17 Things People With Anxiety Wish Their Loved Ones Knew

Originally published 2017-03-06.

If someone you love lives with anxiety, the most useful things you can offer are patience, calm and a willingness to listen without trying to argue them out of their fears. Below are 17 things many people with anxiety say they wish partners, family and friends understood, followed by practical ways to help and a few common myths worth dropping. Every person is different, so treat this as a starting point for a conversation, not a script.

What anxiety is, and what it is not

Everyone feels nervous before an exam or a job interview. An anxiety disorder is different: according to the US National Institute of Mental Health (NIMH), the worry does not go away, shows up in many situations and can get worse over time, to the point where it interferes with work, school and relationships. The main types include generalised anxiety disorder, panic disorder, social anxiety disorder and specific phobias.

Anxiety is also physical. NIMH lists restlessness, tiredness, trouble concentrating, irritability, muscle tension, headaches, stomach aches and poor sleep among the symptoms of generalised anxiety disorder. That helps explain much of what loved ones notice from the outside.

The Stoic philosopher Epictetus taught that people are troubled less by events than by their judgements about events. A popular paraphrase, often attributed to him, says we worry more about our imagined anxieties than about real problems. Many people with anxiety recognise themselves in that idea. Knowing a fear is out of proportion, though, does not switch it off.

17 things your loved one may wish you knew

How to be with them

1. Listening without judgement means a lot. They often know their worries do not quite add up. Being allowed to say them out loud, without being corrected, helps them sort through what is going on.
2. Your calm is contagious. When their mind is racing, a steady voice and relaxed body language give them something solid to hold on to.
3. Talking down to them hurts. Anxiety does not make anyone childish or less intelligent. Speak to them as the capable adult they are, even mid-panic.
4. Odd comforts are still comforts. A particular hoodie, a playlist, a route home or a fidget object may look strange to you. If it helps them feel safe and harms no one, let it be.
5. Point out what seems to help. If you notice that a walk, a scent, a certain place or a person seems to settle them, mention it. They may not have spotted the pattern.

What happens inside

6. It is not something they can reason away. Anxiety is a recognised health condition with physical effects. Facts and reassurance alone rarely shut it down, however much they wish they did.
7. Panic attacks feel like an emergency. During an attack a person may have a pounding heart, chest pain, shortness of breath, trembling and a powerful sense of doom. The Mayo Clinic notes that panic attacks, while intensely uncomfortable, are not dangerous in themselves, but in the moment they can feel like dying.
8. Constant alertness is exhausting. Scanning for threats all day uses up energy. Needing more rest or quiet time is not laziness.
9. Overthinking cuts both ways. The same mind that spirals into worst-case scenarios is often thoughtful, careful and good at anticipating problems.
10. They do not fully understand it either. You do not have to grasp exactly how anxiety feels to be supportive. Accepting that it is real is enough.

The guilt they carry

11. They already know when they have let you down. Cancelled plans and last-minute changes bother them more than you might think. Reminding them only adds to the guilt.
12. Snapping is usually not about you. Irritability is a common symptom. Most people feel bad afterwards. You can still set limits, but try not to take it personally.
13. Patience is noticed and appreciated. Even if they rarely say it, they know that loving them takes effort.

How you can help

14. Ask for the plan when things are calm. Most people can tell you what helps during a bad moment, but not while it is happening. Have that conversation on a good day.
15. Sharing coping tools shows you are on their side. Offering a breathing exercise, a grounding technique or a mindfulness app is a kind gesture, even if not every tool works for them.
16. They want you to look after yourself. You cannot support anyone from an empty tank. Your sleep, friendships and own wellbeing matter too.
17. Anxiety is not the whole of who they are. With support, treatment and self-care, people with anxiety build full, ambitious lives.

What to do during an anxious moment

• Stay near and stay steady. Sit with them, speak slowly and keep your own breathing even.
• Ask, do not assume. "Do you want me to talk, or just be here?" respects their preference.
• Use the agreed plan. If they have told you what helps, follow it: a quieter room, a glass of water, slow breathing together, naming five things they can see.
• Skip the debate. "There's nothing to be scared of" tends to make people feel unheard. "That sounds really hard, I'm here" usually works better.
• Know when it is more than anxiety. Chest pain and breathlessness can also signal heart or other medical problems. If symptoms are new, different or you are unsure, seek medical help.

Common myths about anxiety

"They just need to relax." If relaxing on command were possible, they would already have done it. Anxiety disorders involve the body's stress response, not a lack of willpower.

"Avoiding stressful things is the kindest option." Helping someone dodge every trigger can make anxiety shrink their world over time. Gentle encouragement, at their pace and ideally with professional guidance, is usually more helpful than rescuing.

"It's only in their head." The thoughts are in their head, but the racing heart, upset stomach, tense muscles and broken sleep are very real.

"Nothing can be done." Anxiety disorders are treatable. NIMH describes cognitive behavioural therapy as a well-studied, effective approach, and some people are also helped by medication or support groups. Anyone affected should talk to a doctor or a qualified mental health professional about what is right for them.

Looking after the relationship and yourself

Loving someone with anxiety can be confusing and tiring, and it is fine to admit that. A few habits help both of you:

• Agree on how you check in. Some people prefer a short text to a phone call, or an invitation that is easy to decline without guilt.
• Do not demand a detailed report of their feelings. "On a scale of one to ten?" can be easier to answer than "How are you, really?"
• Keep your own support network. Talking to a friend, a counsellor or a carers' group is not disloyal.
• Encourage professional help without pushing. Offering to help find a therapist or go with them to an appointment can lower the barrier.

A line often attributed to the diarist Anaïs Nin calls anxiety "love's greatest killer", comparing an anxious person to someone drowning who clings to a rescuer. It is a vivid image, but it need not be the whole story. With understanding on one side and treatment on the other, many couples, families and friendships come through anxiety closer than before.

If your loved one ever talks about harming themselves, treat it seriously and contact emergency services or a crisis line. In the United States, you can call or text 988.

Sources: NIMH: Anxiety disorders; NIMH: Generalized anxiety disorder; Mayo Clinic: Panic attacks and panic disorder; I Heart Intelligence (original list).