A Mental Health Expert Explains How to Support Someone With Anxiety
Nastia Vesna/Once Wed
My boyfriend warned me not to fall in love with him because of his anxiety. "I get in these moods," he told me almost seven years ago, as we sat by a pool in Palm Springs, our first real trip together as a couple. "I'm on an upswing right now," he said. "But it's not always like this." He topped off my glass of champagne and smiled, a melancholy look in his eyes.
I've never suffered from anxiety, so I didn't quite understand what he meant back then. I also loved him, so I didn't listen to his warning. I'd become better acquainted with his anxiety in the years that followed. I didn't always handle it well. In fact, I've made all the classic mistakes. Half a decade would go by before I even felt like I recognized what his personal breed of anxiety looked like, and how it informed his behavior. My mental image of the condition involved visible panic attacks and other external displays of agitation; but as I'd learn, not everyone's anxiety looks the same.
"People who struggle with anxiety may show it in different ways," says Helen Odessky, PsyD, psychologist and author of Stop Anxiety From Stopping You. "Sometimes it is subtle because the person is embarrassed and may try to hide it." Anxiety can manifest itself in behavior as understated as your partner "asking you to drive, for example, when they have not previously had an issue with it, or only going to social events if you will accompany them," Odessky says. My boyfriend, a marathoner, stopped running and started spending more time in the second bedroom of our apartment alone. Sometimes it's more overt than this, of course. But sometimes it isn't.
You can't control another person's anxiety, no matter how badly you want to. But there are ways you can modify your behavior in order to be a good ally. I'm still learning how to be the best partner to my dude, so the following tips from mental health experts are helpful reminders for me, too. If you have a significant other, friend, or family member with anxiety, keep scrolling to learn psychologists' tips for what to do (and what not to do) to support them.
1. Notice the signs.
According to licensed clinical professional counselor Julienne Derichs, there are three main ways anxiety can show up: generalized anxiety, panic disorder, and social anxiety. "Most anxiety disorder symptoms include restlessness or feeling on edge, being easily fatigued, having difficulty concentrating, increased irritability, muscle tension, difficulty controlling worry, and sleep problems," she says. But again, not everyone with anxiety will show all these signs.
Social anxiety is fairly common—according to the Anxiety and Depression Association of America, it affects 15 million Americans. Derichs describes social anxiety as when a person feels "highly anxious about being with other people." They might have a hard time talking to others or feel worried about being humiliated, judged, or rejected by them. "Worrying for days or weeks before an event where other people will be, staying away from places where there are other people, having a hard time making friends … and feeling sick to your stomach when other people are around" are all signs of social anxiety, says Derichs.
By contrast, someone with panic disorder might have "sudden and repeated attacks of intense fear," called panic attacks, accompanied by feeling out of control, worrying about when the next attack will occur, or avoiding places where past panic attacks have happened. Understanding the difference between these forms of anxiety will help you notice them in the people you care about.
2. Educate yourself.
"It's important for both partners to learn about anxiety and really understand what the triggers are," says Sanam Hafeez, PsyD, a New York City–based licensed clinical psychologist. Becoming acquainted with the signs outlined above—and identifying the specific ones that apply to your loved one—is a good start. But there are also physical techniques that you can do together during moments of anxiety.
"As simple as it may sound, being armed with some breathing techniques and using them as a guide when your S.O. is having an increase in anxiety can be a very helpful tool," Derichs says. Here's a relaxing breathing technique that Derichs calls the "instant tranquilizer:" Inhale through the nose, hold for a moment, then exhale out slowly through your mouth and nose. Repeat two or three times. "As you let the air out, let go. Relax your muscles—release as much tension as you can," Derichs says. If your loved one starts to feel anxious in the car or in public, this can be a simple but handy exercise.
You can do all the research in the world, but when it comes to your loved one's anxiety, it's important to let them do the talking. "Let them talk about how they feel without judgment," Odessky says. Even if their anxiety doesn't make sense to you, simply listening will help everyone see it more clearly.
What you definitely don't want to do is start explaining your loved one's anxiety to them. "Do not start using logic to prove that there is nothing to worry or be anxious about," Odessky says. "Most of the time, unless you are talking to a child, the person already knows that, and they end up feeling worse."
But what you can do is ask genuine, nonjudgmental questions to encourage an honest conversation about what they're feeling. As Mike Dow, PsyD, brain health expert and author of Healing the Broken Brain, says, "Ask them if they have an idea of where this anxiety comes from. That understanding can go a long way."
4. Vocalize your support.
Here's another tip that sounds so simple but took me way too long to grasp. "Let them know you still love, support, and respect them," Odessky says. "Many people worry that they will lose those things if they disclose their anxiety."
5. Distract them.
"Studies show that distraction relieves the brain's anxiety center," says Srini Pillay, a psychiatrist, assistant professor at Harvard Medical School, and author of the upcoming Tinker Dabble Doodle Try: Unlock the Power of the Unfocused Mind. As Dow advises, "Do something pleasurable or productive when you notice yourself stewing." So when your loved one starts feeling anxious, don't hesitate to take them out to a movie, dinner, grocery shopping, or a walk around the neighborhood.
6. Don't trivialize their anxiety.
"Stop stressing," "stop worrying," "suck it up," and "what's wrong with you?" are all things to avoid saying to your anxious loved one, according to experts. These phrases often make people even more anxious, Pillay says. If they could simply "stop worrying," they would. Unfortunately, anxiety is more complicated than that. "Their brain is likely wired differently than yours may be," Dow says. "They probably have an overactive amygdala, a part of the brain involved in fear, and an underactive prefrontal cortex, the part of the brain that can act as the brakes."
Calling your loved one "crazy" might make them feel judged, which will "decrease the likelihood they seek professional help," Dow says. "In order for treatment to be effective, they need to feel safe and open about their fears and where they come from." For someone without anxiety, being called "crazy" might not seem like a big deal, but it might be to your loved one. (I am not proud to say that I'm guilty of not realizing the gravity of this word.)
Oh, and one last thing: "Do not try to compare everyday anxiety situations with what the person is going through," Odessky says. "Worrying about passing an exam is very different from having a phobia or an anxiety disorder."
7. But don't enable it either.
Being a helpful ally to your anxious loved one is a good thing—but allowing their anxiety to control both of your lives is not. "The goal is to be supportive, not to walk on eggshells or radically change your life to accommodate the person with anxiety," Hafeez says. "Doing so removes the need for the person to address and overcome their anxiety."
For instance, if your spouse has anxiety about leaving the house, you might find yourself doing all the errands by yourself. "Before you know it, you start to feel anxious," Hafeez says. Or, let's say they have social anxiety—then you end up going to all your family functions and work parties alone, which could cause you to build resentment toward them.
Instead, the focus should always be on progressing and getting better—not on letting the anxiety rule everyone's life.
8. Consider therapy.
I am of the belief that anyone can benefit from a little therapy. "I encourage spouses to both come to therapy so that they both understand what the thought processes are, how it's triggered, and what to do," Hafeez says. "Everyone is different, so it's helpful to have a game plan that factors in boundaries that work for both partners."
If time and cost are preventing you from seeing a professional, consider an online therapy service, like Talkspace, which makes the whole thing more convenient and manageable.
9. Ask how you can help.
When you find yourself feeling helpless about their anxiety, remember: You don't have to guess or rely on therapists and research. Because you can always simply ask your loved one how you can be supportive. "Some people want others around, while someone else may want privacy," Odessky says. So when in doubt, do the simplest thing: Ask. It's worked for me every time.
Do you have any tips for how to handle a loved one's anxiety? Tell us your stories in the comments below!