How to help a friend or family member with panic or anxiety disorders

If a friend or loved one has an anxiety disorder, they may struggle to do things that others take for granted, like speaking to a stranger in a store or driving over a bridge. They may feel overwhelmed by the intensity of their fear and embarrassed by their uncontrollable reactions. Maybe you feel overwhelmed, too, not knowing how to help.

It can be hard to relate to the fears and feelings that someone is experiencing during an anxiety attack. Many people misunderstand anxiety and blame it on a flare for the dramatic. But anxiety isn’t merely drama. It’s a genuine, intense fear that can cause physical, emotional, and behavioral reactions.

Recognize the Signs of Anxiety

Anxiety attacks are like false alarms of our protective instincts that cause a fight, flight, or freeze reaction. The symptoms of an anxiety attack come on suddenly, can be intense, and tend to peak within about ten minutes.

An anxiety attack can cause physical symptoms as well as anxious thoughts and behaviors.

Physical symptoms:

  • Feeling lightheaded
  • Feeling edgy or restless
  • Sweating
  • Nausea
  • Racing heart
  • Trouble breathing or hyperventilation
  • Headache
  • Trembling, muscle twitches
  • Chills or hot flashes
  • Diarrhea
  • Fatigue
  • Feeling detached from reality

Anxious thoughts and behaviors:

  • An overwhelming feeling of panic
  • Thinking the worst case will happen
  • Constant worry
  • Thinking in terms of all-or-nothing
  • Overgeneralizing
  • Avoiding situations or events in fear
  • Irritability and frustration in fearful situations
  • Seeking reassurance
  • Second-guessing oneself
  • Compulsive actions

Immediate Help for An Anxiety Attack

During an anxiety attack, your friend or loved one may be afraid, distraught, seem sluggish or frozen in place, and may sound incoherent. It may look and feel like a medical emergency. 

With quick thinking, you can help reduce your friend’s stress and help them gain control over the situation.

1. Help control the environment 

Help your friend to a neutral location away from unwanted attention. Having an audience can make symptoms worse.

2. Breathe together 

Ask your friend to breathe with you. Help them focus on slow, calming breaths. Be a model of calm behavior.

3. Validate their reaction 

It may not make any sense to you, but what your friend is feeling is very real. Don’t question or belittle their experience; trust their truth and ask how you can support them.

man comforting woman

4. Express your concern 

You may not be able to shorten or lessen the severity of an attack. Still, your care and support might be a lifeline. It might also help to ask what’s causing the attack and what your friend needs from you.

5. Don’t enable 

Eliminating the cause of your friend’s distress may seem like the right solution at the time. Still, their anxiety will probably grow if they continue to avoid the cause. Instead, help them through it.

6. Don’t force confrontation 

On the other hand, forcing them to confront the cause of their anxiety when they aren’t ready can damage your relationship and worsen their anxiety. You may need to help them ease into a situation.

7. Reassure them 

Anxiety tends to breed more anxiety. Reassure your friend that this is a temporary reaction, and it does not change who they are or how you feel about them.

Long-term Help for An Anxiety Disorder

Anxiety disorders are chronic conditions that can interfere with work, school, and relationships. Understanding your friend’s anxiety can make you an important ally in their long-term fight to control their symptoms.

1. Educate yourself 

You can research anxiety online or at your library. If you know what kind of anxiety your friend has, you can tailor your research towards that diagnosis. If not, you can still learn about how anxiety works, triggers, behaviors, anxious thoughts and how to reframe them, and more. The more you know, the more you’ll be prepared to support your friend.

2. Learn their response mechanism 

Our brains are wired to react to fear with a fight, flight, or freeze response. Which is your friend’s dominant response? Knowing how they respond to triggers can help you recognize an anxiety attack as soon as it starts. When you recognize their behavior for what it really is, you’ll have more empathy and be better equipped to help.

3. Ask

Some people respond best to emotional support, while others might respond better to practical support like problem-solving or talking through actions. Talk to your friend about how they want you to support them.

seniors doing outdoor yoga

4. Exercise 

Exercise distracts the mind from the cause of anxiety, decreases muscle tension, and boosts the availability of anti-anxiety chemicals in the brain. Work out together for physical, emotional, and relationship benefits.

5. Practice stress management 

Techniques like mindfulness meditation, breathing exercises, or yoga, for example, can help decrease the symptoms of anxiety. Encourage your friend to experiment or take a class together.

6. Pinpoint anxious thoughts 

Help your friend identify and reframe thoughts that cause anxiety. For example, if someone cancels plans with your friend and that triggers negative self-talk, list some reasons they might have canceled that are unrelated to your friend.

7. Address avoidance behavior 

Avoiding situations or tasks because of anxiety can end up causing a snowball effect. The longer one avoids the task or situation, the more overwhelming it seems. It may help to identify the issue that’s causing anxiety, talk about the steps needed to overcome it, and work together to take the first step.

8. Destigmatize 

The fear of having an anxiety attack can be as debilitating as an actual attack. Reassure your friend that they can cope if it happens; that anxiety is not a sign of failure or weakness. Normalize their fears, if you can, by sharing yours. It’s perfectly normal to have fears. Having fearful thoughts doesn’t automatically mean that they’ll happen. Others also have these thoughts and fears and can overcome them.

9. Assist them in getting help

 As badly as you may want to, you can’t cure your friend’s anxiety. Your care and support can be an essential part of their treatment, but there may be times when it is not enough. If your friend’s anxiety is affecting their work, school, relationships, or ability to enjoy life, encourage your friend to get professional help.

Living with an anxiety disorder isn’t easy. Supporting your friend won’t always be easy either, but your efforts could mean the world to them. Don’t worry about what you’re doing right or wrong; you’ll figure it out together. Just being there is an essential first step.

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