Working out how to support a friend with their anxiety disorder can feel like a mystery – especially if you’ve never experienced it before. Here’s how to get it right.
In 2019, it’s more acceptable than ever to speak openly about mental health issues. Whether it’s over social media or down the pub on a Friday, more and more of us are choosing to share our experiences with friends and family – and it’s helping to destigmatise an experience that one in four of us will have every year.
But as the world becomes more accepting than ever, it’s also becoming an increasingly stressful place. Thanks to the culmination of factors including Brexit, Trump and the ongoing climate crisis, living in 2019 can sometimes be massively overwhelming – and many people are finding the news particularly triggering for our anxiety.
If you haven’t lived with an anxiety disorder before, it can be hard to understand what your friends and family might be going through when they speak about periods of panic, intrusive thoughts or an overwhelming feeling of dread. Reading up about the signs and symptoms of a panic attack, for example, can help you to feel more prepared to help, but supporting someone through the daily experience of an anxiety disorder is more complex.
Anxiety is a spectrum disorder that includes panic disorders, generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD), phobias, and OCD. These have unique symptoms, but many commonalities. Anxiety is also one of the UK’s most common mental conditions. At the last comprehensive survey of mental health issues in England and Wales, over 20 per cent of adults were suffering from some kind of anxiety disorder.
Women are almost twice as likely as men to be diagnosed with an anxiety disorder, and mental health experts say that they’re also more likely to open up about it. But if you haven’t experienced anxiety yourself, it can also be pretty hard to understand what someone with an anxiety disorder might be going through.
“Often, family and friends [of someone with an anxiety disorder] are at an absolute loss as to what to do for the best,” says Nicky Lidbetter, chief executive of Anxiety UK. Sometimes, she says, the most well-meant responses can actually exacerbate symptoms of anxiety, and make matters worse.
But fear of saying or doing the “wrong thing” shouldn’t make us clam up.
“You don’t have to be an expert to help someone with anxiety,” says Rachel Boyd, information manager at Mind UK. But a basic understanding of what’s helpful can make everyone’s life easier – and that, after all, is what it’s all about.
The thing is, anxiety is just like the rest of life: everyone experiences it differently. There’s no one-size-fits-all solution, so if someone close to you is struggling, one of the most important things you can do is talk to them about it. “Simply asking them how they’re feeling and listening non-judgementally can make a big difference,” says Boyd.
Ruby, a 30-year-old speech therapist, has mixed anxiety and depersonalisation disorder (which leads sufferers to feel completely detached from themselves, as though they are observing themselves in a movie). “It’s nice to know that people care enough to want to talk about it,” she says. “Sometimes my anxiety literally makes me feel like a helium balloon, like I’m just going to float away. Talking about it reminds me that there are people on the ground holding the string.”
Researcher Gabriella, 23, was diagnosed with post-traumatic stress disorder (PTSD) almost two years ago. She has only recently started speaking openly with friends about her condition. “I always feel better when I tell the truth,” she says. “I can actually joke about it with friends, and I don’t feel nervous anymore about explaining why I can’t really drink alcohol or coffee [both can make anxiety worse]. If there’s no timidity, it breaks the taboo.”
Ask your friend what they find helpful when they’re feeling anxious, and when they’re having an panic attack. The two answers will likely be different. Anna, 23, suffers from anxiety and depression. When she feels her anxiety levels rising, her friends are sometimes able to “talk [her] down” by reassuring her that she’ll be OK, or suggesting that they take a walk. But when she’s in the midst of a panic attack, being “talked down” isn’t an option. “I just need space, as well as gentle reassurance and help breathing,” she says.
Breathing exercises can be a great help for many people when having a panic attack, but they won’t be right for everyone. The only way to find out is to ask.
Empathise, don’t rationalise
We’ve all felt anxious at some point. It’s a natural, human response to stress, and mental health experts recommend trying to remember times when you’ve felt anxious in order to better understand how your friend is feeling. But while drawing on your own experiences can help you empathise, don’t assume that you “get” exactly how someone with an anxiety disorder feels.
27-year-old writer Kate, who has generalised anxiety disorder (GAD), says that one of the most unhelpful things her friends do is dismiss her anxiety as regular common-or-garden worries. “They tend not to take it at all seriously as a mental health issue, and say, ‘Oh, we all get stressed’, but it’s not the same at all,” she says.
When someone experiences an anxiety attack, a rush of adrenaline is released into the body. Sufferers can feel shaky, dizzy, nauseous, numb, and frighteningly “detached” from their surroundings. On the psychological side of things, anxious thoughts can often be summed up as “what if’s”: what if this happens? What if I do this? This is known as “catastrophic thinking”, where the imagined scenario is infinitely worse than what is actually likely to happen.
“So if I miss my bus I’ll be late for work, then my boss will be mad, then I’ll get fired,” says Kate. “Then I won’t have any money, then I’ll have to move out of my flat. So missing the bus ends up meaning homeless.”
If you’ve never experienced an anxiety disorder, catastrophic thinking can seem frustratingly irrational. But trying to force someone with anxiety to see things “logically” is one of the most counterproductive things you can do. Usually, the anxious person is acutely aware that these thoughts aren’t rational – but that doesn’t make their impact any less real.
“There’s no rhyme or reason to anxiety,” says Kate. “Having someone tell you you’re being silly is the worst thing they could do – because chances are you’re already anxious about being anxious.”
Encourage, but don’t pressure
It’s not always easy, but it is possible to acknowledge the power of an anxious friend’s distorted feelings, while gently challenging them. “I have a friend who will say, ‘Take your time, there’s absolutely no rush, but I actually do think you’re capable of getting on this train, or coming to this party, even if you don’t’,” says Ruby.
But there’s a fine line between encouraging someone to try something they feel anxious about, and pressurising them. Alice, 25, also has generalised anxiety disorder, and sometimes feels overwhelmed at the prospect of travelling on public transport – a common fear for people with anxiety.
“Once, I felt unable to leave the house to go to a friend’s birthday party,” she says. “She called to ask where I was, and I explained how I was feeling. She told me I was being ridiculous and basically ordered me to go and get the bus.” Alice didn’t get the bus. “I think she thought I needed tough love, but that just isn’t helpful when you’re already falling off the edge.”
If a friend wants to cancel plans because they are feeling anxious, gently encourage them to give it a go. This can sometimes involve rethinking activities: they might not want to visit that busy art gallery in the centre of town, but would they be up for going for a walk instead? If they really feel like they can’t face socialising, be understanding.
“Patience is really important,” says Anxiety UK’s Nicky Lidbetter. “Remind them that they’ve been ‘here’ before, that they got through it, and they will again.”
Don’t take it personally
Like many mental health conditions, an anxiety disorder can make it incredibly difficult for sufferers to maintain “normal” relationships. It can be frustrating and saddening if you feel that a friend’s anxiety is having a negative impact on your relationship – but it’s absolutely crucial that you don’t see it as a reflection on you, or make your friend feel guilty.
“I totally get why people who have never suffered from mental health issues can become irritated with sufferers,” says Gabriella. “It must be really hard if your friend, more often than not, simply won’t come out and have fun.”
But since people with anxiety are often already people-pleasers by nature, making them feel bad about their inability to “join in” is only likely to exacerbate the situation.
It’s equally important not to view it as a reflection on yourself that you can’t “fix” your friend’s anxiety.
If you’re used to being the friend who people rely on for advice, this can be unnerving. But ultimately, while you can support your friend through their anxiety, it’s not within your gift to “solve” the problem for them.
“No one can ‘save’ you from anxiety; it’s something you have to get through on your own,” says Ruby. “The most helpful thing people can do is just be aware of it. It’s fundamentally reassuring to know that people care.”