Recently I wrote “Some Things You Should Know About Christians Who Struggle With Anxiety” over at Tim Challies’ wonderful blog. Among the many responses it got was a frequent call for a follow-up article in which I could talk about some things that I’ve found helpful in my battle with anxiety and depression. Well, good news. Seven years of dealing with these disorders—coupled with an incorrigible tendency to analyze and overthink everything—have yielded a number of them.

So then, here are a few. I hope they will be helpful to you as well.

Understand and accept that many good and godly fellow Christians do not understand mental health issues.

I don’t mean this in, like, an emo way.

What I mean is this. Since I’ve been open about my struggles and written and drawn on anxiety and depression and antidepressants in the past, I’ve gotten countless messages and emails from Christians trying to explain to me how it’s just a control issue, a faith issue, a submission-to-the-Bible issue, or a whatever else issue.

Like most theological matters, opinions on mental health disorders usually divide people into “camps.” There are Christians—some whom I admire very much—who believe anxiety disorders to be the same thing as sinful anxiety, and hence, always sinful. To be clear, I absolutely believe there is such a thing as “sinful anxiety,” but a physically debilitating anxiety disorder is not the same thing. Telling the “always sinful” folks that such disorders can render one unable to leave one’s house without experiencing vertigo so intense that one cannot drive, stand, or think, does not seem to sway their opinion. Informing them of people you love who have been so deep into a bout of depression that they sleep for 18 hours per day and can’t leave their bedroom doesn’t change their mind. They probably don’t know anyone who at times is unable to walk into a small group or Bible study without hyperventilating. I suppose that’s a good thing?

In short, they see the word “anxiety” and they think “excess worry”—they do not think “physiological central nervous system meltdown.”

The truth is, for many of these folks, they’re just trying to be faithful to the Bible. But what we, as sufferers of anxiety disorders, need to accept, is that no Christian or theologian is infallible. There will always be people who don’t grasp the profoundly physiological aspects of mental health issues saying that anxiety disorders are caused by sin or inadequate faith, so let’s just expect that and try to not let it throw us into an existential blender when it happens.

It’s a disorder, and fighting it starts with accepting it for what it is.

Realize that God allows you to have this malady.

Nothing happens outside of God’s control. You could not have depression or anxiety disorders without the consent of the Father. Just as those who tell you “if you had more faith, you wouldn’t be dealing with this” are (usually unwittingly) falling victim to horrific prosperity theology, so are you if you see your disorder as something you have the power to merely pray away or rebuke at will.

What do you think when you see Benny Hinn on TV “rebuking in the name of Jesus” some poor person’s arthritis or paralysis or cancer? How do you feel when you see Creflo Dollar telling suffering people that “total healing” for any disease has already been purchased by Jesus, and all they have to do is “name it and claim it” with the correct dose of faith? If you’re like me, these sorts of things make you want to reach through the TV and shake them until their eyebrows fall off.

So why do you think you can do the same thing with your disorder?

Can God heal us? Absolutely. Might God heal us? Absolutely. Should we pray for God to heal us? Absolutely. But for now we have these disorders and we have them because God allows us to have them.

Might God choose to never heal us in this lifetime? Absolutely.

Why has God allowed us to have these disorders? I can’t say for sure. But I think one reason—for me, at least, and possibly (probably?) for you, too—is to help bring this issue from taboo-status to a place where it’s more understood in the church. I’ve always been open about my anxiety and depression because I didn’t grow up in the church and thus was not raised under some of the “we don’t talk about this” unwritten rules, and every time I discuss my issues I am flooded with emails from people saying, “Thank God, I thought I was the only one!” There are countless people suffering in the church because they grew up in a Christian culture that does not allow discussion on these topics, and when they realize that there are other Christians suffering as they suffer, it can be incredibly cathartic and healing. You and I can help these brothers and sisters by being open about the disorders that God has allowed us to have.

Three times I pleaded with the Lord about this, that it should leave me. But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. —2 Cor 12:8–9

Almighty God, in His sovereignty, for His reasons, allows this in our lives. His ways are higher than ours. He knows much better than we do. This should give us some measure of comfort.

Set parameters and try to stick to them.

This, like most things on this list, is easier said than done. For the first several years after developing my anxiety disorders, I fought and fought and fought. I saw my anxiety as a “fear” to “conquer.” I can overcome this! I thought. Perfect love casts out fear! God will heal me of this, if I stretch myself and put myself in situations that make me extremely uncomfortable! But an anxiety disorder is not the same thing as fear. Like any health issue, you have to play on its terms, to a certain extent. Each successive attempt to “conquer my fear” resulted in a vicious anxiety snowball that ruined me for months at a time.

It took a long time for me to be OK saying, “Here are some things that I choose not to do because it’s not worth it to me to be unable to be a good husband, father, and worker, for a prolonged period of time, just to see if it might work out this time.”

It’s been so helpful for me to accept my limitations, whether or not other people do. Someone recently told me that a friend of theirs was coming to town from the UK and really wanted to meet me. I just can’t do that sort of thing. A one-on-one meeting with someone I don’t know is like a nightmare to me. Had I accepted, I would have been a complete mess for the entire stretch of time leading up to the meeting, and instead of the jovial cartoonist and writer he was probably expecting, the poor man would’ve had a monstrous black hole of anxiety and panic sitting across from him at Panera.

Of course, I don’t want to seem mean, or stuck up, or whatever, by declining such a nice offer, but you know what? I can’t do anything about that. All I can do is tell the truth, which is what I did.

“I’m really sorry, and I know it probably doesn’t make sense, but I have terrible social anxiety and I just can’t do stuff like that.”

This is the answer that I’ve given to countless wonderful people who have wanted to buy me lunch, or interview me (I’ve done a handful of interviews, but by email only), or have me come to their conference or event—I’m really, really sorry, but I have terrible social anxiety and I just can’t do that. Thank you so much for the offer.

It sucks that this is my reality, sure—but once I was able to accept it as my reality, it helped a whole lot.

Set parameters to guard against anxiety snowballs, and stick to them as well as you can. This will lower your everyday “resting anxiety rate,” which will make your disorder more bearable.

Exercise. No, seriously—exercise.

This is not just some default piece of advice that I’m throwing in here because everyone says exercise is good for anxiety and depression. When people ask me to give one quick piece of advice for managing anxiety, this is what I say: take up running. Exercise has become one of the most effective ways I manage to live with these disorders.

I never wanted to start exercising at all. I’ve never needed to lose weight. I am naturally skinny as a rail and have always been able to eat whatever I want. Though I know I should, I don’t really care all that much about the life-extending health benefits of regular exercise. This was one of the last things I tried in my battle against anxiety, but I eventually decided to go for it out of desperation.

So I started running a few years ago. It sucked and I hated it, until it became an essential part of my life that I can hardly do without. I now consider it part of my work day. I crave exercise now. When I skip out on it for too long, I don’t feel right. It didn’t take long for me to realize why everyone says to exercise for mental health—it’s so, so good for your brain. Physically exerting yourself does all sorts of wonderful things inside your melon. Regular physical exercise literally changes your brain. Google it.

So listen, please listen, fellow anxiety sufferer—go running. Or if you can’t run for whatever reason, ride a bike, or get on an elliptical or whatever—however you can get yourself tired and breathing heavy for a short but sustained period of time. Then do the same thing again tomorrow. Even though you don’t want to, and you’re out of shape, and you’ll hate it. You’ll only hate it until you’re addicted to it, a transition which will take less time than you expect. Don’t worry about doing it right at first. Don’t worry about having to stop and walk sometimes. Don’t worry about how you look. Just go outside and start running. Get your heart pumping and lungs expanding and keep them that way for 20 minutes. Your heart will pound and you will get lightheaded and your vision will get weird—just like what happens when you’re experiencing acute anxiety—but it will be controlled. You will be controlling it. What a feeling that is. I think this is one reason why exercise is such good medicine for anxiety: it simulates some of the physical aspects of that fight-or-flight response on a regular basis, so when the panic of anxiety starts to creep into your mind, along with its various physical manifestations, your brain is more likely to think, “Wait, I just felt these sensations this morning, when my body was panting down the sidewalk for a couple miles. Maybe this isn’t necessarily a reason to short circuit.”

One last thing here: don’t feel like you have to become a marathon runner. I don’t run fast, and I don’t run far. I run 3–6 days per week, usually a 2.25-mile loop. One of the days I’ll do a 3.25-mile loop. I don’t have any running gear. I run in various pairs of old basketball shorts. I should have replaced my running shoes at least a year ago. Don’t kid yourself into thinking that becoming a runner is some big life change or financial commitment—it’s not. Just go outside and start running. If your experience is anything like mine, you won’t believe how much it will help you.

Medication (gasp!) can be very helpful.

“But Christians should never take antidepressants!” says your grandpa who is on medication for his cholesterol, blood pressure, and diabetes. Again, people who dogmatically say that no Christian should ever take antidepressants are simply ignorant of the physiological basis of mental disorders.

Are antidepressants overprescribed? I’m sure they are. Are people sometimes too quick to turn to a pill? Yep. Should you try regular exercise first? Indeed. But can antidepressants offer relief for terrible anxiety and depression? Yes, they can.

Early in my anxiety career, I could barely leave my house. I couldn’t be in close proximity to people I didn’t know. My wife had to drive me to work on a number of occasions because I couldn’t drive myself. I once got stranded in a Meijer parking lot on my lunch break, unable to drive back to the office because I was so dizzy and the world was swimming all around me, and I had to call a coworker to come pick me up.

I was entirely resistant to my doctor’s prescription for antidepressants. It took me a couple months, a couple meetings with my pastor, and a lot of reading before I decided to get on Paxil. And it was very hard at first—it actually made things worse as my brain adjusting to the meds. But once it took effect a few weeks later, it gave me my life back. While it wasn’t a cure-all and certainly didn’t alleviate all my symptoms, it got me to a place where I was able to work and function again like a normal human being.

The side effects were strange and there were trade-offs, of course. I suppose I could write a book on this topic, but suffice it to say, for me, at that time, deep in a pit of anxiety and depression, Paxil was a God-send. It dampened my most acute symptoms and allowed me to get back to living life. It also dampened everything else—such is how these things work—which is why I’ve been off and on meds for a few years now. I stay on them for a while, then I adjust the dosage, then I try to get off them, then I get back on them, then I try to get off them, etc. I’ve never been able to stay completely off them for more than a year-ish. I keep trying mostly because I would rather not be on them for the rest of my life, if possible. But if I do need to be, it’s better than the alternative.

This is just my personal experience, and please keep in mind the serious situation I was in when I was first hit with anxiety. Antidepressants may not be right for someone with much milder symptoms. I am not saying that everyone with anxiety and depression should definitely get on meds. I am saying that, in my opinion, you should not completely rule them out.

In my life, antidepressants have been a gift from God, one that I thank Him for.

Remember, Christian. Remember, remember, remember.

In my current journey through the Old Testament I am once again struck by God’s constant plea to His people: remember! Remember who I am! Remember my promises! Remember what I’ve done for you! Remember who you belong to! Remember who is in control!

Nothing has helped me more in my struggle with anxiety and depression that remembering the beautiful, objective facts of the gospel.

Listen, fellow depressed, anxiety-ridden Christian. We live a weird, hard life. We are not like most people. We are different. We are strange. We are at war with our own emotions. Our feelings regularly try to kill us.

But God created us and chose us before the foundation of the world to be holy and blameless before him (Eph 1:4). The eternal Son of God bore all of our sins on the cross, taking our place under God’s wrath and gifting us His perfect righteousness (2 Cor 5:21). The one through whom all things were made (John 1:3) an in whom all things hold together (Col 1:17) took upon Himself of our griefs and sorrows (Is 53:4). In Him we are a completely new creation (2 Cor 5:17), justified not in ourselves, but in Christ and the work He has accomplished (Gal 2:16).

These are statements of objective fact for the Christian, which are in no way dependent on how we feel about them when we are in a pit of depression or rolling down a mountain inside an anxiety snowball. These facts are not dependent on us and our shifty mental issues—they are dependent on Christ.

Oh, what a glorious truth.

God created us, God loves us, God is for us, and God sees a beloved child covered in the perfect, finished work of Christ when He looks at us. These are God’s promises to His people, and in a stormy life, God’s promises are the sure and steadfast anchor of our soul (Heb 6:19).

Preach the gospel to yourself, Christian. Remember who God is. Remember His promises. Remember what He’s done for you. Remember who you belong to. Remember who is in control.

Remember, remember, remember, remember.