A unique kind of awkwardness blossoms each time I tell someone I have an anxiety disorder. This holds true no matter the scenario: Divulging my condition to my supervisor, telling a friend I’m having a panic attack while we’re at a concert, or clueing in a new romantic partner. (True story: Nothing puts a damper on date night quite like saying, “Hey, so I’m really into you but I kind of feel like I’m going to die right now.”)
Opening up to others is hard even if I’m close with them because I don’t know how they’ll respond. Being stereotyped or treated insensitively when you’re struggling can be nerve-wracking, especially if you already get down on yourself for having anxiety. (Guilty.)
While everyone experiences anxiety, people experience differing degrees of severity, says Ty Lostutter, Ph.D., a clinical psychologist who specializes in anxiety and treats patients at University of Washington Medical Center and Seattle Cancer Care Alliance.
“Anxiety is normal and healthy. It keeps us safe and motivates us,” Lostutter says. “It only becomes a problem when someone becomes overly anxious and it interferes with daily life.”
Anxiety disorders are one of the most common types of mental illness—and they’re on the rise. Around 19 percent of the U.S. adult population is affected in any given year. Chances are you know someone who has clinical levels of anxiety. With that in mind, here’s how to talk to and be supportive of anxious friends.
Don’t say: “I know what you mean. I had a panic attack when I saw Seattle rent prices.”
Panicking about the absurd cost of that tiny studio apartment makes sense because you need a roof over your head and can’t magically increase your salary. Panicking about taking a bus because you’re afraid of having a panic attack on said bus (true story) doesn’t. There’s a difference between the uncomfortable but rational anxiety we all get in stressful situations and the sometimes paralyzing but illogical anxiety super anxious people like me get in situations that aren’t actually stressful or threatening. People with anxiety disorders experience anxiety over things others wouldn’t and with such intensity that it interferes with our ability to function and do things we enjoy. So unless you have a diagnosable anxiety disorder, comparing your anxiety to someone else’s isn’t helpful.
Instead say: “I’m always here for you.”
You don’t have to understand what your friend is going through to be there for them. Showing you care will help if your friend is self-conscious about their anxiety or has a hard time opening up about it. Listen without judgment to what they have to say and what their experiences are like. Being there for someone even when you can’t relate is a powerful way of showing support.
Don’t say: “Have you tried meditation/yoga/[insert some other wellness trend here]?”
Meditation and yoga and deep breathing and all of the other anti-anxiety trends that have taken pop culture by storm might be helpful for some people, maybe even your ultra-anxious friend. But they might not. Extreme anxiety can feel consuming, which means that small things like taking a few deep breaths might not be enough to counter panic in the moment. Everyone with anxiety has different relaxation techniques that work for them—and some people need to do something active, like go for a run, instead of sitting and breathing. Don’t offer unsolicited advice unless you’ve been trained to treat people with anxiety disorders or you have one yourself.
Instead say: “What can I do to help you?”
If your friend has been dealing with anxiety for a while, chances are they already know what does and doesn’t help them feel better. Ask what they need and then do it, even if their request seems silly to you. (Like that time I asked a friend if we could just not talk at all until I calmed down. Sorry, friend.) Showing you’re willing to offer assistance helps us anxious folk feel like we’re being taken seriously.
Don’t say (for the hundredth time): “Are you OK?!”
If your friend told you they’re feeling super anxious, they clearly are not OK. Constantly asking them for a status update can make them feel pressured to get better now. When we see someone we care about suffering, our instinct is often to try to fix it. But some things, including anxiety, can’t be fixed by outsiders.
Instead say: “Let’s go to a quieter place or go for a walk.”
If you want to try to help your friend get out of anxiety mode (and you know them well), you can try grounding them back in reality. Anxiety makes people hyper-focused on the thoughts, emotions and physical sensations that are causing the distress, so to get your friend’s mind off of those things, ask if they want to take a walk, listen to some music or go to a quiet corner. Sometimes we need a supportive push to help break us out of our vicious cycle of panic and panicking about panic. Techniques like this are similar to what trained psychologists and therapists use as part of cognitive behavioral therapy, the gold standard of treatment for people who have anxiety disorders.
Don’t say: “Why aren’t you seeing a therapist/on medication?”
There’s nothing wrong with showing concern for a friend, but be careful it doesn’t come across as accusatory. Suggesting your friend should be doing something can create a sense of shame if they aren’t, or make them feel like they’re being judged. If they do need to see a counselor or take medication, those are decisions they need to make on their own and at their own pace.
Instead say: “I’ve noticed you’ve been anxious a lot lately, and I’m concerned.”
If you notice your friend getting more and more anxious and you know they haven’t sought any kind of professional help, it’s OK to express your concern if it comes from the heart. Focus on how you’ve seen the anxiety change them: maybe they aren’t going to concerts anymore even though they used to love live music, or they haven’t been socializing as much and you’re worried about them being lonely. If they’re open to getting help but feel overwhelmed, offer to do some research on good therapists or to wait for them in the lobby during their first appointment. Remind them that anxiety is treatable, even without medication, and that this isn’t something they have to fight alone.
If someone confides in you that they’re feeling anxious or having a panic attack, the most important thing to remember is that the feelings—and telling you about them—are a big deal. It takes trust to show that kind of vulnerability. Listen and respond in a way that doesn’t minimize their experience.
There are definitely times when I haven’t been heard, when my anxiety has been dismissed or questioned. I’ve been subjected to jokes about how me and my fellow Millennials are the “Xanax generation” or how I’m only anxious because U.S. culture is in an age of anxiety, as though everyone feels exactly as I do so I should just suck it up.
Ultimately, however, I want to be honest with my friends, no matter how difficult it may be at first. Far from the nightmare I often envision, opening up to others is usually a positive experience that strengthens my relationships and makes me feel supported and less ashamed.
Even if you can’t take your friend’s anxiety away, showing support can help them feel more comfortable and take away some of the stigma that compels them to hide—which is a pretty amazing thing to do for someone you care about.