7 Things You Should Never Say to Someone With Anxiety

“This can be invalidating,” says Janine Domingues, Ph.D., a clinical psychologist in the Anxiety and Mood Disorders Clinic at the Child Mind Institute in New York City. “You’re telling the person to do something that’s hard to do. If he could calm down, he would, so this makes him feel even more frustrated and anxious.” The person thinks, “What’s wrong with me? Why can’t I calm down? Other people don’t think this is a big deal. Why do I think it’s a big deal?” This leads to feelings of sadness and guilt, Domingues says.

“An anxiety disorder is thought of as ‘the wimp disease,’” LeDoux says. “If you were just a little stronger and weren’t such a baby, you could get past all this.” But the person with an anxiety disorder can’t control her responses to fear—and tough love doesn’t work, says Domingues. “It makes the person feel worse because she says to herself, ‘I don’t know why I can’t just do it.’” This can actually have the reverse effect and can cause more anxiety.

People with anxiety disorders tend to fall into thinking traps: They focus on the worst-case scenario. It’s tempting to try to reassure them that their worst fears won’t come true, but this too has the opposite effect. “It’s hard for the person who’s anxious to believe that, and you can’t guarantee it anyway,” says Domingues. “So if they try to face their fear and it doesn’t go well, they’re set up for failure.” A better thing to say: “Hey, if something bad happens it’s not going to feel great but you’re going to be able to get through it.”

Say a person’s worry relates to speaking in public. The thought pattern goes likes this: “What if I get up there and I forget what I’m going to say or I start to shake when I give the speech?” So you say: “Get that worry out of your mind and don’t even think about your speech right now.” But that’s not helpful because it becomes harder to push an anxious thought out of your head than to accept the fact that you’re thinking an anxious thought and letting it go by. “If I say I don’t want you to think of a pink elephant, that’s all you can think about,” Domingues says. “That’s how worries work. The harder you fight not to think about it, the stronger the worry becomes.” It’s more helpful to acknowledge the worry, validate it, and say, “This is how I feel. This is my worry. I’m going to accept it and hope I can let it go.”

There’s a fine line between being understanding and being overly accommodating. If you’re having a party with 20 people and you know your friend with anxiety won’t feel comfortable, it’s tempting to tell her she doesn’t have to come. “But this only confirms that the person isn’t able to get through it and perpetuates her anxiety,” Domingues says. “It makes the person feel sad and guilty for burdening another person.” More helpful: coming up with a plan for how she can attend. You can say, for example, “I think you’ll really get along with this one friend I have.” You could even try practicing conversation so the person feels more confident. At that point it’s up to her to decide whether she’ll come. And if she says no, keep inviting her. She might say yes the next time.

If a person genuinely has an anxiety disorder, it won’t go away on its own and she won’t grow out of it—and saying this could deter her from getting the help she needs. If someone you care about is struggling with anxiety, instead suggest that she see a mental health professional. “It comes down to intensity,” Domingues says. “If the worries are consuming the person’s day and affecting her ability to leave the house, go to work, and make friends, or if the person is more depressed and isolating herself, those are signs it’s time to get help.” She recommends a psychologist who specializes in cognitive behavioral therapy. “Exposure therapy is the main treatment—coming up with a plan for how to gradually and systematically face the fear.”