Helping an anxious person: Dos and Don’ts

Anxiety is a feature, not a bug! Anxiety can save a life. Anxiety evolved as a protective mechanism to alert us to danger; thus, it is good to have a “healthy dose of worry” in our life. But unfortunately, it is very common to see anxiety manifest in an excessive, unhealthy, and dysfunctional manner. Or, more correctly, people adopting to coping behaviors that cause anxiety to create a self-perpetuating vicious cycle.

Seeing a loved one suffer from anxiety or having an anxiety attack can be distressing. It can also be very intimidating to try and help an anxious person if you don’t know-how. 

This article contains some simple strategies to help anxious people develop healthier ways to deal with their anxiety. You’ll learn what anxiety is, what you can do to help yourself or someone else suffering from anxiety, and the dos and don’ts of helping an anxious person.

Educate yourself about anxiety

Understanding how anxiety works might help you better assist loved ones without unintentionally exacerbating their anxiety. This is particularly true if the person you are trying to help doesn’t understand anxiety themselves. 

First things first – not all anxiety is a sign of anxiety disorder, but anxiety disorders are pervasive. It is estimated that some 40 million Americans and 38 million Indians suffer from some anxiety disorder, and even though treatable, only 33% take treatment for anxiety disorder. 

Types of anxiety disorders 

Because anxiety is a complicated condition, defining and diagnosing it with a single set of broad criteria can be challenging. As a result, mental health professionals have classified the illness into several subtypes; I will very briefly describe three of them generalized anxiety disorder, panic disorder, and social anxiety disorder.

Generalized Anxiety Disorder (GAD) is defined by excessive worry, thoughts, feelings, and behaviors that occur most of the time for at least six months. People suffering from GAD are often worried about everyday tasks such as job, money, family, and health.

Panic disorder is characterized by recurrent unexpected panic episodes, which are brief bouts of acute fear, worry, or discomfort. Some people feel compelled to flee until the episode has ended, which usually lasts only a few minutes.

Social Anxiety Disorder aka Social Phobia. The Anxiety and Depression Association of America (ADAA) defines social phobia as an intense fear of being judged, negatively evaluated, or rejected in a social or performance situation. As a result, the sufferers frequently avoid these situations, and if they cannot avoid them, they experience significant anxiety and stress.

What are some of the common signs and symptoms of anxiety?

Anxiety may present itself in a variety of ways and degrees of intensity. However, the symptoms and signs are frequently the same. While not a complete list, the following are some of the most prevalent physical symptoms, anxious thoughts, and behaviors.

Physical/Body

• Chest pain
• Breathing is shallow.
• Palpitations or racing of the heart.
• Sleep issues
• Trembling
• Sweating
• Shoulders, neck, and back tension
• Nausea, abdominal pain, or diarrhea
• Headaches

Cognitive/Thoughts

• Intrusive thoughts (unwelcome, accusatory thoughts)
• Rumination or worrisome pondering (repeating thoughts, stories, and ideas over and over)
• Feelings of impending danger, doom, or disaster
• Constant comparing to others
• Indecisiveness
• Concentration problems

Behavior/Actions

• Avoidance of stressful circumstances (including avoiding people, touch, media, books, or other triggers)
• Withdrawal and isolation
• Agitation and restlessness
• Irritability
• Surprised easily
• Compulsive or obsessive behavior

We’ve evolved to respond to threats in three ways: fight, flight, or freeze. Anxiety is an exaggerated response to a threat, and thus one of these responses of fight, flight, or freeze will often predominate for anxious individuals. For example, I had a client who tended to freeze and bury her head in the sand rather than cope with situations that made her feel worried and panicked. When stressed, I tend to become angry, excessively perfectionistic, or dogmatic (I am working pretty successfully to overcome this). 

When you realize that anxiety is meant to put us in a state of danger awareness, it’s simpler to understand and sympathize with someone terrified (or worried) and behaving out by being angry or defensive. Paying attention to how anxiety develops in the person you care about allows you to learn their patterns and be better equipped to help. At times, you may be able to detect these signs before your friend, spouse, or parent does it themselves. By kindly asking, “Hey, I’m sensing some stress from you,” you might be able to assist them in understanding what they’re feeling. You can also request them to share, “Would you like to tell me how you’re feeling?”

With all that you have just learned about anxiety in mind, here’s what to say and how to help someone suffering from anxiety. Given the complexity, it is impossible to give a bullet point list, but I have tried to present a broader picture that you can adapt to your situations.

The dos and don’ts of helping an anxious person

Anxious people are not broken, don’t try to fix them.

If you see someone struggling and spinning out of control, hurting and terrified, your initial instinct may be to “fix” them by offering advice and rational thought. This is well-intentioned. We want our loved ones to get better and not be in pain!

This desire, however, has an undesired side effect. Without even realizing it, we started to approach the people in our lives as machines that needed to be fixed or puzzles that needed to be solved. We want to rush in and repair them when they are scared or panicked. Read this: your loved one is not a malfunctioning machine. They are not broken. Anxiety indicates that they feel unsafe and alienated. Rather than attempting to “fix” them, lean in and listen. Create an atmosphere of trust for connection. 

You can work together to devise a plan to support this process, such as meeting in person, chatting on the phone, or interacting online. The bottom line is to offer support, not fixes.

Here are some common ways people say unhelpful things and what are the alternatives.

Don’t say: “I know! I also had a panic attack when I saw the petrol prices.” 

Instead, say: “I am here to support you.”

Don’t say: “Have you tried exercising more/meditation/yoga/cutting caffeine/exercising more?” (all helpful, but…)

Instead, say: “How can I help you help yourself?”

Don’t repeatedly say: “Are you OK?!”

Instead, say: “Let us take a walk/green tea/quiet moment together.”

Know what can help the anxious person

If you know what kind of anxiety your friend has, you may use some of the online anxiety assistance resources for that specific condition. Understanding what relieves anxiety requires some time and work, but it is doable if you are willing to take it one step at a time. Do share the helpful resources you find with the anxious persons. 

If your loved one understands their anxiety, you may assist them in recognizing when their anxiety-driven patterns arise. For example, I find it helpful when my wife points out that I’m showing my nervousness about work by being irritated with her or being too fussy. We can point out each other’s tendencies since we know one other’s routines so well and have such a trusting partnership. I must admit that I am not always graceful or grateful with this, but I do get the message. A simple thing that avoids friction in these situations is kindly asking permission before helping. 

Plus, there are some well-known things that are beneficial with anxiety, such as 

• Exercise – almost any type, running, cardio, weight training – everything helps.
• Mindfulness – Going to a yoga class or performing meditation or breathing exercises together.
• PMR- Progressive Muscle Relaxation exercises do help
• Limiting stimulants like caffeine and alcohol 
• Sleep 
• Challenging unhelpful negative thoughts and concentrate on what you can control. Limiting worry time without fighting it (setting yourself a time limit of 10–20 minutes to worry about everything that bothers you, then shutting it off) – You can help them work through an anxious thought diary page – more on that later. 

Resist their avoidance behavior. 

Avoidance behavior contributes significantly to perpetuating the anxiety cycle. When someone avoids doing what they need to do because they are anxious, their anxiety increases. As a result, we may feel compelled to “help out” by doing things for our avoidant loved ones, unknowingly contributing to their avoidance. For example, if your nervous roommate finds making phone calls extremely distressing and you do it for them, they will never overcome their avoidance.

An excellent general guideline to remember is that assistance involves assisting someone in helping themselves rather than doing things for them, covering almost everything short of actually doing it yourself. In other words, provide support but do not take control.

Be careful with their reassurance-seeking behavior.

In certain forms of anxiety, the individual may grow desperate for reassurance. Someone suffering from health anxiety, for example, may continually ask you, “Are you certain that I don’t have cancer? Should I go back to the doctor? Do you believe my doctor knows what they are doing?” A spouse who suffers from interpersonal anxiety may ask you daily or weekly, “Do you promise you won’t leave me no matter what?” “Are you sure you’re not furious with me?”.

Excessive reassurance seeking is another mechanism through which the vicious cycle of anxiety is perpetuated. It is a common anxiety symptom and does not imply that the person is a crazy, clingy, or hopeless case. Like all other anxiety symptoms, reassurance-seeking can also be countered. It’s nothing to be embarrassed about, but it does necessitate a strategy for changing the patterns.

If you notice a pattern of excessive reassurance-seeking, you need to set limits. You would probably need a therapist’s help setting boundaries and an action plan to counter this. Again, a collaboration between a CBT therapist, the anxious person, and you can be incredibly beneficial. 

Help an anxious person with reframing their thinking.

I had briefly mentioned before about challenging unhelpful negative thoughts. Before you try this, it is important to remember that you should not try this during an anxiety attack or panic attack. The person has to be relatively calmer to practice this CBT technique. 

Anxious people have a natural tendency to imagine the worst-case scenarios. This is an abridged version of what is known as “Anxious Thought Diary” to assist them in gaining some perspective on this by asking them to ponder and write answers to these three questions about the thoughts they are having:

• What’s the worst that could happen?
• What’s the best that could happen?
• What’s most realistic or likely?

Then at a later date, when the event has come to pass, you can ask them to go back and write what actually happened. Gradually, over time, they will have a database of what really happens and that worst-case rarely happens. This also reframes the thinking pattern by training the brain to not consider only the worst-case scenarios every time.

Download and print Anxious Thought Diary Page

Help them and support them with getting help.

A question that carers often ask me of anxious people is when is the right time to get professional help for anxiety, and my answer always is – Now! 

You cannot expect to heal your loved one’s anxiety on your own, no matter how intelligent you are, how much you care about them, or how much time you are ready to devote. Also, irrespective of how mild or severe the anxiety is, seeking professional help is always helpful. 

If they haven’t already tried Cognitive Behavioral Therapy (CBT), it is the best place to start for anxiety relief. It is the form of therapy that has the most research backing it up for reducing anxiety. If your buddy is receiving professional anxiety treatment, encourage them to share what they’re learning and working on with you. However, do exercise caution to not appear as breaching their privacy.

Tip: If something about their therapy sessions isn’t working for them, urge them to speak with their therapist directly. Anxious people frequently avoid discussing such things with their therapist. 

Take care of yourself too.

Recognize that your purpose is to help, not cure the person of their anxiety. Taking on too much responsibility is a sign of anxiety, so be sure you’re not sliding into that trap.

Helping someone with anxiety isn’t always simple, and you may feel as if you’re doing it all wrong. However, reminding yourself that you and your loved one are trying your best will help you maintain perspective. It’s critical to maintain compassion and, as the expression goes, to put your own oxygen mask on first. That way, you’ll have a clearer mind to figure out what’s wrong with your anxious loved one and how you might actually help.

Bonus: Helping during anxiety attacks

Anxiety attacks are the fight/flight/freeze system’s false alarms. They differ from high anxiety or worry in that they appear unexpectedly and often peak in severity within 10 minutes. You can usually tell whether someone is suffering an anxiety attack. They may look frozen and disoriented or appear terrified and upset. Because their physical symptoms are so severe, the individual may think they are suffering a heart attack or other medical emergency.

Grounding exercises help in this situation. The most straightforward grounding exercise is to help the person concentrate on slow breathing and be there to reassure them. Another exercise you can learn and ask your loved one to learn is the 54321 technique. I have made a video that you can download and play on your phone to help them.

Note: It is important to exclude medical conditions, specifically heart conditions that might be present, especially if this is the first time a person has had an anxiety attack.

In conclusion

If someone confesses to you that they are anxious or experiencing anxiety, the vital thing to remember is that their emotions — and telling you about them — are a big deal to them. That kind of vulnerability requires courage, confidence, and trust. So listen carefully and answer in a way that does not diminish their experience. Even if you can’t eliminate your loved one’s anxiety, showing support helps them feel more at ease and removes some of the stigma that forces them to conceal – which is an incredible thing to do for someone you care about. Want to know more? let us have a virtual coffee together.