This article was co-authored by Rebecca Ward, LMFT, SEP, PCC, MA. Rebecca A. Ward, LMFT, SEP, PCC is the Founder of the Iris Institute, a San Francisco, California-based business focusing on using somatic expertise to teach individuals and groups the skills to deal with dilemmas using interventions, including her own Original Blueprint® method. Ms. Ward specializes in treating stress, anxiety, depression, and trauma. She is a Licensed Marriage and Family Therapist (LMFT), a Somatic Experiencing® Practitioner (SEP), and a Professional Certified Coach (PCC) accredited by the International Coach Federation (ICF). Rebecca holds an MA in Clinical Mental Health Counseling from Marymount University and an MA in Organizational Leadership from The George Washington University.
There are 28 references cited in this article, which can be found at the bottom of the page.
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People with anxiety problems may experience anxiety in social situations, because of triggers and other symptoms related to Post-traumatic stress disorder (PTSD), Social Anxiety Disorder, Panic Disorder, and for many other reasons, some of which are often unidentified. These problems can range from mild to severe, and are often most prominent when the anxiety is acute. If you have a friend, family member or a relative who is dealing with this stress, it's important to provide non-judgmental support during anxiety attacks and other times of crisis.
Steps
Handling an Anxiety/Panic Attack
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Stay calm. It's easy to become anxious around another person who is anxious.[1] Make sure to take deep, steady breaths. You need to stay calm in order to help your loved one calm down too. You need to keep your mind clear as a person who is having an anxiety attack is in fight or flight mode and won’t be thinking logically.
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Take your loved one somewhere quiet and sit them down. If possible, remove them from the environment that is triggering the anxiety attack. When a person is anxious, they believe they are in danger: anxiety is fear out of context.[2] Taking them away from the situation they are currently in will help them feel safe. Sitting down will calm the adrenaline that is rushing through their body, and help take them out of fight or flight mode.
- Avoid talking about anything that's going to worsen your friend's anxiety. Instead, show that you're engaged and supportive by asking questions like, "Have you reached out to anyone you can count on for support?"[3]
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Offer medication. If your loved one has been prescribed medication to take during an anxiety attack, offer it now. If you don’t know, ask them what their prescribed dosage is. It’s best to familiarize yourself with the dosage and contraindications of any medication your loved one has been prescribed. It’s also good to know how long ago this medication was prescribed and what directions the doctor has given along with it.[4]
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Tell them that they are safe. Speak in short, simple sentences and in a calming, comforting tone. The important thing is to remind them that they are not in danger, the anxiety they are feeling will pass[5] and that you’re present and ready to be supportive. Reassuring things to say include
- "It's going to be okay."
- "You're doing just fine."
- "Quiet your mind."
- "You are safe here."
- "I'm here for you."
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Do a breathing exercise with them. Deep breathing alleviates symptoms of anxiety.[6] Tell them to breathe with you. Tell them to inhale through their nose while you count to 5 and exhale through their mouth while you count to 5. Say, "We can take some deep breaths together. Put your hands on your stomach, like this. When we breathe in, we'll feel our stomach rise and fall with our breath. I'll count as we hold it. Ready? In... one... two... three...four...five... out... one... two... three… four… five..."
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Implement a grounding strategy. Bringing the focus on present reality will help a person having an anxiety attack realize that they are not in danger.[7] Help them focus on and describe their immediate environment. You can also ask them to name all the furniture in the room, then all the wall decor in the room, etc. You want to help distract them from their internal experience by helping them focus on their external experience.
- As your friend calms down, ask them if they'd like to talk about it more or if it would be more helpful to change the subject to something more positive. If they're open to it, you can try talking about things that are calming or pleasant, like something interesting you saw on a walk one day, a cute story about your cat, or your quest to find the perfect cup of tea.[8]
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Call an ambulance or take them to a hospital if their symptoms are severe. Some of the symptoms of anxiety attacks are similar to that of a heart attack.[9] If you’re unsure of what is going on or if your loved one has another anxiety attack as soon as they have calmed down, call professionals for help. A medical expert can best assess the situation.
Dealing with Anxiety on a Daily Basis
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Encourage your loved one to practice self-care. Anxiety may cause people to neglect their physical or emotional health, and you can help by suggesting that they do something if you notice they have forgotten.[10] Self-soothing activities may be especially important if they have frequent anxiety. For example, ask them if they would like to get something to eat or suggest that they take a warm, long bath.
- When dealing with children, engage in relaxing activities together. Let them pick what they want to do.
- Invite your friend to join you in exercise. Getting their body moving may help alleviate their anxiety, and it will show them that you care.[11]
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Allocate time for worrying. Not everyone with anxiety will have an anxiety disorder but that doesn’t mean it doesn’t need to be dealt with. Set aside 30 minutes out of the day, where your loved one can just have a good worry. During this time, don’t let them be distracted by anything other than worrying and feeling anxious. Encourage them to think of solutions to their problems. This technique is effective with children as well as adults and helps them gain a sense of control over their problems.
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Validate their feelings. Your loved one may tell you why they feel upset, or you may have been able to tell based on what set off the anxiety. Try saying how upset they look, and recognize that this is hard. This lets them know that you care, and that you think their struggles are valid. Ironically, affirming their stress can reduce it.[12]
- "That sounds really hard."
- "I can see why that would be upsetting to you. It sounds like visiting your father can be difficult for you sometimes."
- "You look stressed. Your face is scrunched up and you look hunched over. Do you want to talk about it?"
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Offer human touch. Hugs can bring comfort to an anxious person.[13] You may try to pat their back, give them a one-armed hug or put your arm around their shoulder to make them comfortable. Only do what you and they are comfortable with.
- Always give them opportunities to decline. If they are dealing with sensory overload or are autistic, touch may make things worse. Or they may not be in the mood.
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Accept that their needs are different. This can be an enormous relief to the anxious person. Be accommodating, and don't question their bad days or unusual needs. Treat their anxiety like a fact that, while unfortunate, is not a dreadful burden upon your life. Recognize that their feelings matter, and treat them with compassion, anxiety and all.
- Be flexible. It may take longer for people with anxiety problems to get ready for events such as getting ready for school. Factor in this time and allow for delays.
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Encourage them to seek professional help. If your loved one isn't being treated already, seeing a doctor about their anxiety may allow them to get the help they need. It’s important to rule out any underlying medical or biological causes of the anxiety.[14] Once you know that the cause of your loved one’s anxiety is psychological, you will be in a better position to seek treatment. To give them a boost, you might suggest accompanying them to take notes, help them remember symptoms, or just for moral support.
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Form a support network. Asking others for help can be very encouraging for a person with anxiety problems. In fact, persons with strong informal support networks have increase their chances of benefitting from treatment for anxiety. [15] You don’t have to do anything specific. Just knowing that there are people around with whom to talk to and share their worries with, can help a person with anxiety problems feel better.[16]
Taking Care of Yourself
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Remember that you are not responsible for anyone’s health. You can help them, and you can offer resources, but you can not cure their anxiety disorder.[17] Any difficult symptoms or relapses are not your fault. Chronic anxiety changes the brain chemically and neurologically[18] and this take time to heal.[19] It is the responsibility of the individual to work with their doctor or psychologist and better themself.
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Practice self-care. Living with or being friends with someone with anxiety disorders/problems can be taxing.[20] Take plenty of time for yourself. You don’t have to feel guilty. Your needs also matter, and your emotional health is important. Give yourself alone time and be willing to set boundaries. Turn off your phone at a certain time every night, and don't take calls. Be available for two hours, but then go home to relax.
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Use your own support network. It’s important to have your own friends and family to support you too. Having someone to talk to about to encourage you to be patient will prevent burnout and keep your stress levels at bay.[21] Taking care of yourself and being in a state of well-being, puts you in the best position to help someone with anxiety problems.[22]
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Consult a psychologist independently if you feel overwhelmed. It can be helpful to turn to experts to learn more about anxiety disorders, mental health, and positive coping mechanisms both during crises and in the long term. A psychologist can help you deal with your own feelings about handling a person with anxiety as well as give you strategies for taking care of them. Anxiety disorders also affect caregivers’ health and relationship with the person suffering from the disorder.[23]
Understanding Anxiety
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Understand that an anxiety disorder is a mental illness.[24] Though it may not be something that is immediately obvious, like a broken leg or an arm, an anxiety disorder affects daily functioning and the quality of life of the person suffering from it. An anxiety disorder is more than temporary anxiety (worry or fear) that most people encounter from day to day and can become worse over time if not treated.[25]
- This is especially important if you yourself have never had an anxiety disorder.
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Know the difference between anxiety and a disorder. There is a significant difference between feeling anxious occasionally, such as when you’re going for a job interview or meeting new people, and an anxiety disorder. Anxiety is a normal part of life.[26] An anxiety disorder works on many levels: cognitive, biological, neurological and perhaps even genetic. An anxiety disorder will require professional help to be cured through talk therapy, medication, or both.[27] This may sound difficult and with persistence, it can be done.
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Learn about anxiety disorders. Knowing what your loved one is going through can give you empathy and put you in a better position to help them. If you know what type of anxiety disorder your loved one has, familiarize yourself with the particular symptoms of that order. Anxiety disorders include Generalized Anxiety Disorder, Social Phobia/Social Anxiety Disorder, Panic Disorder, PTSD and Separation Anxiety Disorder.
- If you’re not sure if your loved one has an anxiety disorder, look up the different symptoms of anxiety.
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Learn relaxation techniques and calming strategies. Anxiety disorders and attacks are not untreatable.[28] You will be better able to help your loved ones during acute anxiety, when you know how to calm them down and alleviate their symptoms. Especially learn how to do breathing exercises and interventions that make a person focus on the here and now. (These are known as grounding techniques).
Expert Q&A
Tips
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Remember that anxiety attacks are nearly impossible to prevent. Chances are, your friend feels terribly embarrassed about being unable to control their anxiety, especially if it happens in a public situation.[29] Do your best to remind them that it's not their fault, and that they are being very courageous by facing their anxiety attack.Thanks
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Don't help a person avoid what gives them anxiety. Encourage them to slowly face that fear and experience and learn that they aren't in danger. Avoidance can make anxiety worse, stronger over time.[30]Thanks
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Use positives when giving advice. Your loved one is pretty stressed already, so an encouraging and gently helpful tone is best. Make sure that your feedback about their feelings is constructive whenever possible, and recognizes that feeling unsafe, even in a safe environment, is a legitimate experience.
- "Try to slow down your breathing a little." (This is better than "Don't breathe so fast," because it tells them what to do rather than what not to do.)
- "Sit down if you need to"
- "Here's some water. Do you want to try to drink?"
- "You're doing really well so far. Keep it up."
Thanks
Warnings
- Avoid hurting the feelings of the person. It can be frustrating, especially if your loved one with anxiety problems is a family member. Be patient.Thanks
- Do not try to insult or make harsh demands to encourage stopping a behavior. If your friend is doing something that may worsen the situation, such as berating themself, try to confront the person in a calm voice.Thanks
References
- ↑ https://www.anxiety.org/is-anxiety-contagious
- ↑ http://anxietynetwork.com/content/what-you-fear-most-cannot-happen
- ↑ Rebecca Ward, LMFT, SEP, PCC, MA. Licensed Therapist. Expert Interview. 29 May 2020.
- ↑ http://www.anxieties.com/152/introduction-common-medications-for-anxiety-disorders
- ↑ https://books.google.com.pk/books?hl=en&lr=&id=hnpfMUAYsCoC&oi=fnd&pg=PR5&dq=how+to+calm+a+panic+attack&ots=uIcON85ch9&sig=D5_GBqOsYOzAAeTYE_cS9Aezg2g#v=onepage&q&f=false
- ↑ https://books.google.com.pk/books?id=E2sKf-sexZwC&pg=PA106&dq=calming+anxiety+attack+through+breathing&hl=en&sa=X&ved=0CBsQ6AEwAGoVChMIk4mNiKuhxwIVS38aCh2Awg5W#v=onepage&q=calming%20anxiety%20attack%20through%20breathing&f=false
- ↑ https://www.psychologytoday.com/blog/anxiety-zen/201411/taking-control-panic-attacks
- ↑ Rebecca Ward, LMFT, SEP, PCC, MA. Licensed Therapist. Expert Interview. 29 May 2020.
- ↑ http://www.calmclinic.com/anxiety/symptoms/heart-attack
- ↑ http://www.takingcharge.csh.umn.edu/conditions/anxiety-depression
- ↑ Rebecca Ward, LMFT, SEP, PCC, MA. Licensed Therapist. Expert Interview. 29 May 2020.
- ↑ https://www.psychologytoday.com/blog/pieces-mind/201204/understanding-validation-way-communicate-acceptance
- ↑ http://ajot.aota.org/Article.aspx?articleid=1882368
- ↑ http://www.clinicaladvisor.com/features/separating-anxiety-from-physical-illness/article/117767/
- ↑ https://www.learntolive.com/importance-support-network-social-anxiety-forum/#.Vcocwfmqqko
- ↑ https://onlinelibrary.wiley.com/doi/abs/10.1002/jclp.21925
- ↑ http://www.adaa.org/understanding-anxiety/myth-conceptions
- ↑ archpsyc.jamanetwork.com/article.aspx?articleid=492820&resultclick=1
- ↑ https://socialanxietyinstitute.org/social-anxiety-chemical-imbalances-brain-neural-pathways
- ↑ http://www.adaa.org/finding-help/helping-others/spouse-or-partner
- ↑ www.uptodate.com/contents/psychosocial-issues-in-advanced-illness
- ↑ www.ncbi.nlm.nih.gov/pmc/articles/PMC4446949/
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/18281843
- ↑ http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
- ↑ https://www.anxietycentre.com/anxiety-attack-symptoms.shtml
- ↑ http://www.mayoclinic.org/diseases-conditions/anxiety/basics/definition/con-20026282
- ↑ http://www.adaa.org/finding-help/treatment
- ↑ www.adaa.org/finding-help/treatment
- ↑ https://www.psychologytoday.com/blog/the-dance-connection/200909/anxiety-and-shame-lesson-in-courage
- ↑ https://www.psychologytoday.com/blog/hidden-motives/201102/anxiety-avoidance-denial-and-worse
About this article
If you need to help someone with anxiety problems, sit them down somewhere quiet and tell them that they are safe. Try telling them "It's going to be okay” or “You’re doing just fine,” as long as you remind them that the feeling will pass and that you’re there to be supportive. It might be difficult to stay calm when you’re around someone having a panic or anxiety attack, but you can keep your mind clear by taking deep, steady breaths. You can even ask them to breathe with you and count to 5 as you inhale and exhale. For more tips from our Mental Health co-author, like how to handle anxiety on a daily basis, read on.
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