How to help someone with anxiety

There’s a good chance that someone in your life is dealing with anxiety. According to a National Center for Health Statistics (NCHS) report, roughly 15% of U.S. adults experience anxiety symptoms. And that data was collected back in 2019—before the coronavirus pandemic (Terlizzi, 2020).

Anxiety is also widespread among kids and young adults. By some estimates, roughly one in five young people have anxiety (Barker, 2019).  

You want to help—to say the right things, and to offer support in other ways. To do that, it’s helpful to understand what anxiety is and what sorts of symptoms it causes. 

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Anxiety is closely tied to fears or worries that are future-oriented. That means these thoughts are focused on things that may or may not happen instead of something that has already happened.

There are many different anxiety-related mental health conditions. For example, people with generalized anxiety disorder (GAD) often experience anxiety related to work, money, school, and other elements of daily life. Meanwhile, people with social anxiety disorder may only experience fear or worry in response to specific situations, such as large social gatherings. In any case, fear or worry can cause some predictable symptoms (Chand, 2021).

The signs and symptoms of anxiety fall into three categories. These categories are cognitive (mental), physical, and behavioral.

The cognitive symptoms of anxiety include (Chand, 2021):

• Anxious thoughts

• Fear or worry

• Fear of injury or death

• Fear of negative judgment from others

• Frightening thoughts, memories, or mental images

• Poor concentration

• A sense of unreality or detachment

• Fear of losing control

The physical symptoms include (Chand 2021):

• A racing heart rate or heart palpitations

• Shortness of breath

• Chest pain

• Sweating or sweaty palms

• Muscle tension

• Rapid breathing

• Hot flashes

• Nausea

• Upset stomach

• Weakness or unsteadiness

• Problems sleeping

The final category includes behavioral symptoms. Some of these are (Chand, 2021):

• Avoiding certain things or situations

• Feeling an urge to escape or flee

• Moving away from sources of fear or worry and toward safer situations

• Seeking reassurance

By learning these symptoms, you may be better able to spot those times when the people in your life are struggling with anxiety.

Anxiety is a complicated mental health condition. You’re not going to do or say all the right things all the time. But there are ways you can help the person (or people) in your life deal with anxiety.

Some things you could do include (ADAA, n.d.) (UMich-a, n.d.):

• Learn more about anxiety or the specific anxiety disorder your friend or loved one is dealing with.

• Try not to criticize any of that person’s fears, avoidances, or rituals.

• Offer encouragement when that person takes healthy steps to deal with the anxiety, such as meeting with a therapist, practicing mindfulness, or getting more physical activity.

• Ask how you can help.

• Be ready to listen rather than give advice.

• Acknowledge that you don’t understand what the person is experiencing.

• Be patient

• Be predictable, meaning someone the person can rely on.

• Maintain your own activities and lifestyle.

You may be tempted to do things that are not helpful, even if they feel right to you. For example, you may want to protect someone from the things that trigger their anxiety, but this can be counterproductive. Over time, this can make a person’s anxiety worse (JHM, n.d.). On the other hand, it’s better not to push someone with anxiety to do things they don’t want to do. It can potentially sour or weaken the relationship you have with the person.

Meanwhile, avoid saying these things, which tend to be unhelpful (URMC, 2016; UMich-a, n.d.):

• "Stop worrying."

• "Think positive."

• "It's all in your head."

• "You're just being silly."

• "You need to get over it."

• "Don't be anxious."

• "You can fight this."

These are the wrong things to say to someone with anxiety.

Now that you know what not to say, here are comments that your friend with anxiety may appreciate (UMich-a, n.d.; UMRC, 2016).

• "I'm sorry you're feeling this way. How can I help?"

• "If you want to talk about it, I'm ready to listen."

• "Tell me what you need right now."

• "Do you want to share with me what you're feeling?"

• "You are brave."

• "This is hard, but you can get through it."

In general, expressing concern and validation—letting the person know that you're taking the anxiety seriously—is almost always helpful (JHU, n.d.).

In some cases, anxiety can be so severe that it can cause a panic attack, sometimes called an anxiety attack. A panic attack is a sudden surge of intense fear or intense discomfort that reaches a peak within minutes (SAMSA, 2016). 

The symptoms of a panic attack are (SAMSA, 2016):

• Heart palpitations, a pounding heart, or an accelerated heart rate

• Sweating

• Trembling or shaking

• Shortness of breath

• Sensation of choking

• Chest pain or discomfort

• Nausea or an upset stomach

• Feeling dizzy, unsteady, lightheaded, or faint

• Derealization (feelings of unreality) or depersonalization (feeling detached from oneself)

• Fear of losing control 

• Fear of dying

• Sensations of numbness or tingling

• Chills or hot flashes

If you think someone has a panic attack, it may be helpful to advise them to take slow, deep breaths. For example, you might counsel the person to breathe in through their nose for five seconds, hold it, and breathe out slowly for five seconds. Keep this up for several minutes (BYU, n.d.). These kinds of breathing exercises can be helpful.

Also, saying these things may help (UMich-a, n.d.):

• "This may feel scary, but what you're experiencing isn't dangerous."

• "Don't try to stop what you're feeling. It will pass."

• "Stay in the present. Please tell me what's going on around you right now."

When anxiety starts to mess with your life—your job, school, relationships, or well-being— it’s time to get help from a mental health professional. If it seems like someone in your life is at that point, it may be helpful to encourage them to make an appointment with a professional (JHU, n.d.).

If you’re worried about a young person in your life, understand that pretty much all children experience some anxiety from time to time. Along with the symptoms listed above, some of the signs of anxiety among young people include:

• Problems concentrating

• Not sleeping or bad dreams

• Poor eating or appetite

• Irritability or tantrums

• Lots of worrying or negative thoughts

If these symptoms of anxiety seem to be getting worse, or if anxiety seems to be interfering with a child’s life, it’s time to talk with a professional (NHS, 2020).

There’s a lot you can do to help the people in your life who are dealing with anxiety. But it’s also important to recognize that you can only do so much as someone who isn’t trained in treating mental health conditions. Maybe the best advice is to ask questions, be supportive, and encourage your friend or loved one to talk with an expert.

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Current version

July 12, 2021

Written by

Health Guide Team

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.