7 Things Not to Say to Someone With Anxiety—and How to Phrase Them Instead
Your intentions might be good, but these statements could make things worse.
Anxiety disorders are the most common form of mental illness in the United States, affecting 40 million adults (about 18 percent of the population) each year, according to the The Anxiety and Depression Association of America. As if the actual symptoms of anxiety—racing heart, sweaty palms, dizziness, trembling, and inner turmoil—aren’t life-hindering enough, many people with anxiety also withstand well-intentioned but hurtful comments from people who don’t truly understand the nature of the disorder, and how serious it really is. Hint: It goes way beyond just "being worried. " So we asked two anxiety experts to help clear up the confusion on what not to say to an anxious person, and what to stay instead. Here are seven things people with anxiety disorders don’t want to hear anymore.
On one hand, this is true—anxiety is a universal biological reaction. “Fear and anxiety are natural processes that are part of life,” says Joseph LeDoux, PhD, a neuroscientist and director of the Emotional Brain Institute at New York University. Both fear and anxiety protect us and motivate us. “The student who doesn’t worry about an exam isn’t going to do as well. You need a little bit of worry,” he says.
But on the other hand, it’s a fallacy to compare your "normal" temporary anxieties to the pervasive and chronic anxieties of someone with an anxiety disorder. Their worries are more intense, interfere with their ability to perform daily life tasks, and their symptoms are often difficult to manage without help.
Say instead: "You seem really anxious, that must feel awful. I'm always here for you—what can I do to help?"
This is a gentle but direct offer of support. It conveys the message, I see you, I'm here to listen and here to help.
“This can be invalidating,” says Janine Domingues, PhD, 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 they could calm down, they would, so this makes them feel even more frustrated and anxious.” The person will think, “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.
Say instead: "Let's do something to take our mind off of things. Want to go for a walk or have a cup of tea?"
The act of "calming down" isn't a switch someone with anxiety can just flip (put it this way: It's like telling a clinically depressed person to "just be happier!"—unhelpful). Try to help them get back into the present—instead of spiraling about the future—with something like a walk, breathing exercises, a funny video, or simply talking it out. In other words, don't command them to calm down—help them actually calm down.
“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 their responses to fear—and tough love doesn’t work, Domingues adds. “It makes the person feel worse because they say to themselves, ‘I don’t know why I can’t just do it.’” This can actually have the reverse effect and can cause more anxiety.
Say instead: "What's worrying you the most, and how can I help ease it?"
This is an acknowledgment of the validity their experience and a thoughtful way to help them unpack what's really bothering them.
This is a tricky one. 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.”
Say instead: "Hey, if something bad happens it’s not going to feel great, but you’re going to be able to get through it. And I'll be with you the whole way/here when it's over."
You can't predict a rosy future for them, but reminding them in a non-patronizing tone that even if something not-ideal does happen, it's not the end of the world.
Say a person’s worry relates to speaking in public. Their thought pattern goes likes this: What if I get up there and 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.”
Say instead: "I know this kind of thing makes you really anxious. If you want to talk about what you're feeling or practice with me beforehand, I'm all ears."
It’s more helpful for an anxious person 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.”
Say instead: "I know it's not always your thing, but you're always welcome. If you're up for it I think you’ll really get along with this one friend I have."
It's more helpful to come up with a plan for how they can attend, since people with anxiety tend to like concrete plans. 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 they won’t grow out of it—and saying this could deter them from getting the help they need. 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.”
Say instead: "I hate seeing you going through this and am concerned. If you're considering talking to someone, I am here and happy to help you find the right person."