Anxiety disorders are the most common mental health conditions in America, affecting nearly 1 in 5 adults, according to the Anxiety and Depression Association of America. This means you likely know someone — a relative, spouse, friend, or coworker — who lives with an anxiety disorder.
If you’ve never experienced impairing anxiety — that is, anxiety that goes beyond a healthy response to a stressor — it can be hard to understand someone who is experiencing it, says Helen Egger, MD, cofounder and chief medical and scientific officer at Little Otter, a family mental health care practice in San Francisco.
Occasionally experiencing the jitters or worries is a normal part of life. The difference, according to the National Institute of Mental Health, is that people with an anxiety disorder experience symptoms often, and those symptoms do not easily go away. Symptoms vary from person to person and can include:
- Difficulty controlling worries
- Getting fatigued easily
- Having trouble concentrating
- Headaches, muscle aches, or pains with no other apparent cause
- Panic attacks — periods of intense and sudden fear or feeling a loss of control despite no clear danger present
- Frequently feeling restless or on edge
- Sleep problems
- Sweating, trembling, or racing heartbeat
Even though you might not understand everything someone experiencing anxiety is going through, you can provide reassurance and help ease their angst. However, even with the best of intentions, it’s all too easy to inadvertently say or do things that hurt more than help, says Joanne Frederick, a licensed mental health counselor in private practice in Washington, DC.
Your words do have the power to help someone with this condition. “Knowing the right things to say to a person who has an anxiety disorder can make a huge difference to the person who is struggling,” Dr. Egger says.
So, what shouldn’t you say to someone with anxiety — and, just as importantly, what can you say to be helpful? Experts advise avoiding these four phrases:
1. ‘Calm Down’
More often than not, this all-too-common phrase comes across as condescending, Frederick says. “If the person experiencing anxiety could calm down at that moment, they’d simply do it.”
Egger adds that the phrase “calm down” implies that your friend or loved one is choosing not to be calm or that they’re choosing to feel anxious, when in reality their condition makes it extremely difficult for them to feel calm. As a result, this phrase can cause them to feel ashamed, powerless, and alone.
Gently offer support without judgement, suggests Frederick, by using phrases such as:
- “I’m here for you.”
- “I’m here to listen if you want to talk.”
- “I’ll stay with you if you’d like.”
2. ‘Be More Present’
Many people with anxiety disorders have anticipatory anxiety, meaning they worry intensely about things that haven’t happened yet but might happen in the future, Frederick says. “Asking your loved one just to be present [in the moment] would be the same as asking them to wave a magic wand and have their anxiety disappear,” she explains.
Ask them what’s currently causing them their greatest worry. If they rattle off a list of several things, Frederick suggests asking them to focus on whatever is most pressing or fast-approaching and then help them address their fears surrounding that thing first.
“Work with them to deescalate the situations they have coming up right away, and do not try to tackle everything at once,” she advises.
If they’re willing, offer to help them practice staying within the present moment, Egger suggests. One technique to try: Ask them to choose something in their immediate surroundings to focus on, then ask them to use their senses to describe what they see, hear, touch, smell, and taste. This so-called “grounding technique” helps distract them from their worries and pull them back into the present moment.
Alternatively, try walking them through a visualization exercise — a technique that encourages the mind and body to relax, Egger says. To begin, ask them to close their eyes, take a few deep breaths, and then think of a happy memory or imagine being in a serene place such as a flower-filled meadow or a sunny beach. Encourage them to spend five or so minutes taking it all in before opening their eyes.
3. ‘Quit Overthinking’
Similar to the phrase “calm down,” telling someone to stop overthinking implies that they’re simply choosing not to control their anxiety.
In truth, anxiety is a complex but treatable illness like diabetes. In the same way you’d never tell someone to just “quit” feeling the symptoms of diabetes like being thirsty or very tired, it’s unhelpful to tell someone with an anxiety disorder to just stop feeling the symptoms of their condition, says Egger.
In fact, most people with anxiety are aware to some extent that their worries may be out of proportion to the situation at hand — and knowing that they can’t control their reaction only makes them feel worse. “When anxiety rears its head, it is vast,” Frederick explains.
What’s more, telling someone in the middle of an anxiety attack that what they’re worried about is not a big deal or that they should stop overthinking disregards their genuine distress, she says.
Listen to their concerns and validate their feelings without trying to offer any solutions in the moment. Phrases Egger suggests trying are:
- “I can tell you’re having a really hard time.”
- “You’re safe.”
- “I’m here to help you get through this.”
4. ‘Worrying Won’t Change Anything’
When someone we care about is suffering, our instinct is to try and fix the situation for them. The trouble is that anxiety disorders don’t typically have an easy fix because the anxious thoughts often aren’t logical or are focused on the worst-case scenario.
Trying to soothe someone’s anxiety by telling them their thoughts aren’t productive, worthwhile, or that they’re a waste of time also invalidates their feelings and may even leave them feeling more distressed than before, Egger explains.
Showing your loved one understanding, patience, and empathy can go a long way.
“If I’ve learned anything in my 30 years as a psychiatrist, it’s that our words have power,” Egger explains. “What a person with an anxiety disorder needs to hear is that you understand that they’re having a hard time and that you are there to support them.”
Let’s say a family member or friend with anxiety is very stressed about a big presentation at work and convinced they’ll fail. Frederick suggests reinforcing that it’s okay to be anxious while reminding them of past successes, telling them, for example, “It’s perfectly normal to feel stressed. But I know you’ve worked hard to prepare for this and have already given great presentations in the past.”
Other helpful phrases you might say:
- “Do you want to do something to take your mind off things?”
- “How can I help right now?”
- “Let’s try to navigate through this together.”