Mental Health

What to Say: Anxiety

Help support your loved ones while they live with anxiety

Amanda Engel

Oct 19, 2022 • 5 min read

Help support your loved ones while they live with anxiety

Risa Kerslake

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Nathaniel Glanzman

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Help support your loved ones while they live with anxiety

What we'll cover

Anxiety can be a temporary or ongoing mental challenge for an individual. In this “What to Say” guide, we’ll cover what anxiety is and how it can impact an individual’s life—from interpersonal relationships to physical and mental side effects. We’ll also offer suggestions for how you can thoughtfully respond to a friend or loved one facing anxiety, what you should avoid saying and ways you can support them through a difficult time.

What it is

According to the National Alliance on Mental Illness, anxiety disorders are the most common mental health concern in the United States. More than 30% of adults have reported being affected by prolonged anxiety at some point in their lives. Anxiety disorders not only differ from feelings of anxiousness, but also manifest in different types.

Stress and anxiousness

The Jed Foundation, an organization that protects emotional health and prevents suicide, defines typical anxiousness as a proportionate response to a trigger, which can be internal or external. On the other hand, according to therapist Robin Torres LMSW, CASAC, “Anxiety is more of an overall feeling of doom and helplessness whose cause is more difficult to pinpoint.” It has a ringing effect where the intrusive thoughts and agitation continues even beyond the elimination of the stressor, sometimes causing others.

“The best way to self-differentiate is to see if the person can identify the reason for the stress,” says Torres. “Can they say ‘I’m stressed out because of XYZ reason?’ If so, it may be passing anxiousness.”

Anxiety disorders

With anxiety disorders, as the fear or anxiety experienced is either out of proportion to the situation, age-inappropriate, or hinders a person’s ability to function normally—or a combination. These emotions can go on for a prolonged amount of time.

Anxiety disorders can often be treated by mental health professionals, who may recommend psychotherapy (talk therapy, including cognitive behavior therapy) and medication, such as those specifically designed for managing the symptoms of anxiety or antidepressants or beta blockers. Recourse depends on the type of disorder someone is facing and their symptoms, but in Torres’ experience, the most effective treatment is often a combination of the two.

Other forms of anxiety

These may include:

— Generalized Anxiety Disorder: Characterized by a persistent and excessive worry over everyday things, such as work, health and even chores or unforeseen tasks or added responsibilities. It can manifest in physical symptoms that may include restlessness, fatigue, edginess, difficulty concentrating, muscle tension and an inability to sleep.

— Phobias: This form of anxiety is triggered when individuals are exposed to a specific object or situation, and have a strong desire to avoid it.

— Panic Disorders: Commonly known as panic attacks or anxiety attacks, panic disorders may cause people to feel palpitations, sweating, a shortness of breath, dizziness, numbness, tingling, chills or hot flashes, and even a sense of detachment, abdominal pain, or fear for their lives.

— Social Anxiety Disorder: Beyond shyness, this form of anxiety stems from a deep-seated fear of embarrassment, rejection, disdain, or contempt. They may go to great lengths to avoid situations with other people, from smaller interactions such as eating or drinking around others to larger ones like events and functions.

What not to say

Anxiety is a sensitive subject and bringing it up—especially if and when a loved one is not expecting it—can exacerbate those anxious feelings by causing more stress or self-consciousness. Here are examples of things you should steer clear of saying to someone dealing with anxiety.

"Calm down."

Why it doesn't work: In any stressful situation, telling anyone to relax is often the least relaxing thing someone can do. According to The Wall Street Journal, this phrase usually creates the opposite effect. One’s inability to comply and the implication that they are being unreasonable can then cause frustration on top of anxiety, which in turn may make them spiral further.

"You’re worrying over nothing. It’s not that bad."

Why it doesn't work: A brush-it-off response, like telling someone they’re overreacting, minimizes and dismisses their anxiety after they have trusted you with their vulnerable thoughts. This creates a feeling of insecurity and breaks trust, potentially impacting their desire to confide in you again.

"Something’s up with you. Tell me what it is."

Why it doesn't work: Those with anxiety may feel self-conscious about their disorder or how it manifests. Shining a direct spotlight on it can make them feel more anxious. Following that up with a demand for an explanation can breach their right to privacy and selective trust.

"What is this really about?"

Why it doesn't work: It is of course important to consider all potential causes to ensure you’re tackling a root problem, but second-guessing a person who is sharing their reasoning with you can make it seem like you don’t trust their judgment or believe they can’t identify or articulate their own feelings. Self-doubt can be detrimental to someone working through anxiety.

"I think you need serious help."

Why it doesn't work: While this may be a valid concern, this is a strong, aggressive response that can bring up feelings of helplessness and hopelessness, amplifying their anxiety. Saying something like this in such a direct fashion can feel like you’re already giving up on them. It can also drum up the stigma that surrounds mental health and mental health conditions.

Nothing.

Why it doesn't work: Finding the right words can be difficult for anyone, but that doesn't mean you should neglect to say anything to your friend or loved one. During especially difficult situations, your loved one will appreciate any kind or reflective words you can offer during their time of need. Saying something—with intention and thoughtfulness—is better than saying nothing.

Instead of avoiding a conversation in a fraught moment, try a phrase like, "I can't begin to know what you are going through, but I am here for you." If the moment is more lighthearted or celebratory, a simple, "I am so happy for you right now!" goes a long way.

What to say

With those guidelines in mind, here are some ways to empathetically begin a conversation about the anxiety that may be troubling your friend or loved one.

Note: These conversation starters are just suggestions. Each individual’s experience will vary and users should measure their words based on what they know and do not know about their loved one.

"I know you’re going through a lot."

Why it works: This softly worded observation is vague and general enough to invite them to elaborate or explain, while avoiding any prying or uncomfortable questions. It also denotes sympathy toward whatever they’re feeling challenged with, implying that they don’t need to go through it alone.

"It seems like you haven’t been yourself. Do you want to talk?"

Why it works: When using a mild tone, noting that their behavior has been different shows concern without being accusatory. Closing with a gentle open-ended question allows them the option to reveal more. It is a common enough query that they can decline without fear of seeming impolite. It also gives them the open door of coming back later if they’re not ready to talk about it yet. Alternatively, you can say “I’m worried something might be bothering you. Am I misreading that?” The “I” statement puts the onus on you, so that they don’t feel called out.

How to recover

While your intentions are good, sometimes the wrong words in a delicate situation can become a hazard. If you’ve found that you somehow said the wrong thing, the first and best thing to do is apologize, and quickly follow up by asking how you can help. Sometimes, the best thing you can do is just listen, whether it’s to their reason for being upset at your response or about their reasons for feeling anxious.

Other suggestions

To help them through their time of high anxiety, you can make small gestures, like handling a task that is related to their anxiety, so that it doesn’t pile up and/or they don’t have to think about it. You can also assist in removing any stressors themselves, such as cleaning off spiderwebs around the home if they are arachnophobic.