Tips For Supporting Someone with Anxiety

Anxiety is a mental health condition characterized by excessive worry that interferes with daily activities. There are several types of anxiety disorders, each with different presentations. Many people are diagnosed with anxiety disorders; according to the National Institute of Mental Health, nearly 20% of adults met the criteria for the diagnosis of any anxiety disorder in the past year. Given the prevalence of anxiety disorders, it is useful to understand how anxiety works. If you have someone you know who experiences anxiety, a firm understanding of anxious thoughts, feelings, and behaviors can help you support them.

What is anxiety?

Anxiety is a feeling of worry and tension that interferes with daily activities and overall well-being. It can also cause physical changes like a faster heartbeat, higher blood pressure, and restlessness. People with anxiety disorders may have recurring anxious thoughts that are hard to control, which can make managing anxiety symptoms difficult.

Anxiety is a normal part of the body's fast stress response, known as "fight-or-flight." This system helps humans react to danger by either confronting it (fight) or running away (flight). When the fight-or-flight response is triggered by an immediate threat, like seeing a charging bear, the body and brain quickly adjust to become more alert and aware.

If the threat is clear and immediate, the fight-or-flight response gives us an extra boost to avoid danger and produces the emotion we call "fear." For example, if the fight-or-flight response were to be activated by a charging animal, the response would activate, helping the person escape from the animal. It would then deactivate, allowing the body to return to a calm state. During this ordeal, the person experiences fear, not anxiety.

Fear arises when there is a direct and present threat, while anxiety occurs when the threat is in the future. This is the main difference between fear and anxiety: fear is a response to an obvious immediate threat, whereas anxiety is a response to future threats that may not be clearly understood.

If anxiety becomes overwhelming and uncontrollable, it may indicate an anxiety disorder, such as generalized anxiety disorder (GAD). GAD is the most common type of anxiety disorder. People with GAD constantly feel anxious or worried and often struggle to identify the specific future threat causing their anxiety.

The outlook for those with anxiety disorders is generally positive. Anxiety disorders are highly treatable mental health conditions. However, those with anxiety disorders can still benefit from the support of friends and loved ones. The burdens of anxiety can be significant, and help from others can reduce the mental load considerably.

Supporting someone with anxiety

If a friend or loved one lives with an anxiety disorder, you may already be aware of some of their challenges. Depending on the severity of the condition, anxiety disorders can range from relatively low impact to a nonstop barrage of worrisome thoughts. Anxiety disorders can also worsen in response to specific triggers, like in the case of a specific phobia.

Supporting someone you know with an anxiety disorder takes some energy, but it doesn't have to be draining. It is important to set your own limits and moderate your expectations depending on what you know about the person. Below are some tips on how to best provide support to someone with anxiety:

Understand their diagnosis

Anxiety presents in different ways depending on the person experiencing it. Some people may only experience anxiety in social situations; others may be in a near-constant state of worry. Talk to the person you are supporting about the specifics of their condition. They may not want to share every part of their diagnosis, but they will likely explain their feelings and how you can best accommodate them.

Here is a brief description of the most common anxiety diagnoses to give you a sense of what the person you are supporting may be experiencing:

• Generalized Anxiety Disorder (GAD). GAD involves a persistent feeling of worry or dread that can last for months or years. Those with GAD are usually restless and wound-up. They may frequently be fatigued due to sleep disturbances. Irritability and difficulty concentrating are also common.

• Panic Disorder. Those with panic disorder experience sudden periods of intense fear and anxiety, known as panic attacks. People with this diagnosis often try to minimize the chances of a panic attack by avoiding places, situations, or behaviors they associate with an attack.

• Social Anxiety Disorder (SAD). Social anxiety is an intense, persistent fear of being judged by others. Those with SAD may fear social situations so much that they may feel out of control and avoid work or school.

• Phobia-related Disorders. A phobia is an intense worry about a specific object or situation. Phobias are inherently irrational; the anxiety a person feels is disproportionate to the actual danger.

There are many ways anxiety can present in a person. Don't rely on your knowledge of their diagnosis when considering how to best support your friend or loved one. Ask them how you can provide support and if they would like to share any specific nuances about their anxiety.

Avoid common pitfalls

There are two common errors people often make when supporting someone with anxiety: enabling and forcing confrontation. Enabling occurs when you want to help the person you are supporting by going out of your way to eliminate the source of their anxiety. This may seem helpful, but facing the anxiety trigger is an important part of managing anxiety. Over time, in certain situations, the person you are supporting may need more and more accommodation and effort from you to reduce their anxiety.

Forcing confrontation is the opposite of enabling. Don't push the person you're supporting to do something they are uncomfortable with. Making them do something that scares them will likely damage your relationship or cause other distress. Instead, you can encourage them to work on overcoming deep apprehension by working with a therapist.

Validate and express concern

Many anxious people experience belittling comments regularly, like "I can't believe you are worrying about something so small." You can help them feel validated as they manage anxiety by offering help or expressing concern. When someone has an anxiety attack, there isn't much that can be done to lower the intensity of the episode.

However, if you notice your friend or loved one withdrawing from activities that cause anxiety, you can demonstrate your support by commenting on their changed behavior. For example, you could say something like, "Hey, I noticed that you've been avoiding [activity or location]. Would you be willing to share what caused the change?" Then, if they respond positively, you can offer support and ask how you can help them best.

Don't take over support

Avoidance is one of the main symptoms of anxiety. You may feel tempted to help your friend or loved one by helping them avoid the things that make them anxious. For example, if the person you are supporting gets very anxious at the thought of making a phone call, you might think you are being helpful by making their phone calls for them. While that may help them avoid anxiety at the moment, it doesn't help them push through avoidance and increase their functional abilities.

A good general principle of supporting someone is to help them help themselves and avoid doing things for them directly. An exception is when someone's anxiety is accompanied by severe depression. As many as 60% of people who experience anxiety also experience symptoms of depression, but only a small amount of those people experience severe, overwhelming depressive symptoms. However, if the person you are supporting is struggling to get out of bed or feed themselves, it's okay to help them directly.

How can online therapy help?

An online therapist can help both you and the person you're supporting. If you desire, you can get help from a therapist managing the burdens of helping your loved one. It may be difficult to control your own worry, frustration, or burnout, depending on how involved you are in their care. Online therapy can help the person you're supporting by removing common barriers to therapy, like traveling to an office or being restricted to nearby therapists only.

Online therapists use the same evidence-based techniques as therapists who practice in an office setting. Both traditional therapists and online therapists have the same training, qualifications, and credentials. Online therapy has experienced a surge in popularity in recent years, prompting additional research into its effectiveness. Current research indicates that therapy delivered online is just as effective as therapy delivered in an office.

Takeaway

Helping someone with their anxiety is a noble goal. Many people experience significant challenges navigating daily life with anxiety symptoms. If you want to do the most good, help the person help themselves. Don't do things for them directly or help them avoid things that trigger anxiety. Instead, ask them how you can help and be ready to support them when needed. Validation is also helpful; people with anxiety regularly have their symptoms dismissed. You can also help by simply taking time to understand their diagnosis and getting a clear picture of how you can best provide support.