such as a home-cooked meal, or the offer of an hour to help with housework is also often invaluable.

Many women with antenatal or postnatal depression feel very lonely, and find it difficult to talk to other mums. Churches can help to minimise isolation and loneliness by making an extra effort to ensure that mums with depression are included in toddler groups and family-friendly social activities. Remember also to offer emotional and practical support to dads whose partners are affected by postnatal depression.

Faith & Finding Purpose in Pain

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

““I’m going through something that’s shaken me. It’s hard, painful, and I’m struggling to see how anything good could come out of it. I want to trust God, but right now I just feel overwhelmed.””

Talking Point 

Life has a way of wounding us. Whether it’s heartbreak, disappointment, loss or a personal crisis—pain often arrives unexpectedly and leaves us feeling vulnerable, uncertain, and disoriented.

But what if, like the oyster that forms a pearl in response to an irritant, we too have the capacity to respond to pain in a way that produces something of value?

When a sharp fragment enters the oyster’s shell, it protects itself by releasing nacre—a healing substance that transforms the threat into something beautiful. Over time, that irritant becomes a pearl. Not every oyster does this—some never respond, and the damage wears away the living part inside, leaving an empty shell.

We’re not so different. When pain enters our lives, we face a choice: to be eroded by it, or to respond with grace, wisdom, and—crucially—with help.

Psychologists talk about Post-Traumatic Growth, a concept describing how some people grow in strength, insight, or character after adversity- not just despite the adversity, but because of it. As Christians, we see a similar invitation in Scripture: “suffering produces perseverance; perseverance, character; and character, hope” (Romans 5:3–4). God doesn't bring pain to grow us – that is not in His character. But our faith can help give this worldly pain purpose.

It’s important to say this: sometimes pain cuts deep, and processing trauma may need the support of a qualified therapist or counsellor. That doesn’t mean you’re weak. It means you’re wise. Healing is not something we do alone—and it doesn’t mean rushing to find silver linings, either. But it does mean being open to the possibility that beauty can still emerge from painful places.

Truth to Ponder 

Hold on to the One that is Unchanging.

The Bible tells us that God is the same yesterday, today and forever (Hebrews 13:8). He is the beginning and the end—and every season of instability or loss is best navigated with Jesus at the centre.

If you’re struggling with a life transition—if you can’t seem to find your footing—then grip on to Him. Jesus is your anchor (Hebrews 6:19). He will steady you, guide your steps, and lead you from this present season into the next, one filled with hope, healing and purpose.

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‘Worship Anyway’

Faith & Self-Acceptance

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

“People always tell me to just be myself—but what if parts of ‘myself’ aren’t healthy or helpful? What if who I am right now isn’t who I want to stay?”

Talking Point 

We’ve all seen the slogans: “Be yourself,” “You do you,” “Everyone else is taken.” The idea is empowering on the surface—embrace who you are, don’t pretend, live authentically. And yes, there’s something good in that.

But the phrase “just be yourself” can sometimes do more harm than good—especially when it becomes an excuse to stop growing. What if “yourself” is impatient, defensive, entitled or harsh with words under pressure? What if the current version of you is insecure, reactive, or just stuck? Is it still good advice to stay exactly the way you are?

Even Jesus, though perfect and without sin, grew in wisdom, in stature, and in favour with God and people (Luke 2:52). If growth was part of His journey, how much more must it be part of ours?

Being “yourself” isn’t a full stop. It’s a comma. Be yourself, yes—but then keep going. Be the best version of yourself. Grow in grace. Identify areas where maturity is needed. Recognise habits and attitudes that need to change. Embrace who you are, but also who you’re becoming.

Authenticity is not the end goal - transformation is.

Truth to Ponder 

Embracing who you are is not the same as embracing who you can become.

True self-love isn’t permission to stay unchanged—it’s the motivation to grow. And as believers, we don’t walk that growth journey alone. The Holy Spirit works in us to shape us, refine us, and help us reflect more of Christ over time.

So yes, be honest about who you are—but don’t settle. Let God continue the good work He began in you (Philippians 1:6). Be yourself—but let Him lead you to become more.

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Faith & Boundaries

Faith & Instability

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

“I love meeting up with friends and family over Christmas, but everyone else seems to have it all together. My life, by comparison, feels like such a mess. Where am I going wrong, and where is God in it all?”

Talking Point 

The Christmas story starts in the most unlikely of places: a dirty stable. Can you imagine the confusion and disappointment that Mary and Joseph would have felt? How could God ask them to give birth to the Messiah, and not provide a place to stay?

Jesus was not born in comfort and control, but in the midst of instability and vulnerability. This is how God chose to enter the world, and how He continues to show up.

If we are honest, most of us look at those whose lives are tidy, peaceful and predictable and assume they have cracked the faith-code. Their prayers must be the ones being listened to. And we look around at our own mess and mistakes and wonder where we have gone so wrong. Finding God in these moment feels hard. It’s easier to see him in the blessing; harder when things feel missing.

Mary and Joseph were exhausted travellers. Their plans had been interrupted more than once. Nothing in their situation felt secure, and the arrival of Jesus didn’t change anything – they still ended up fleeing for their lives. Can you relate to any of those feelings?!

And yet this story is the first chapter of the ultimate story of Hope.

Truth to Ponder 

So what can the Stable teach us about navigating instability?

1. God meets people in their ordinary, messy reality. Take heart. Healing often begins in places that feel unglamorous, chaotic, or unfinished. You don’t have to “get your life together” to be on the path towards hope. Restoration grows in the midst of imperfection.
    

2. Vulnerability is not a liability. Even Jesus, despite being God, started his journey as a baby utterly dependant on those around him, and remained reliant upon others throughout his ministry. Allowing ourselves to be supported – by God, community or professionals – can be a pathway to resilience.
    

3. Love enters the world quietly, not through force. God’s redemption plan wasn’t a political take over, as many hoped. It was a quiet revolution that started with an infant nursed and nurtured by a loving mother. Softness, compassion and patience can be more healing than striving for quick fixes. Don’t be discouraged by the small gentle transformations that will eventually change everything.

So if your life feels unstable this season—if circumstances feel shaky or uncertain—take heart.
The Christmas story is not about avoiding instability, but discovering Who is with us in it.

Just as Christ was cradled in a simple manger, may His presence rest in the unsteady places of your life, bringing peace that doesn’t depend on perfection, and hope that rises even from the straw-covered floor of uncertain days.

Prayer:
Lord, meet me in the unstable places of my life. Give me courage to rest in Your presence, even when circumstances feel messy or unpredictable. Let Your peace take root in my heart today. Amen.

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Purpose in Pain

Locked in: Understanding Agoraphoboia

What is Agoraphobia? 

The term agoraphobia translates from the Greek as a fear (phobos) of the marketplace (agora). It is used to describe both a psychiatric condition in its own right and a psychiatric symptom in which people fear crowded spaces and/or going outside. It therefore may occur in isolation or as part of another anxiety disorder, such as a panic disorder or generalized anxiety disorder. 

In panic disorder, discreet panic attacks occur, whereas with generalised anxiety disorder, anxiety symptoms may occur throughout the day. 

Agoraphobia is thought to affect approximately one in every 200 people.

What does agoraphobia look like? 

The symptoms people with agoraphobia may experience include both physical and psychological symptoms of anxiety. The physical symptoms of anxiety include: sweats; palpitations (the sensation of a pronounced heartbeat); difficulty breathing; and chest discomfort. 

Psychological symptoms of anxiety include a sense of constant worry and a tendency to catastrophize i.e. to think the very worst of a given situation. These symptoms typically lead to avoidance behaviour i.e. people avoid situations that they anticipate will lead to distress. This helps to explain why people with agoraphobia often stay in a place they regard to be safe, such as their home. 

Agoraphobia can cause people to become very disconnected from their friends, family and colleagues. As a result, it can cause the affected person a great deal of shame and embarrassment.  

Is agoraphobia more of a problem in light of Covid-19? 

There has been more interest in agoraphobia over the past year as significant numbers of people around the world have had to isolate at home because of enforced lockdowns and some have found it very difficult to integrate into wider society as populations have opened up after restrictions have eased. Although self-reported rates of anxiety did go up in the early months of the pandemic, it is unclear whether the prevalence of agoraphobia has increased. 

Anecdotally, there have been a significant number of people who have presented to healthcare professionals with agoraphobia, having not done prior to 2020. This includes those who had never experienced major anxiety symptoms or any previous mental health problems and those with pre-existing mental health problems who had not previously had agoraphobia. Some people who coped reasonably well with lockdown itself have found the easing of restrictions to be particularly unnerving, leading to the onset of these symptoms. 

How can agoraphobia be treated? 

Like other anxiety disorders, agoraphobia is primarily treated by psychological therapy and may also respond to treatment with medication. 

The main form of psychological therapy is cognitive behavioural therapy (CBT). This seeks to explore how thoughts, feelings and behaviour are interlinked, uncover the underlying assumptions that people make in anxiety-provoking situations and identify the core beliefs the person with agoraphobia has about themselves, the world around them and the future. The therapy thus aims to challenge the existing responses and to reduce the distress caused. 

Medications used to treat agoraphobic symptoms include antidepressants, particularly those that act on the serotonin pathway. Serotonin is a neurotransmitter (chemical messenger) that is strongly implicated in the onset of most anxiety disorders: the exact reason for this remains unclear. There are other drugs that may be used as second or third line options for patients with agoraphobia. 

Treatment for agoraphobia may be started by a GP or may require input from a mental health professional such as a Clinical Psychologist or a Psychiatrist. Anyone who is concerned about whether they themselves or a loved one may have agoraphobia should seek support from their GP in the first instance.

Dr Chi-Chi Obuaya is a Consultant Psychiatrist working in the NHS and in independent practice, as well as a Mind & Soul Foundation Director.

Chi-Chi Obuaya

First Steps with Anxiety

I have had a lot of conversations recently with people who want to know what to do when anxiety starts coming up; maybe before getting a doctor’s appointment, or before medication has started to work or therapy begins.  I thought it may be helpful to outline 3 simple early steps that can change the direction of anxiety in this kind of moment. 

Breathing

The anxiety we feel in our bodies is part of a network of responses that form part of our ‘Fight or Flight’ response. Unfortunately, in the absence of any distinct danger our bodies can still prepare to run away or exercise superhuman strength. A big part of this process is oxygenating our major muscle groups.

Imagine you are about to swim the length of a pool underwater. Typically you try to take onboard extra oxygen by over-breathing, which you will then use during the exercise. Anxiety can make us do something very similar, although we are rarely aware of it. Sometimes breathing can look like yawning, panting or gulping so look out for those. 

The trouble with over-breathing is that it makes your head feel ‘swimmy’. You may feel nauseous, dizzy, depersonalised or light-headed. To counteract these feelings I use 2 breathing techniques that restore my balance between oxygen and carbon dioxide.

The first is the staple 7:11 technique:

Breathe in through your nose for 7 beats slowly. Then breathe out throughyour mouth for 11 beats. Try to focus on your tummy (diaphragmatic breathing) making it rise and fall as you breathe in and out. Continue for 5 cycles.

The second is a little more involved and is called Box Breathing:

Breathe in through your nose for 4 beats. Hold the full breath for 4 beats. Release the breath through your mouth for 4 beats and then hold your empty breath for 4 beats before breathing in again. 

In this model you are only breathing in for 25% of the breathing cycle and it tends to restore your sense of calm and ‘groundedness’ within just 3 cycles. A good general rule when you are anxious is to use your nose to breathe in so as to limit the amount of oxygen you can take in. 

Aggressive Relaxation

This sounds like a paradox, but it is a key recovery tool for early anxiety. We tend to have a very pragmatic approach to relaxation and assume it just ‘happens to us’ when we do certain activities. 

The trouble is that when you are filled with adrenaline, your body and mind don’t respond in the ways that they usually do. You can feel on edge and uncomfortable in previously relaxing environments. Rather than being unstructured and pragmatic I take a very direct approach to relaxation which has three steps:

1. Body scan – observe your body for obvious tension points. These might look like a clenched jaw, holding your body, sitting on your hands, crossing your legs or tensing any number of specific muscles. 

2. Re-posture – In a sitting position, uncross your body and place your feet evenly on the floor. Place your hands palm side up on your thighs. Drop your shoulders and relax your jaw. (Gripping, tensing or pressing your body sends threat signals back to your brain which further stimulate your fight or flight response.)

3. Tense and Relax – When you are in a good position begin a progressive relaxation process: Staring at your toes, tense (or flex) and then relax each muscle right up to your forehead. This reminds your body exactly what relaxed versus tense, feels like. You will be amazed at the muscles they you find have been held in tension for hours.

Relaxation Script

One of the most hidden but painful aspects of anxiety are the frightening, often fast-cycling intrusive thoughts that come with the physical sensations. These thoughts pour petrol on the already smouldering anxiety fire and very much keep the whole cycle alive. 

One of the most common responses is to try and ‘make the thoughts go away’. Whilst this is totally natural it is also completely impossible. Even if you weren’t struggling with anxiety you can’t just switch off your thought stream.

Anxiety propagates endless ‘what if’ thoughts, as well as hypervigilant alertness to these threats. So it basically bakes and then eats its own cake. You have to muscle into this process if you are going to get your anxiety down. 

I have learnt that the worst thing I can do is to try not to think about something. However, I can push my relaxation script into this barrage of frightening ideas. Imagine that it’s a bit like the front row of a rock concert; you cannot pull other people off the barrier, but you could squeeze yourself into the line. 

A relaxation script is a visual and auditory diversion that you squeeze into the line of terrifying thoughts in your mind. Mine is an image of simply casting my fishing line out into a gently flowing river over and over again. At the same time, I imagine the sound of the water and the words, ‘And relax. God is with you.’

Relaxation scripts need to be simple and work best when you keep using them over and over again, as your brain locks into their familiarity and takes the prompt to begin shutting the fight or flight system down. But remember, you have to be aggressive and persistent with your script because you are biologically designed to give more attention to threat thoughts. It takes time to gain the confidence to prefer your relaxation script.

Three things to try together: Breathing, Aggressive Relaxation and a Relaxation Script. 

Give them a go and let us know how you get on. Don’t forget that God is present with you in this battle.

Be Blessed, Will. 

Will Van Der Hart

Worship Anyway

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

“I want to worship, but I’m hurting. What if I don’t feel like worshipping? Is it dishonest to praise when I’m struggling?”

Talking Point 

Worship was never meant to depend on how we feel. It’s not a performance or a reward for good times. It’s a response to the unchanging truth of who God is—His holiness, His worthiness, His goodness—even when our circumstances seem to say otherwise.

That’s why Scripture calls it a sacrifice of praise. Because sometimes it costs us—when our hearts are heavy, when the healing hasn’t come, when the breakthrough feels far away.

The most powerful worship often rises not from celebration, but from surrender.

Acts 16 tells us about Paul and Silas. After being beaten and imprisoned for doing God’s will, they lifted their voices in prayer and praise. Not because they felt great. Not because they saw a way out. But because they knew who God is. That kind of worship—despite the pain—opened heaven’s response. The earth shook, the chains fell, and everyone around them witnessed freedom.

Worship shifts things. It may not always change what’s happening around us, but it can profoundly change what’s happening within us. Gratitude and praise lift our eyes from the weight of the moment to the One who holds it all.

Truth to Ponder 

We don’t worship because life is good - we worship because God is good.
When life hurts, here’s how to offer Him praise anyway:

• Acknowledge the pain.
  God doesn’t ask you to fake it—He can handle your honesty.

• Remember who He is.
  His worth doesn’t change with our situation.

• Choose the sacrifice.
  Worship costs something—but that’s what makes it meaningful.

• Let your praise lead your perspective.
  Magnifying God helps put everything else in context.

• Don’t wait to feel it.
  Feelings may follow, but faith often acts first.

Psalm 54:6 says:
“I will sacrifice a freewill offering to you; I will praise your name, Lord, for it is good.”

Worship isn’t about pretending everything is fine. It’s about choosing to honour God because He is worthy, not because life is easy. And in doing so, we often find that while He doesn’t always remove the pain, He transforms our perspective within it.

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Faith & Passion

Does your passion feel quiet? Don’t panic. This may be a holy pause, not a problem to fix.

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

"I used to feel driven by passion and purpose, but lately... I just feel drained. Is there something wrong with me, or is this part of the journey?”

Talking Point 

Think of passion as a wild stallion, like the one in the header image. Passion will lend you his speed, jump you over obstacles, elevate your perspective and help you rally others around your cause. But like any stallion, Passion needs reins to ride it safely. Without reins, he will trample over flowers you’re meant to protect, race past landscape you’re supposed to enjoy and land you way off course before you even know it. Without reins (or without reign!) Passion will eventually drain you.

Yet, passion is a gift from God. It helps us move forward, gives us energy for our purpose, and fuels deep joy in serving. But it was never meant to be our master. Passion isn’t always about doing more. It’s not about galloping into every storm or pushing harder when your soul is tired. It’s about knowing what matters—and letting that truth lead.

Passion needs tending. Jesus lived with deep, unwavering passion. But even He retreated often to quiet places to pray, to rest, and to reconnect with the Father. Passion doesn’t thrive on pressure—it grows through presence.

If your passion feels dim right now, that doesn’t mean it’s gone. It may simply be resting, waiting, or healing. And that’s okay. Passion isn’t just for mountaintops—it’s for the valleys too. In fact, some of the deepest, most lasting callings are forged not in noise and fire, but in silence and surrender.

Truth to Ponder 

When your passion feels quiet, don’t panic. This may be a holy pause, not a problem to fix. Here's how to make peace with the season you're in:

• Name your need. Is it rest? Renewal? Clarity? God isn’t asking you to fake energy you don’t have. He meets you with kindness.

• Let go of pressure. Passion isn’t about performance—it’s about alignment. Let yourself breathe.

• Stay near the Source. Draw close to the One who kindled your passion in the first place. Sometimes the flame returns in a whisper.

• Pay attention to small sparks. A conversation, a scripture, a quiet stirring—God often rekindles the fire gently.

• Trust the process. Seasons of stillness can deepen the roots of your calling more than constant motion ever could.
   

Want to go a bit deeper on this subject?

Talk some time to reflect on this passage and consider what God might be trying to say to you:

Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest. Walk with me and work with me - watch how I do it. Learn the unforced rhythms of grace. I won't lay anything heavy or ill-fitting on you. Keep company with me and you'll learn to live freely and lightly.
Matthew 11:28-30 (MSG)

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Love your neighbour... as yourself

Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

"I’m great at being there for everyone else—but when it comes to me, I feel drained, critical, or just…disconnected. Is it selfish to focus on myself?”

Talking Point 

We were created for connection—deep, meaningful relationships that enrich our lives and ground us in love. But there’s one relationship that often gets overlooked: the one you have with you.

Loving others well begins with learning to love yourself well. Not in a self-centred or egotistic way, but in the way you would treat someone you love—with kindness, patience, grace, and care. If you’re going to spend every minute of every day with someone… wouldn’t it be wise to make peace with them?

Being a good friend to yourself starts with:

• Knowing yourself – your likes, dislikes, values, and strengths. Personality tools like 16personalities.com can offer helpful insight.

• Speaking kindly to yourself – check your self-talk. Would you say that to someone you love?

• Enjoying your own company – pursue hobbies, explore joy, make time for what lights you up.

• Caring for yourself like you would a friend – rest, nourish, move, recover. You matter too.

This is not indulgence - it’s wisdom. Even Jesus said, “Love your neighbour as yourself.” That command assumes you know how to love you. When you constantly give without receiving - even from yourself - you run dry. But when you nurture a healthy inner life, you give from a place of fullness, not depletion.

Truth to Ponder 

The greatest gift you can give those around you is a healthy you. Ask yourself:

• Am I treating myself like someone I’m called to love?

• Would I want my children or friends to treat themselves the way I treat myself?

• Do I need to pause, replenish, and reconnect with who I really am?

At Mercy UK, we believe that wholeness flows from a strong relationship with God, with yourself, and with others. That’s why we created Keys to Freedom —a powerful discipleship resource designed to help you discover how to live in truth, freedom, and healthy connection.

Because when you flourish, everyone around you benefits too.

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Faith & Boundaries

Faith & Boundaries

Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Written by Arianna Walker

Tension Point

“I often feel exhausted and stretched thin, giving away all my resources—time, love, energy or attention to others in need. But I feel like generosity is a good thing- is it unChristian to hold something back?”

Talking Point 

Near my house, there’s an apple tree heavy with the sweetest, juiciest apples imaginable. It stands behind a high wall, clearly marking what’s private and what’s public. Apples that grow beyond the wall onto the path are free to anyone who can pick them – and they do! But if someone climbed over that wall to take apples from the other side, though the same tree, it would be trespassing and theft.

That wall represents a boundary. It protects, defines ownership, and creates order. Our personal boundaries function exactly the same way: clearly marking what is ours—our time, affection, resources, and choices.

When we do not put boundaries around our resources they get depleted by others' demands, and we can end up exhausted, overwhelmed or empty. Jesus modeled healthy boundaries. He gave deeply but deliberately. He reserved special time for the twelve disciples and even closer relationships, creating clear separation from the crowd’s endless needs. He didn’t feel guilty when people walked away with unmet needs. He operated from clarity, obedience, and purpose—not from overwhelming demand.

Boundaries aren’t selfish; they're essential. They protect what is precious, enabling us to steward our resources wisely, intentionally, and joyfully.

Truth to Ponder 

You don’t have to give everything to everyone. Setting healthy boundaries actually multiplies your fruitfulness and effectiveness. Here’s how to begin:

• Clarify Your Fruit. Recognise what resources—time, energy, love, wisdom—you have available. Identify what you’re willing to freely share and with whom.  

• Build Your Wall. Clearly communicate your boundaries. Let people know what's available and what isn't. It’s kindness, not rejection, to make your limits known.

• Prioritise Purposefully. Follow Jesus’ example—invest deeply in relationships and activities that align with your calling and values.

• Say No Positively. Practice the power of a gracious, confident ‘no.’ Saying no isn’t a reflection of inadequacy but clarity of purpose.

• Enjoy the Fruit. Intentionally set aside time for replenishment and joy. Boundaries enable you to thrive, not just survive.
   

Boundaries help you give generously without losing yourself. When built intentionally, they free you to live wholeheartedly, faithfully stewarding every gift God has given.

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Faith & the Power of Pause

Top Tips for Binge Eating Recovery from Marie

* Tastelife is a UK Charity helping young people understand eating disorders and how to prevent them, within the context of faith in God *

Question: Do you have any practical advice for recovering from Binge Eating Disorder?

I want to start by saying that I understand where you're coming from, as I'm someone who's struggled with Compulsive Overeating for most of my adult life, and I continue to walk my journey of recovery one day at a time.

I hope the tips and information I share below will be helpful to you, alongside all the good content and support you’re receiving through the tastelife Recovery Course.

Just to note that what I’m sharing comes from my own personal experience and what I’ve learned through being part of tastelife. This isn’t official advice from tastelifeUK, but rather what’s helped me personally and might help you too. Here are your three questions below, and my responses.

1. Do you have any examples of baby steps for someone who binge eats/overeats? e.g reducing the number of binges? Or reducing the amount involved in a binge?

The key to combating binges, for me, has been learning to identify why they’re happening and what’s led up to that moment. If I’m completely honest, once the urge takes hold, it can feel almost impossible not to binge. That’s why I now put most of my time and energy into avoiding the binge in the first place.

These days, when I feel the early signs of an urge or compulsion, I try to pause, even just for a few minutes, to sit quietly and really listen to what’s going on inside me.

I ask myself questions like:

• Am I anxious about a phone call I need to make or an email I’ve been putting off?

• Has something a family member said or done upset me?

• Am I feeling low?

• Have I forgotten to take my antidepressants?

Once I’ve identified what’s actually going on, I can usually figure out some small action points or practical steps to help deal with it. Even if I can’t fully resolve the issue, just acknowledging it and doing something about it often makes the urge to binge disappear or shrink significantly.

But when I ignore those underlying things—and they build up through the day—and then I’m tired and it’s 10 pm… that’s when I find myself binging.

That’s where the real work is, not just with the food, but with what’s driving the need for it.

2. How do small steps progress to becoming recovered? Is there a time for how long this can take?

This is such a good question, and the honest answer is: there’s no set timeframe for recovery. Everyone’s journey is unique.

During the 8-session Recovery Course, we celebrate every single step towards recovery, no matter how small, because we believe in meeting people where they are. But once you get the hang of them, you’ll likely find yourself taking more and more steps without even realising it.

How long that takes varies hugely and depends on things like:

• Your personality and character traits

• How determined or ready you are to change

• How long you’ve been struggling

• The support systems you have in place

• Life circumstances, health, and other individual factors

I’ve seen people make amazing progress within a year of doing the Recovery Course, and well on their way to full recovery.

Others may still be at the beginning stages, and that’s okay. Also, it’s really important to say this: relapse is a part of recovery. It doesn’t mean failure. It’s a sign that there’s more to explore and that it may be time to revisit some of the basics.

The key is learning how to pick yourself up, be kind to yourself, and keep going. So with all of that in mind, no, I can’t say how long recovery takes. But I do know that every small step counts, and the journey is always worth taking.

3. What does a recovered over-eater/binge eater’s life look like then and now? Do they still binge & overeat? Is it considered a failure if they still get the urge to binge? Do they still have food and celebrate with it, i.e. at Christmas/birthdays, or do they stay abstinent?

At tastelife, we truly believe in and have seen full recovery. That includes physical, mental, and spiritual recovery. For someone who has reached this stage, it can almost become hard to remember what it was really like to live with an eating disorder. The tools and techniques learned along the way become a natural part of their lifestyle. Thinking, feeling, and behaving in new ways means they’re not regularly placing themselves in situations where they’re tempted to binge or overeat.

In many ways, a recovered binge eater’s life starts to look like anyone else's, a ‘normal’ life, free from the grip of disordered eating.

That means:

• Yes, they celebrate with food, like anyone might at Christmas, birthdays, or on holiday.

• Yes, they might eat a little more during those times, and then naturally return to a more balanced rhythm afterwards.

• And yes, they may eat less at other times—when feeling unwell, in hot weather, or during busier seasons of life—just like someone without an eating disorder would.

But here's the important caveat:
Even in full recovery, there’s often a lasting self-awareness. A recognition that, in times of stress, sadness, or crisis, the old coping mechanisms may try to resurface. For example, if someone has been well for years but then experiences a sudden and deeply upsetting bereavement, it's good practice for them to remain mindful. They may need to revisit the techniques that helped them recover in the first place.

It’s a bit like any other physical or mental vulnerability:

• Someone with asthma may take extra precautions during flu season.

• Someone with dental issues won’t miss a check-up.

• And someone in recovery from an eating disorder remains self-aware and kind to themselves if old feelings emerge.

It’s not failure to feel the urge to binge again. As I mentioned, relapse is widely recognised as part of the recovery journey. In my opinion, the only true failure would be giving up entirely and surrendering to the eating disorder without trying to fight it again.

Recovery is possible. Full recovery is real. But it's also a journey that may require ongoing care, selfcompassion, and a toolbox of strategies to return to if needed. These are the tools we give you.

I truly hope these top tips and insights from my personal experience are helpful to you. Wishing you all the very best for the rest of the tastelife Recovery Course and in your ongoing journey of recovery.

- Marie

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Supporting Those Receiving Treatment

When emotional and mental health problems become serious enough to require professional treatment, churches used to be advised to stand back and ‘leave it to the professionals’. However, particularly with NHS services under such pressure, we now know that people receiving treatment need and benefit from the additional support that the wider church family can offer.

So what can/should churches do? Here are five top tips for getting involved:

1. Consider the impact rather than trying to understand the complexities

If you break your leg, get diagnosed with cancer, or have an operation, the church generally understands, and responds with a variety of support: cooking meals, doing shopping, visiting regularly and offering prayer and sympathy. Those who suffer from mental illness don’t get the same response, perhaps because people do not understand the illness as well and may fear doing the wrong thing. However, no matter how complex the illness, the impact on sufferers and their immediate family and friends is usually obvious.

Aim to focus on the impact of mental illness in terms of impact on the individual and their family/friends, rather than getting bogged down trying to understand the complexities of the illness itself. For example, if someone is admitted to a psychiatric ward then, like any other ward, it is often bereft of the simple niceties of life, such as grapes, up-to-date magazines of interest and quality food. Patients, too, will benefit from the same things as those who are physically unwell. If someone you know is admitted, why not pop in at the agreed visiting times, bring something nice and spend some time with them. Maybe take them out for a short walk, if safe to do so.

If someone is feeling depressed and anxious and living at home, think about what might ease a bit of pressure and/or bring a little pleasure. If they have children, then offer to babysit; if they have a spouse, offer to spend some time supporting them. Get to know what their hobbies are and what used to bring them joy and arrange an opportunity to do that with them.

If you cannot visit or really don’t know what to say, remember that little texts – to let them know you care and that you’re thinking of them and praying – can be worth a lot. Remember that in order to support, you do not have to make everything better, or somehow become an expert clinician to cure them. You do not have to produce a miraculous healing or find a route to breakthrough. You simply have to be there.

2. Journey instead of judging

Where physical illnesses are concerned we often have little or no idea how they developed, what caused them or if and when someone will discover effective treatment, or even a cure. We may know things that place people at greater risk (smoking, say), but even where there may have been contributing factors, self-blame or being judged by others will not improve a person’s ability and resilience to deal with their illness. It is no different when the illness is emotional/psychological.

Where mental illness is concerned, there is often considerable curiosity as to what the cause of the illness might be. However, causes are rarely clear or simple – even to the experts. Trying to hunt down some moral, rational or spiritual rationale is unlikely to be productive for anyone. Be particularly careful of this when supporting an individual: the only thing that is worse than facing mental illness alone is feeling surrounded by people who point out that it’s your own fault you find yourself there.

Try to focus on the journey the person faces – and above all, aim to respond ‘shoulder to shoulder’, walking alongside them, rather than ‘face to face’ confronting them. This person you care for is finding themself on a tough part of life’s journey. Journey with them so they do not walk it alone.

3. Make sure people are getting the treatment they need and deserve

Never underestimate the impact you can have when you help people you are supporting to have a ‘voice’ in the system caring for them. It’s a sad fact of the system that if you have someone alongside you in any type of illness who is prepared to ask reasonable questions and pleasantly insist on the best possible treatment, then you tend to get a better service. Don’t be afraid to be gently assertive, attend meetings with them (if they are happy for you to do so) and help them to manage things if they (or you) feel that they are not getting the kind of care they should.

Remember that this principle includes medication. For most people the medications prescribed work well. However, there can be times (for example in the case of side effects) when it is worth enquiring whether other medications are available which might have a better outcome. Don’t be afraid to support those you are caring for in exploring the options open to them or querying the prescribed treatment. Simply asking the questions might get you surprising results.

If things are not going well, remember that all clinicians and managers in the system have to respond to complaints about satisfaction and experience. These complaints are to be received in the spirit of openness, curiosity and desire to improve. The principle of the unjust judge (Luke 18:1-8) is relevant to this system. Keep knocking for justice. Lots of people experiencing mental health issues don’t complain, for whatever reason, even though the service they are receiving is inadequate. Help them complain! Always have the spirit of collaboration and reasonability but don’t accept second best.

4. If in doubt, ask: no response does not mean no impact

Many loving, faith-filled people know other loving, faith-filled people who are suffering from mental illness but never talk to each other! People suffering don’t like to talk about it and the people caring don’t like to ask. Often someone will not ask for help until they hit rock-bottom and real crisis. Letting them know you’re there and that you care can stop them tipping over the edge, and is an intervention in itself.

Be sensitive but direct if you think someone might be struggling. Ask them if they are all right, offer the chance to talk but do not insist that they do. Let them know the door is open, and that judgement and criticism won’t come into it. They may prefer to be left alone. But even if they do not choose to engage, most will massively appreciate someone noticing and taking the time to show they care, and the offer of support.

5. Sustain for the long term

Mental illness can be a long-term problem, with many ups and downs, highs and lows, crisis points and celebrations. Be prepared for this: it is a marathon rather than a sprint. Often, pastoral care teams tire themselves out by trying to sustain high intensity support beyond their capability and capacity. Instead, make an early decision as to what can be offered, and how often. Be aware of your own and your team’s limits.

Remember also to support the other people caring for the person who is unwell. If a spouse, parent, sibling, friend, or pastoral care worker is supporting someone suffering, then they need:

• Someone to unload to. You don’t have to be qualified to listen. But you do need to listen.

• Time out. Give them a break, revolve the pastoral care worker to someone else for a time. Take them out for a pamper day, or a trip out.

• Material support. Think of what would help them: holidays, transportation (public transport to appointments can be strenuous), prepared food, treats and so on.

• Prayer. Pray for them and with them, encourage them, strengthen them, hold them up when their energy is at its lowest.

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Demistifying OCD

Will Van Der Hart: Understanding Panic Attacks

I didn't realise that my first panic attack was actually a panic attack until nearly 10 years later. I still remember it really clearly. I was on my gap year teaching in North Wales and it was my first real experience of being away from home. As an outwardly confident and mellow young person I had no context for understanding my panic attack as anything other than it being a serious heart attack. I woke up in my bed in the middle of the night, I could hardly breath and my heart was racing in my chest. It was beating so hard I thought it was going to explode. At the same time my skin was clammy and cold, beads of sweat ran down my face and a terrible, horrible dark fear gripped my mind.

I stumbled upstairs in the darkness, waking up another young teacher who was working in the same school. He took one look at me and went white himself, which made me feel even worse. Within a few moments we were off to the hospital, where to my amazement I was pretty much ignored. I couldn't understand why I wasn't on the bed being taped to machines and zapped with electrodes. Instead the doctor put an oxygen mask over my face and went away for fifteen minutes. When he returned from dealing with some less serious stabbing or heart attack he came back took off the mask and sent me home. The only explanation I was given was that I had panicked in my sleep.

Did you know that 10% of the population experience occasional panic attacks and an even larger number of adults in the UK will have experienced a panic attack at one time or another? (NHS)

It is also extremely common for the individual to head straight to the hospital during or following their first attack. No wonder my doctor looked so relaxed!

The thing I have realised about panic attacks is that there are a cocktail of psychological (mind) and physiological (bodily) responses. When you really understand them they loose some of their power, and you can even learn to stop or minimise them. The really frightening thing about having panic attacks is their unpredictability. Some of us move from the experience of having one or two panic attacks in a few years to something called Panic Disorder, where sufferers might have several attacks per day or night.
 

Common symptoms experienced during a panic attack are:

• dizziness or feeling faint

• palpitations or increased heart rate

• sweating, trembling or shaking

• difficulty breathing

• feeling of choking or nausea

• chest pain

• numbness or tingling sensations

• chills or hot flushes

• feelings of unreality and detachment

• fear of losing control

• fear of dying

• a sense of great danger and an urge to escape (NHS)

This is not an exhaustive list, so if you are experiencing other sensations don't be concerned that they aren't mentioned here. Panic attacks are actually a result of what is known as the fight or flight response. We really need this response in our lives; it is what makes us run from attackers or bears or other dangers. If we didn't have it we wouldn't last that long. But if you think about it, the response isn't intelligent it is instinctual, we don't stop to consider if a man's gun is loaded or just a toy, if it is pointed at us we are out of there. Panic attacks are just the "fight or flight" response kicking in when there is an inappropriate stimulus. Most commonly panic attacks are actually a result of frightening thoughts that trigger a stressed nervous system into panic. This panic then causes another flow of frightening thoughts like, "I am going mad", which in turn trigger more attacks. Now the intent of me writing here is not to be expressly medical (I leave that in Rob's safe hands). Instead it is to try and make sense of some of these things as a pastor, so please bear with me.

More Content

When I was in my late twenties I experienced several panic attacks in one week. It was as if my previous ignorance to them had stopped me from worrying about them, but now I was conscious of what was happening and it really frightened me. The first thing I did was to go to the internet and read about them. This I realised later was a big mistake, there is a lot of helpful information on the net but there is also so much sensationalist rubbish. My trawl of the net left me extremely stressed, I thought that I was going to loose my mind and be stuck in some twilight world that was punctuated by horrible panic attacks. Needless to say the result of this exploration increased the number and frequency of the attacks.

If you are in that place right now, I really sympathise. I know it is horrible, but I also know that there is real hope, it is an experience that can be overcome. I have not had a panic attack for two years now, but even if I did, I know it would be alright! It's funny being a vicar because you are never sure how much of yourself you are supposed to express. I guess I'm maybe saying too much about myself, but I realise that when I was in the thick of it, all I wanted to know was that there were people who had been where I was, but weren't there anymore.

I don't know what is worse with panic attacks, the feeling of fear or the experience of the physical symptoms. Whichever you find hardest to cope with, you can be sure they are both there. If we fear the fear, we get the symptoms and if we fear the symptoms we get the fear. The bottom line is that fear is the result and the initiator of the symptoms.

Do you know the verse in the 1 John 4:8, "But perfect loves casts out fear." It is a lovely verse, but perhaps it appears a little idealistic when you are suffering from panic attacks. Well, have another think about this verse, it actually has a lot to say. The mistake that is often made about this verse is interpreting the concept of love with human undertones. The perfect love that God offers is a distant cousin of our notion of romantic love. The perfect love of God is a superlative love, it incorporates acceptance, justice, security, trust, sanctuary and peace. The fear that it replaces is that of the future, of the past and of the present. Panic attacks and particularly Panic Disorder, where people have a regular flow of attacks, are caused by stress and fear. In light of this there has never been a better time to press in to the perfect love of God.

Well, thats okay, but what does it mean in practice? It means practical confidence. This perfect love is active, it casts out, it isn't defensive or passive. Many of the people who have talked to me about struggling with panic attacks are living very defensively, trying to avoid another attack. This defensive behaviour means that they are scanning themselves continually for slight physiological changes that might indicate an attack is imminent. As a result they are feeding the fear that will ultimately maintain their condition. You might have heard it said that, the best form of defence is attack. This is definitely true for people struggling with regular panic attacks.

Having become very frightened of my own attacks, I was amazed when my friend who is a trained psychologist came over and suggested that we have a panic attack together! I couldn't believe that she could have a panic attack at will, and I certainly couldn't believe that I had any control over when or how these things could happen. We sat opposite each other and on her lead we hyperventilated for about five minutes before I experienced all the same physiological sensations that I had felt before, spinning head, sweating, dizziness, heart beating fast, etc. The self-induced attack reached a peak of intensity before declining as before.

Now obviously this experience wasn't quite as frightening as some of the spontaneous attacks I had had before. However, it did show me several key things that helped to diminish my fear. Firstly, I realised that I wasn't going mad, which was a relief. Secondly, I realised that whilst attacks were unpleasant, they were not actually detrimental to my health and were not causing any damage to my brain or heart. Thirdly, I realised that my unwitting hyperventilation when I got stressed or fearful was a major contributor to my attacks. If I could stop hyperventilating then I was deactivating the attack before it could happen (by stopping the over oxygenation of my brain that causes the symptoms). My friend told me that it was impossible to have a panic attack if I was completely relaxed. The final thing that I became confident of was that panic attacks had a beginning, middle and end, they could not continue of forever and a day. This was a great relief and reduced my fear massively.

I began to aggressively challenge my fear, by finding out every weakness in the panic attack enemy. I was searching for its failings and loopholes, anything that gave me an edge over it. Instead of slipping into defensiveness and fear I became resolute that I could move out of this. The perfect love of God was one weapon in my armoury that I knew could not be overcome, it was my security. Behind me I knew some absolutes that I would hold on to for security and peace. I knew that God would not abandon me, that he had won my eternal victory, that I was safe in his hands and that he had plans for my life that would not be thwarted by panic attacks. All this gave me huge confidence when fear came suddenly I realised that I was not alone but that perfect love could practically cast out my fear.

Combining my spiritual understanding of Jesus' presence with practical action I began to see a marked decline in my attacks. When an attack came I decided to aggressively relax. Sounds like an oxymoron? Well it isn't! Relaxation, I learnt, was like a weapon in an attack. I would let all my muscles go loose, soften my breathing and move it into diaphragmatic and steady rhythms. Instead of increasing my terror by willing it to end, I just embraced each attack in the knowledge that it would definitely end. Like a powerful switch this approach ended many attacks as soon as they started. The result of this success increased my confidence, further reduced my fear, and as a result reduced my attacks until the disappeared all together.

Just a little note of caution! I think that many of us exacerbate our problems when we solidify our attitudes into all or nothing categories. You might have noticed that in my introduction I said, "and if I had another attack, I would be alright." I realise that I am probably one of the 10% of people who get occasional panic attacks. If I make concrete decisions in my mind like, "I cannot live a happy or valuable life unless I never have another panic attack." I will live my life in the constant fear of another attack, which massively increases the likelihood of having more attacks, besides ruining my life. Some people who are trying to recover see every attack as a failure, then when they have an attack the feel terrible and believe that it's all going to go downhill.

Try not to live your life or your recovery like this. Embrace every attack as an opportunity to experiment on what stops them. Try to laugh at your attacks while they are happening, make them smaller and less serious than they are now. I know this sounds hard, but believe me it works! Life is a tough journey and for some of us panic attacks can be an additional hazard. Remember that you are a child of God, you are not the sum of your attacks, they do not represent any terrible weakness, or any sinful lack of faith. They are just there right now. It has been okay, it is okay and it will be okay. God is with you, in every moment.

Practical tips:

1) Do go to see your GP to discuss your attacks. Try and go armed with a log of how frequently they have occurred and explain their intensity and length.

2) Avoid reading tons of internet sites! some are just plain wrong. The ones on the Mind and Soul links page are all great and sound, so use them.

3) Don't be ashamed of them. They are common and most people will know what you mean.

4) Pray about them, invite God to lead you away from them. (Be cautious if people claim to have 'broken' them or 'freed' you from them! They are not usually spiritual, they are behavioural).

5) Aggressively relax when you feel the warning signs of an attack coming on.

6) Create lots of relaxation space in your life and engage in meditating on the Lord and his peace.

7) Don't stop doing anything you would normally do because of your attacks or begin to live defensively, instead fly in the face of them.

8) Try not to see attacks as 'setbacks' or 'failures'.

9) Remember that their frequency will decline as your system begins to regard them as insignificant. This will take time.

10) Your stress system is working correctly just not appropriately.

You are a child of God and never forget that he never forgets you.

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Will has been an Ordained Anglican Priest in London since 2004, he is also an accredited ICF coach who works both in secular business and church settings. His interest in emotional health is wide ranging, reflecting his broad experience in a variety of pastoral contexts. Will is an author and an integrative bible teacher who speaks at a number of national forums. He is a MHFA mental health first aider and is passionate about equipping church leaders to look after their own emotional health as well as empowering them to manage the emotional needs of the people in their care.

Embracing Neurodiversity

Embracing Neurodiversity 

The concept of neurodiversity is increasingly gaining recognition and importance across different sectors of society, including education, workplaces, and communities. However, discussions about neurodiversity within the Church are still seemingly in the early stages. Speaking about this topic at a recent church conference, where I shared the stage with someone with lived experience of several neurodiverse conditions, I was struck by the strong and novel sense of validation various members of the audience, a number of whom spoke of their own lived experience, felt just from the fact that it was being discussed. 

This article explores the distinct contributions and challenges encountered by individuals with diverse neurological profiles – such as autism, developmental co-ordination disorder (DCD) and dyslexia – within Church settings. It also seeks to make the case for embracing neurodiversity in order to cultivate more inclusive, compassionate, and spiritually enriching environments, where every member of the congregation is valued and supported in their faith journey.
 

What does this term ‘neurodiversity’ mean?

Neurodiversity is an umbrella term to identify people whose brains work differently than most others – the so-called ‘neurotypicals’, resulting in different strengths and challenges.  These can manifest in conditions such as autism, ADHD, dyslexia, and DCD, amongst others.

Rather than viewing these differences as mental illness or disorders that need to be "fixed," the neurodiversity perspective views them as part of the normal variation in human brains and minds. This approach promotes greater inclusion and equity when we consider the differences in how our brains are wired. 

Here are some examples of how neurodiversity may present:

Ruth, a 4-year-old girl, is brought to her doctor because her parents are concerned that she has not started talking yet and seems uninterested in playing with other children. She prefers to line up her toys in a specific order, rather than engaging in imaginative play. In nursery, she often becomes upset by changes in routine and avoids eye contact with her teachers and peers. The doctor observes that she exhibits repetitive hand-flapping and repeats phrases she hears,  rather than engaging in spontaneous speech.

This is an example of Autism Spectrum Disorder (ASD), which is characterised by difficulties in social interaction, communication, and the presence of restricted, repetitive behaviours or interests. 

•    Social communication challenges: individuals with ASD often have difficulties with verbal and nonverbal communication, understanding and interpreting social cues, and forming and maintaining relationships. 

•    Repetitive behaviours: This can include repetitive movements (e.g., hand-flapping, rocking), insistence on sameness or routines, and intense focus on specific interests or activities. 

•    Sensory sensitivities: Many people with ASD are highly sensitive to sensory inputs such as sounds, lights, textures, or smells, which can lead to either hyper- or hypo-reactivity to sensory stimuli.

The term "spectrum" reflects the wide variation in challenges and strengths possessed by each person with autism.

Matthew, a 9-year-old boy, has been struggling with reading since his first year of school. Despite extra help from his teacher and parents, he reads slowly, often mixing up letters like "b" and "d" and struggling to decode new words. In class, he tries to avoid reading out loud and frequently guesses words rather than sounding them out. His difficulty with reading is beginning to affect his performance in other subjects, such as maths, where word problems pose a significant challenge. Despite these difficulties, he is articulate and shows a strong understanding of concepts when they are presented verbally.

Dyslexia is a specific learning disorder that primarily affects reading and related language-based processing skills, as described in Matthew’s case. Individuals with dyslexia often struggle with accurate and/or fluent word recognition i.e. relating sounds to letters/words. Spelling and decoding can be challenging, despite normal intelligence and adequate instruction. People with dyslexia thus appear to be bright orally but find it hard to get information down accurately on paper. 

Mary, an 8-year-old girl, has always struggled with tasks that require motor coordination. In school, she finds it difficult to write legibly, often holding the pencil awkwardly and tiring quickly. Her parents and teachers notice that she frequently trips or bumps into objects and has trouble catching a ball during recess. Despite her enthusiasm, she becomes frustrated during art class because her drawings do not match what she envisions. While she is academically bright, her difficulty with motor tasks affects her confidence and participation in physical activities.

Mary’s challenges are indicative of Developmental Coordination Disorder (DCD or Dyspraxia), more commonly referred to as dyspraxia, is a motor skills disorder that affects a person’s ability to perform coordinated, everyday physical tasks. Children with DCD often have difficulty with activities like writing, dressing, and sports, which require fine and gross motor coordination.

What causes these conditions?

Neurodiverse conditions are thought to arise from a combination of genetic, biological and environmental factors. 

1. Genetic Factors: Variations or mutations in certain genes (but no one specific gene) can influence brain development and function.  These genetic factors can be inherited from parents or occur spontaneously.

2. Biological Factors: Differences in brain structure and function have been identified between neurotypical and neurodiverse conditions. For example, research has shown that individuals with autism may have differences in brain connectivity, while those with dyslexia might have variations in areas of the brain responsible for processing language.

3. Environmental Factors: Environmental influences, particularly during prenatal development (i.e. in the womb), can also play a role. Factors such as poor maternal health, infections during pregnancy and complications at birth may contribute to the development of neurodiverse conditions. However, these factors often interact with genetic predispositions rather than acting as sole causes.

It's important to note that the causes of neurodiverse conditions are not fully understood and are likely to involve multiple contributing factors rather than a single cause.

What impact does neurodiversity have on Christian faith for those with these conditions?

Neurodiversity can have a profound impact on the Christian faith experience for individuals with neurodiverse conditions, both positively and in more challenging ways:

1. Unique spiritual perspectives and approaches: Neurodiverse individuals often bring unique insights and perspectives to their faith and Church communities. For instance, someone with autism might adopt a highly analytical or detailed approach to their reading of Scripture, finding deep meaning in specific words, phrases or patterns. Others might find comfort in repetitive prayers or rituals that provide structure and predictability. Someone with ADHD might prefer more active or varied forms of worship, such as walking meditation or creative arts, rather than prolonged periods of silent prayer. 

2. Challenges in communal worship: Traditional church services and activities can sometimes pose challenges for neurodiverse individuals. For example, those with sensory hypersensitivity (e.g. to sound, light or touch, associated with autism or ADHD) might find loud music, bright lights, or crowded spaces unsettling. Similarly, long periods of stillness or structured activities might be difficult for those with poor attention or motor coordination issues. 

3. Community and inclusion: Feeling accepted and included in the faith community is crucial for spiritual growth. Neurodiverse individuals might experience challenges in social interactions, making it difficult to connect with others in the church. These challenges may lead to feelings of alienation or frustration. Some neurodiverse individuals may also grapple with questions about their identity and place within God's creation, seeking assurance that they are valued and loved as they are.

4. Theological reflection and understanding: Neurodiversity can influence how individuals understand and relate to theological concepts. For instance, abstract concepts like grace or the Holy Trinity might be difficult for someone with a concrete thinking style, while others might find deep meaning in the stories of Jesus' interactions with marginalized individuals. 

In summary, neurodiversity can shape the Christian faith experience in various ways, offering both unique challenges and enriching perspectives. When churches acknowledge and support neurodiverse individuals, they not only enhance these individuals' spiritual lives but also enrich the entire faith community by embracing the full spectrum of God's creation.

How can we best support neurodiverse Christians?

1. Fostering a more inclusive environment

Awareness: Church leaders and neurodiverse congregants may educate the congregation about neurodiversity to reduce stigma and increase understanding, either during specific neurodiverse awareness days/weeks (such as World Autism Acceptance Week) or at any time of the year. This could involve workshops, sermons, or small group discussions focused on neurodiverse conditions. 

Cultivating a culture of acceptance: Differences can be explicitly respected and celebrated, with encouragement for all members to adopt an attitude of patience, understanding, and accommodation of diverse needs. For example, some neurodiverse people may prefer to stand or move around during services, or use noise-cancelling headphones to manage sensory input.

2. Adapting Church services and activities

Sensory-friendly services: Worship may be made more sensory-friendly by offering lower lighting, softer music, and/or designated quiet spaces (with comfortable seating and minimal sensory stimuli), where people can retreat if they feel overwhelmed. Being willing to adapt and evolve church practices based on the needs and suggestions of neurodiverse members, demonstrates a commitment to their well-being.

Physical accessibility: There is a need to ensure that all areas of the church are accessible to those with physical disabilities, which often co-occur with neurodiverse conditions. This includes ramps, seating arrangements, and accessible restrooms.

Supporting spiritual growth: Some neurodiverse people would benefit from having access to information ahead of the weekend service about the Bible verses that will be covered, as they may find it challenging to follow the sermon without prior preparation. Additionally, if the sermon notes available afterwards, this allow people to review and digest the content, especially if they lost focus during the service. Providing materials in multiple formats (e.g., written, visual, auditory) caters to different learning styles.

3. Engagement and inclusion in ministry

Identify and utilise strengths: Neurodiverse individuals should be explicitly encouraged to use their strengths and gifts in ministry roles. This might include tech support, creative arts, or being on the welcome team, or someone with a passion for detail might excel in a roles that involves organising or maintaining records.

Open communication: Opportunities can be created for neurodiverse individuals and their families to provide feedback on church programmes and services. 

Mentorship: Implementing mentorship or buddy systems where neurodiverse individuals are paired with supportive peers can help them navigate social situations more easily and feel more connected to the community.

By implementing these strategies, churches can create a supportive and nurturing environment where neurodiverse Christians feel valued, understood, and able to fully participate in the life of the Church. This not only benefits the individuals but also enriches the entire faith community.

Where can I get more information?
https://www.autism.org.uk/  
https://www.bdadyslexia.org.uk/dyslexia/neurodiversity-and-co-occurring-differences/dyspraxia 
 
Chi-Chi Obuaya - Dr Chi-Chi Obuaya is a Consultant Psychiatrist working in an NHS ADHD service and in independent practice, as well as a Mind & Soul Foundation Director.

Faith & the Power of Pause

Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

 "I know I need to rest, but I just can’t seem to stop. Even when I try to take time, I feel guilty or restless. Why does it feel so hard to switch off?”

Talking Point 

We live in a world that glorifies hustle, where productivity is mistaken for worth. Even in Christian circles, we can fall into the trap of thinking our output defines our obedience. But Scripture tells a different story.

In the creation narrative, God didn’t wait until everything was finished to rest—He paused in the middle of the work. Each day, He created, then paused. “And there was evening, and there was morning…” This divine rhythm teaches us to value reflection over perfection and to see rest not as weakness, but as wisdom.

And yet… many of us struggle with internal beliefs that resist rest. Thoughts like: “I’m too busy to stop,” or “Rest is laziness,” or “If I slow down, I’ll fall behind.” These beliefs aren’t just cultural—they’re deeply ingrained, often unconsciously. But left unchecked, they lead to burnout, anxiety, and disconnection from God and ourselves.

God’s rhythm invites something better. He didn’t just rest after creation—He paused within it. Rest isn’t about checking out. It’s about checking in—with ourselves, with God, and with the deeper rhythms that lead to wholeness.

Truth to Ponder

If rest and pause feel elusive right now, here are some ways to bring them into reach—practically, psychologically, and spiritually:

PAUSES: The commas of your day

• Breathe deeply. Intentional breath slows your stress response. Inhale for 4, hold, exhale for 10. Do this anywhere – in your car, in the shower, between meetings.

• Unplug intentionally. Be smarter than your smart device. Use “Do Not Disturb” mode after a set time in the evening and guard moments of quiet like treasure.

• Redefine rest. Make space for activities that are truly restorative – for instance, if you like reading, don’t read work related books (3 ways to be a better leader, 5 tips to be more effective etc!) and count it as rest.

• Inject joy. Do more of what brings delight—whether it’s tinkering, having a hot bubble bath, chatting, or sitting still with a cuppa.

• Don’t neglect the basics. Nutritious food, decent sleep, and exercise aren’t luxuries—they’re vital pause points for body and mind.
   

REST: The full stops of your week

• Rest your thoughts. Challenge yourself to sit and be present for 3 minutes a day. No planning. No reflecting. No mental to do lists. Just. Be. Still.

• Rest your pace. Walk slower. Drive slower. Pack less in. Stop replacing work with a hyperactive version of ‘rest.’

• Rest your soul. Let go of guilt. Stop ‘should-ing’ yourself. Follow what brings joy, connection, and peace.

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You were made in God’s image. And He chose to rest—not because He was tired, but because rest is sacred. It honours our limits, our need for rhythm, and our call to live not just effectively—but faithfully.

So this week, take one pause. Then take one rest. And watch what shifts in you.

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Love your neighbour... as yourself

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

 "I’m great at being there for everyone else—but when it comes to me, I feel drained, critical, or just…disconnected. Is it selfish to focus on myself?”

Talking Point 

We were created for connection—deep, meaningful relationships that enrich our lives and ground us in love. But there’s one relationship that often gets overlooked: the one you have with you.

Loving others well begins with learning to love yourself well. Not in a self-centred or egotistic way, but in the way you would treat someone you love—with kindness, patience, grace, and care. If you’re going to spend every minute of every day with someone… wouldn’t it be wise to make peace with them?

Being a good friend to yourself starts with:

• Knowing yourself – your likes, dislikes, values, and strengths. Personality tools like 16personalities.com can offer helpful insight.

• Speaking kindly to yourself – check your self-talk. Would you say that to someone you love?

• Enjoying your own company – pursue hobbies, explore joy, make time for what lights you up.

• Caring for yourself like you would a friend – rest, nourish, move, recover. You matter too.

This is not indulgence—it’s wisdom. Even Jesus said, “Love your neighbour as yourself.” That command assumes you know how to love you. When you constantly give without receiving—even from yourself—you run dry. But when you nurture a healthy inner life, you give from a place of fullness, not depletion.

Truth to Ponder

The greatest gift you can give those around you is a healthy you. Ask yourself:

• Am I treating myself like someone I’m called to love?

• Would I want my children or friends to treat themselves the way I treat myself?

• Do I need to pause, replenish, and reconnect with who I really am?

At Mercy UK, we believe that wholeness flows from a strong relationship with God, with yourself, and with others. That’s why we created Keys to Freedom —a powerful discipleship resource designed to help you discover how to live in truth, freedom, and healthy connection.

Because when you flourish, everyone around you benefits too.

Faith & Passion

Does your passion feel quiet? Don’t panic. This may be a holy pause, not a problem to fix.

Your fortnightly 1-2-3: Helping you navigate the tension between faith & mental health by looking at a tension point, a talking point and a truth to ponder.

Tension Point

 "I used to feel driven by passion and purpose, but lately... I just feel drained. Is there something wrong with me, or is this part of the journey?”

Talking Point 

Think of passion as a wild stallion, like the one in the header image. Passion will lend you his speed, jump you over obstacles, elevate your perspective and help you rally others around your cause. But like any stallion, Passion needs reins to ride it safely. Without reins, he will trample over flowers you’re meant to protect, race past landscape you’re supposed to enjoy and land you way off course before you even know it. Without reins (or without reign!) Passion will eventually drain you.

Yet, passion is a gift from God. It helps us move forward, gives us energy for our purpose, and fuels deep joy in serving. But it was never meant to be our master. Passion isn’t always about doing more. It’s not about galloping into every storm or pushing harder when your soul is tired. It’s about knowing what matters—and letting that truth lead.

Passion needs tending. Jesus lived with deep, unwavering passion. But even He retreated often to quiet places to pray, to rest, and to reconnect with the Father. Passion doesn’t thrive on pressure—it grows through presence.

If your passion feels dim right now, that doesn’t mean it’s gone. It may simply be resting, waiting, or healing. And that’s okay. Passion isn’t just for mountaintops—it’s for the valleys too. In fact, some of the deepest, most lasting callings are forged not in noise and fire, but in silence and surrender.

Truth to Ponder

When your passion feels quiet, don’t panic. This may be a holy pause, not a problem to fix. Here's how to make peace with the season you're in:

• Name your need. Is it rest? Renewal? Clarity? God isn’t asking you to fake energy you don’t have. He meets you with kindness.

• Let go of pressure. Passion isn’t about performance—it’s about alignment. Let yourself breathe.

• Stay near the Source. Draw close to the One who kindled your passion in the first place. Sometimes the flame returns in a whisper.

• Pay attention to small sparks. A conversation, a scripture, a quiet stirring—God often rekindles the fire gently.

• Trust the process. Seasons of stillness can deepen the roots of your calling more than constant motion ever could.
   

Want to go a bit deeper on this subject?

Talk some time to reflect on this passage and consider what God might be trying to say to you:

Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest. Walk with me and work with me - watch how I do it. Learn the unforced rhythms of grace. I won't lay anything heavy or ill-fitting on you. Keep company with me and you'll learn to live freely and lightly.
Matthew 11:28-30 (MSG)

Demystifying OCD

“Cast all your anxiety on Him, because He cares for you” - 1 Peter 5:7

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that affects one in every 50 people. It is common to hear people refer to themselves as “OCD” or obsessive, but these terms are frequently misused and misunderstood. There are two main types of symptoms in OCD: obsessions and compulsions.
 

Obsessions

Obsessions are unwelcome and intrusive thoughts, images, urges, worries or doubts.  They occur in a repetitive fashion and are experienced as distressing; there is often a fear of losing control completely. Examples include an irrational fear of contamination or distress caused by items not being kept in an orderly fashion.

Obsessions should not be confused with instances in which people insist that they are ‘obsessional’, which commonly refers to a preoccupation with certain themes that they tend to ruminate on. Although distressing, it is not the same.  Similarly, being tidy or paying extra attention to hygiene does not mean that you have OCD.
 

Compulsions

Compulsions are behaviours that people undertake to reduce the distress caused by the obsessions. Examples include repetitive hand-washing, checking doors are locked and counting to a specific number or engaging in other rituals to prevent something bad from happening. So-called ‘compulsive’ gambling or eating is not a true compulsion as defined here.

People diagnosed with OCD may have just obsessions, only compulsions or both sets of symptoms. OCD can have a significant impact on a person’s day-to-day activities and in some cases the quality of their relationships e.g. someone who compulsively checks the front door may spend many minutes leaving their house. The embarrassment and distress caused by the symptoms may result in some people becoming socially withdrawn.

For Christians and non-Christians alike, obsessional thinking can cause significant self-doubt. The nature of obsessions, such as the belief that one may harm other people or thoughts that appear to have a blasphemous theme, can cause some Christians to question the strength of their faith. There can be a lot of guilt and shame about the symptoms they experience and some people may form the belief that they are experiencing OCD owing to some unresolved sin.

What causes OCD and how do I know if I have it?

There is no single known cause of OCD. It does occur more commonly in some families, where an existing family member already has this diagnosis. Some research suggests that people with certain personality traits, such as a tendency towards being methodical and with very high standards, may be more likely to develop OCD. 

There may also be links to trauma and in clinical practice it is common to see OCD appearing in new or expectant parents, for reasons that remain unclear. It is important to emphasise that the obsessional beliefs and compulsive behaviours do not indicate the presence of any character flaws, but are random and irrational manifestations of this condition.

Anyone concerned that they or someone they know may have a OCD should seek support from their GP in the first instance. They may be referred on to specialist mental health services, where a further assessment can take place.

Treatment for OCD

The mainstay of treatment is psychological therapy, in the form of Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP), a behavioural therapy that gently exposes people to anxiety-provoking situations under the guidance of a trained therapist.

People with OCD may also benefit from taking antidepressant medication: the neurotransmitter serotonin (a chemical messenger in the brain) appears to be implicated in the onset of several anxiety disorders, including OCD.  A number of antidepressants act on this pathway and thus relieve the OCD symptoms.

If in doubt, talk to your GP and if your symptoms are limiting your life, seek out professional help and advice rather than worrying and trying to diagnose yourself.

Further Reading:

Royal College of Psychiatrists:
https://www.rcpsych.ac.uk/mental-health/problems-disorders/obsessive-compulsive-disorder

Mind:
https://www.mind.org.uk/information-support/types-of-mental-health-problems/obsessive-compulsive-disorder-ocd/about-ocd/
 

Chi-Chi Obuaya, 30/08/2021