Have you ever felt so nervous, uneasy and jumpy you thought you’d throw up and faint at the same time? For the 18 percent of Americans with anxiety disorders, these feelings are common – and friends and family often don’t know what to say to help.
What should (and shouldn’t) you say or do to someone struggling with anxiety? To find out, ENTITY talked to Health Coach Isadora Baum, Dr. Keith Humphreys, Stanford professor of psychiatry and behavioral sciences, and Dr. Janine Domingues, a clinical psychologist in the Anxiety and Mood Disorders Center at the Child Mind Institute.
Here are three things you shouldn’t say or do to a friend with anxiety – plus four things you should.
Stress is nothing new for most Americans: 75 percent of surveyed adults reported experiencing moderate to extreme stress in the last month. Knowing what stress or anxiety feels like, though, doesn’t mean you “understand” the experiences of someone with an anxiety disorder.
As Baum explains, “Beyond underestimating what they’re going through, saying you ‘understand’ often leads you to complain about your own problems, shifting the focus to yourself. Instead, be there for your friend in need.”
Dr. Domingues agrees that everyday stress differs greatly from an anxiety disorder. “An anxiety disorder is not a typical experience. An anxiety disorder causes significant distress and leads to a person not being able to do the things they need or want to do,” she says. Besides not claiming that you understand, you should avoid over-simplifying anxiety with questions like, “Why are you so stressed?” According to Dr. Domingues, that kind of behavior “is invalidating to the person’s experience and may also indicate a lack of understanding that the person is experiencing something much more than just stress.
Anxiety triggers can vary between people and days. As shown by one Huffington Post article quoting people with anxiety, triggers can range from heat to being alone to being surrounded by too many people to hearing an ambulance. So, it’s understandable if you feel frustrated when your friend or loved one has an anxiety attack from some seemingly “normal” part of everyday life. However, don’t tell them to just grow up and calm down. As Dr. Humphreys puts it: “If they could calm down, they would have done it already.”
If they’re feeling anxious about an upcoming event – like a big presentation – don’t tell them to just “do it and get it over with” either. “It’s important to remember that when a person is suffering from anxiety that they desperately want to do things that cause them anxiety, but just feel like they can’t,” explains Dr. Domingues. “It’s understandable that, as a loved one, you are trying to perhaps encourage them to get through it, but doing it in this manner may make them feel worse.”
It isn’t easy to have a loved one or friend with an anxiety disorder. One survey of those with generalized anxiety disorder found that they were twice as likely to have at least one significant relationship problem, ranging from regular arguments to not spending enough social time together. Even if you aren’t dating or married to someone with anxiety, Dr. Domingues says, “There will be challenging moments between you and the person suffering with anxiety.” What you absolutely shouldn’t do? Blame yourself – or something you did – for his/her anxiety. “Do not ask ‘What did I do wrong?,'” Dr. Domingues advises. “This can add to the person’s sense of guilt and increase their anxiety.”
You also shouldn’t hold yourself responsible for finding “the cure.” Sure, maybe Susie from your work has been boasting for weeks how yoga and meditation made her anxiety disorder totally disappear. True, some studies on animals suggest that exercise could help decrease a person’s anxiety levels. Research on meditation has been even more promising. However, Baum argues, “These healthy outlets can be helpful in general, but they can’t treat an anxiety disorder. It’s way more complex.”
Not only that, but everyone – and every anxiety disorder – is different, so what works for one person may not for another.
So what can you do or say to help friends with anxiety? First off, follow Dr. Humphreys’ advice and “empathize with them by reflecting on their feelings. Express sympathy by saying, ‘I understand that you are really anxious – I imagine that’s really unpleasant.'”
Dr. Domingues agrees that support is one of the best ways you can help people with anxiety. “Listen and validate – this means letting them know that you are open to listening and understanding where the person is coming from in a nonjudgmental way,” she says. “Also, notice and be excited when they improve – even if it seems small. This positivity will help to encourage them to continue to make small steps toward big change.” Countless studies have shown that social support can drastically improve people’s mental and physical health. Maybe all you really need to give is, well, you.
If you’re at a real loss on how to show your support, Baum suggests simply asking, “How can I help you?” You “should try and be there in whatever way you can,” but asking what they need ensures your efforts will actually help or, at the very least, comfort.
If someone’s feeling anxious, don’t resign yourself to leaving him or her alone either. “People with an anxiety disorder may have a tendency to isolate because they worry or feel anxious; however, the more time you spend together, the more opportunities you are providing to help them distract and not engage in the worry,” explains Dr. Domingues. “At times, for people with anxiety it may feel like their life is all about anxiety. You spending time together and inviting them to do things (even if they say no at times) is really helpful in providing them with something to look forward to.”
Research supports Dr. Domingues’s suggestion. One 2015 study found that face-to-face social interaction can reduce stress, anxiety and depression. If someone is struggling with social anxiety, facing his or her fears may also be the best medicine. As for what kind of quality time you should enjoy, try activities that involve movement and don’t include electronics. Studies have linked a sedentary lifestyle, as well as increased time on TVs, computers or other devices, with increased anxiety. So, instead of watching a movie together, you may want to try to go on a walk instead!
RELATED: 3 Breathing Exercises for Anxiety
Even though “anxiety disorders are really common,” according to Baum, Dr. Domingues still observes a lot of “shame and stigma attached to having a mental illness.” This stigma can not only make it harder for people to open up about their battles with anxiety, but can also cause “a majority of people who are diagnosed [to] not get treatment.” The more you research you do, the more prepared you’ll be to interact with your friend/loved one without any judgement or incorrect preconceived notions about anxiety.
It’s also important to realize that, as Dr. Humphreys says, “Anxiety and most psychological problems are genetic.” In fact, research has linked seven genes to anxiety disorders like obsessive compulsive disorder and social anxiety disorder. Realizing that anxiety has genetic roots may help you understand that feeling anxious is really not in your friend’s control.
As much as you might hope that you alone can help your friend beat anxiety, professional support is probably needed. Nowadays, a variety of treatments are available, ranging from medication to cognitive behavioral therapy. In fact, in treating people with social anxiety, researchers have reported a 75 percent success rate using CBT.
When you do suggest professional help, make sure you keep a couple of tips in mind. “Be warm and supportive when you’re asking, as it can come off as a bit pushy,” advises Baum. “If your friend rejects this, or says he or she is already doing so, back off.”
Beyond giving advice to seek medical help, you also need to make sure you’re giving yourself plenty of TLC. “When taking care of someone with anxiety or any mental illness, it is really important to be in tune with how you are feeling and how you are coping,” says Dr. Domingues. “Your loved one is looking to you not only for support, but also as a model.”
Anxiety disorders are difficult to understand if you have never personally experienced them, and helping a friend or loved one battle anxiety can be even more challenging. However, by following these guidelines and focusing on offering as much non-judgemental help as you can, you can be just the support system your friend needs.
And, if all else fails, just remember to tell them one thing: “I love you, and I’m here for you – no matter what.”
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