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How to Help Someone With Anxiety: A Guide for Family & Friends

How to Help Someone With Anxiety

It can be hard to know how to help someone with anxiety. Many friends, family members, and romantic partners tell us that they’re not sure what to say to their loved one, don’t know how to help someone with an anxiety attack, or aren’t sure where the line is between typical everyday nervousness and the need for anxiety treatment. Loved ones can play a strong role in a person’s support system, but you don’t have to take this on alone. There are ways to help the person in your life while taking care of yourself.

How to Recognize Anxiety in Someone You Love

Recognizing anxiety in someone you love can be a big part of being a supportive person in their life. Rather than “Why are you acting this way?” learning more about what anxiety is and how it might look in your loved one creates a powerful sense of understanding. 

Emotional signs 

Before you learn more about anxiety, the emotional signs a loved one displays can be confusing. Emotional signs of anxiety often include:

  • Constant and/or excessive worry.
  • Feelings of dread or impending doom.
  • Trouble making decisions.
  • Irritability. 

Realizing these might be associated with anxiety helps parents, friends, and partners understand what their loved one is going through and why.

Physical signs

Many people with anxiety disorders have physical anxiety symptoms. You might notice physical signs of anxiety in your loved one, such as:

  • Restlessness.
  • Tension (e.g., muscle tension, jaw tension).
  • Digestive issues (e.g., nausea).
  • Sleep problems.
  • Fatigue. 

During panic attacks and high-anxiety moments, some people also experience sweating, shaking, a racing heart, or heart palpitations. Some of these aren’t observable from the outside, but your loved one might mention them. 

Behavioral signs 

The behavioral signs of anxiety are often things people with anxiety disorders do in an attempt to soothe distress. They may or may not realize that that’s what they’re doing. Unfortunately, these behaviors often make a person’s life smaller, especially if they become patterns. In your loved one, you might notice:

  • Reassurance-seeking.
  • Avoidance (e.g., avoiding social situations in social anxiety disorder).
  • Canceling plans.
  • Rigid routines. 

Anxiety therapists often work with people to identify other actions they can take instead. These behavioral changes aren’t always “perfect.” They take time. There can be slip-ups. Successfully navigating a small deviation in one’s routine is an example of a manageable goal someone might work toward early in mental health treatment for anxiety.

What to Say - and What Not to Say

People wondering how to calm a person with anxiety aren’t always sure what to say or do. Some things help. Other things can hurt. They’re not always what you’d expect. Keep these in mind during high-anxiety moments. 

What helps 

Here are several things you can do to help a loved one with anxiety.

  • Use validating phrases (e.g., “It makes sense that you feel overwhelmed,” “That sounds like a hard thing to navigate,” or “It must be difficult to think clearly/focus/unwind/relax right now.”
  • Ask open-ended questions (e.g., “Can you tell me more about what happened?” or “Can you tell me more about how you’re feeling?”
  • Maintain a calm presence.
  • Respect their pace.

Remember that feelings of anxiety are real, even if they are not rooted in logic. Focus on acknowledging how your loved one feels and supporting them through that feeling. 

What backfires

Some common actions family members, partners, and friends take can backfire. They may cause more distress or make the person feel misunderstood, even if you believe you are helping. Here are some things to avoid. 

  • “Just relax.”
  • Minimizing.
  • Taking over decisions.
  • Expressing frustration at reassurance-seeking. 

Your role as a loved one is not the same as a therapist. Do not push someone into high-stress situations as a form of exposure. Professional exposure therapy is slow and gradual. Loved ones can provide support in other ways.

What helps and what can backfire when supporting someone with anxiety, including validating feelings, staying calm, and avoiding minimizing their experience.

Grounding Techniques You Can Use Together

In addition to offering comforting words and staying patient during anxious moments, friends, family members, and partners may offer to try grounding exercises with their loved one. Here are a few common, easy-to-remember options. 

  • The 3-3-3 rule for anxiety. Identify three things you can see, name three things you can hear, and move three body parts (e.g., fingers, toes, arms). 
  • Box breathing (4-4-4-4). Inhale for four seconds, hold your breath for four seconds, exhale for four seconds, and pause for four seconds. Repeat this 4-6 times. 
  • 5-4-3-2-1 sensory method. Name five things you can see, four things you can physically touch, three things you can hear, two scents in your environment, and one thing you can taste.

Remember that these are things to offer – not impose. Grounding techniques calm the nervous system and help a person re-enter the present moment when they’re anxious.

How to Help During an Anxiety Attack

When your loved one is having an anxiety attack, they’re likely experiencing racing thoughts. It can be difficult to think clearly or make choices. Remember that they are in a high-stress state and:

  • Stay calm. Your nervous system is contagious. Speaking in a slow, low, steady voice and being patient can help your loved one feel more at ease.
  • Ask the right questions. Don’t ask “what’s wrong?” Instead, ask “What do you need?” Alternatively, ask yes-or-no questions like “Do you want me to sit with you?” This gives them the chance to answer by nodding or shaking their head rather than speaking. This can help when the person is very anxious and may be struggling to communicate or identify their own needs. 
  • Don’t problem-solve during the attack. This isn’t the time to talk about solutions. It is not the time to suggest fixes for the situation that triggered the attack. While it might be a step to take later, it is also not the right time to suggest professional help. 

If attacks are frequent or severe, seeking professional help is key. Some loved ones wonder–when is it time to encourage a loved one to get anxiety treatment? If not during the attack, how and when do I bring it up?

When to Encourage Professional Help - and How to Bring It Up

Clinical anxiety disorders do not go away on their own. They often get worse without treatment. Anxious thoughts and reactions can become a cycle when left unaddressed. Encourage your loved one to seek help if:

  • Anxiety symptoms last for two weeks or more.
  • Avoidance behaviors (e.g., avoiding social situations) are shrinking their life.
  • Their work, relationships, self-care, or quality of life are affected. 

How do you encourage a loved one to seek help for anxiety? First, choose the right time. You should not talk to them about getting treatment during an active panic attack, for example, unless they bring it up. It should be a calm moment. 

Use “I” statements or reflective language (words they’ve used to tell you what’s going on or how they feel. For example:

  • “I noticed you’ve been feeling overwhelmed.”
  • “You mentioned that you haven’t been sleeping lately.”

Then, you can say, “If you’re open to it, I’d love to help you find a therapist,” “Therapy could be a way to offload some of this,” or “Seeing a therapist really helped me. I can help you look for one.” Offering to help them find anxiety treatment can be beneficial, especially if they’re nervous about phone calls, are a minor, or haven’t gotten help before and don’t know where to start.

What Anxiety Treatment Looks Like

Therapy is effective in treating anxiety disorders. Non-invasive forms of talk therapy like cognitive behavioral therapy (CBT) are broadly considered the first line of treatment. Anxiety therapy can be used on its own for people with mild-to-moderate symptoms. People who have moderate to severe symptoms or who do not respond to therapy alone may benefit from a combination of therapy and medication. 

Specific antidepressants, including some SSRIs and some SNRIs, are the most common medications used for anxiety disorders like generalized anxiety disorder (GAD). Other medications, like Buspirone, beta blockers (e.g., propranolol), and hydroxyzine (an antihistamine), may also be used at times. The best medication(s) for one person may differ from that of another. 

If a person has a co-occurring condition (e.g., they have both depression and anxiety, an eating disorder and anxiety, or substance use and anxiety), it is important that they get care for both or all relevant conditions. This is called dual-diagnosis treatment or integrated treatment. 

Some people need or benefit from a higher level of care than traditional once-weekly therapy. Multiple levels of care are available. Your loved one may benefit from inpatient anxiety treatment, a partial hospitalization program (PHP), or an intensive outpatient program (IOP). We offer outpatient anxiety treatment that makes balancing commitments like work or school with therapy possible.

Taking Care of Yourself While Supporting Someone

Compassion fatigue is real. You can be an incredible part of your loved one’s support system, but the key word there is “part.” Their recovery is not up to you. Clinical anxiety requires professional treatment. It’s important that you take care of your own physical and emotional health needs. Part of anxiety recovery is learning to better tolerate distress. Limits on reassurance-seeking are healthy and will help your loved one in the long run. 

Sanford Behavioral Health’s family program is a great fit for loved ones who are helping a person in their life find anxiety treatment. By involving loved ones, we help them learn how to support someone with anxiety while taking care of themselves and empowering their loved one’s success in treatment. To learn more, call 616.202.3326 or contact us online.

Frequently Asked Questions

What is the 3-3-3 rule for anxiety?

The “3-3-3” rule for anxiety is a technique people with anxiety can use to ground themselves. To use the “3-3-3” rule, identify three things you see, three things you hear, and three body parts you can move in that moment.

Validate their feelings. Do not attempt to “fix things” by alleviating their immediate distress (e.g., making phone calls or canceling commitments for them). Both of these things matter and should go together: Loved ones can provide emotional support by acknowledging feelings (e.g., “I know this is overwhelming”) without enabling avoidance in anxiety.

You should encourage someone to seek professional help for anxiety if symptoms last for weeks (e.g., 14 days or more). Chronic anxiety symptoms can get worse without treatment and don’t often go away on their own.

Comforting words for someone with anxiety often include statements like “I’m here to listen,” “Take your time – there’s no rush,” “Do you want me to sit with you while this passes?” or “You are safe.” You may also offer to try a breathing exercise. For example, you might say, “Do you want to try box breathing so that we can focus on something else for a few minutes? I’ll do it with you.”

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