How to help & support someone with anxiety or depression | Priority Health

By Charletta Dennis, M.D., CCHP | Medical director of behavioral health at Priority Health with Board Certification in Psychiatry and Forensic Psychiatry

Anxiety and depression are mental health conditions that can be overcome with professional help and a solid support system.

Watching a friend or family member struggle with anxiety or depression is often painful, stressful and exhausting. These conditions can impact their relationships, work, school and other aspects of their lives in ways that hinder their goals and erode their well-being.

If someone in your life is experiencing anxiety or depression, being part of their support system can have a positive impact on their ability to overcome their mental health condition. 

How to support someone with anxiety or depression

While worry, fear and sadness are normal parts of life that everyone experiences at times, anxiety disorders and major depressive disorder are mental health conditions that typically don’t just go away on their own. People with these disorders need support as they navigate their mental health journey.

First, it’s important to understand both disorders.

What is anxiety?

According to the American Psychiatric Association, “Anxiety disorders are common mental health conditions that involve excessive fear, worry, or nervousness that interfere with daily life.” These disorders are persistent, difficult to control and can even get worse over time.

Anxiety can be caused by hormone or other chemical imbalances in the brain, genetics, or severe or long-term stress.

Types of anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, separation anxiety disorder, selective mutism, agoraphobia and other specific phobias.

Symptoms of anxiety disorders can be different for each person and it’s common to experience multiple at once. Some of those symptoms include:

• Persistent worry, fear or nervousness that is difficult to control
• A feeling of impending danger
• Intense focus on worry coupled with difficulty concentrating on other aspects of life
• Feeling on edge, restless or tense
• Rapid heartbeat, muscle tension, fatigue, insomnia, digestive problems, sweating or shaking
• Avoiding anxiety triggers
• Seeking reassurance related to the source of anxiety

What is depression?

According to the American Psychiatric Association, “major depressive disorder is a common and serious mental disorder that negatively affects how you feel, think, act, and perceive the world.” It is characterized by a persistent feeling of sadness or loss of interest in regular day-to-day activities. Harvard Health Publishing explains that depression can be caused by “faulty mood regulation by the brain, genetic vulnerability, and stressful life events.”

Symptoms of major depressive disorder can be different for each person and it’s common to experience multiple at once. Some of those symptoms include:

• Feelings of sadness, emptiness, irritability, worthlessness or hopelessness
• Loss of interest in things the person used to enjoy
• Sleeping and eating too little or too much
• Fatigue and lack of energy
• Slowed thinking, speech or movement
• Trouble with concentration, decision-making or memory
• Suicidal thoughts or attempts
• Guilt and self-blame
• Increased, unexplainable pain

Ways to offer support

Support is crucial for people with anxiety and depression. It can reduce stress, prevents isolation and helps the person to develop healthier coping habits. Having a solid support system of family and friends is just as important as receiving professional help from a psychiatrist or therapist in efforts to overcome anxiety and depression.

Dr. Charletta Dennis, medical director of behavioral health at Priority Health and a practicing psychiatrist and forensic psychiatrist, recommends meeting them where they are.

“If you notice that they’re anxious in certain situations say, ‘Hey, I notice that you seem a bit anxious or nervous. Is there anything I can do to help you right now?’” Dennis says. 

She adds that it can be helpful to ask if they have experienced something like this before and, if so, how they overcame it previously. “It’s also OK to ask, ‘Have you thought about seeking out professional assistance?’” 

Here are a few other ways you can help someone navigating anxiety and depression:

• Listen without problem solving
• Validate their feelings
• Remind them of their positive qualities
• Provide companionship and a safe space
• Foster healthy coping habits and self-care
• Encourage them to seek professional help and stick with it
• Explain that anxiety and depression are health conditions, not flaws, but that they often require treatment to overcome
• Offer specific help, such as setting up appointments or making them a mealGet other people involved in providing support

What to say (and what to avoid saying)

When you’re talking to someone about their experience with anxiety or depression, it’s important to approach the conversation with love, care and concern rather than aggression, judgment or accusation. Keep the focus on how their anxiety or depression impacts them rather than the people around them.

“Using I statements works phenomenally,” Dennis says. “When you say, ‘I want to help you’ instead of, ‘You need help,’ that puts the onus on you rather than blaming that person for being anxious or depressed.”

You also want to avoid unintentionally minimizing their experience or condition.

Don’t Say: 

• “You need help.”
• “This is your own fault.”
• “Calm down.” 
• “Just snap out of it.”
• “We all get sad/anxious sometimes.”
• “Other people have it worse.”
• “Everything will be OK.”
• “You’ll be fine.”
• “It’s all in your head.”
• “Is this my fault?”
• “Have you tried meditation?”

Do Say: 

• “How can I help you right now?”
• “I can assist however you need.”
• “I care about you and I’m here for you.”
• “I’m proud of how far you’ve come.”
• “There are ways to control anxiety and depression.”
• “There are people who specialize in what you’re going through. We can seek that person out.”

Why: 

“Avoid saying things like, ‘You’ll be fine’ or ‘It’ll be OK,’ because that’s predicting the future, and we just can’t do that,” Dennis says.

Saying the wrong thing can have the unintended effect of minimizing someone’s experience, even if you’re trying to cheer them up or encourage them. It’s important to validate their feelings and let them know you’re there for them. Whether they are actively seeing a mental health professional or in denial about the severity of their mental health, having someone in their life who makes them feel supported and safe is important. 

How to help someone during a panic attack

Someone experiencing an anxiety attack or panic attack is in a fear-driven, heightened emotional state and often experiencing physical symptoms of anxiety  such as hyperventilation, chest pain, racing heart, shaking, sweating, numbness, dizziness, upset stomach or nausea. They generally aren’t thinking clearly and may be experiencing a negative feedback loop where the panic attack exacerbates the anxiety and fear, making it more difficult for them to calm down.

To help someone during an anxiety or panic attack, it’s recommended that you:

1. Stay with the person to help calm them down. If possible, move them to a quiet, comfortable place where they’ll feel safe. Tell them what you’re doing rather than making unpredictable movements. 
2. Speak simply and clearly. Doing so ensures they can understand you even while experiencing emotional distress. Reassure them that they are safe and will get through the situation.
3. Ask them what they need. If they’re used to experiencing panic attacks, they may have special items or tactics to help calm themselves down. Make sure to ask before hugging them or holding their hand, as these actions may increase their anxiety if they’re not ready.
4. Walk them through grounding techniques. This will help them to focus on their breathing or things around them that distract them from the source of their anxiety and fear.

Encouraging them to seek professional help

Dennis says it’s important to not normalize a disorder, but instead normalize seeking treatment.

“I like to tell people that mental health conditions such as anxiety, depression and bipolar disorder are not unlike hypertension or diabetes,” Dennis says. “If someone develops symptoms and they’re not treated, they tend to get worse. But if they seek out treatment, they can better manage the symptoms and have a better quality of life.”

Psychotherapy can be a beneficial tool for all mental health conditions, but not everyone is open to the idea. Therapy and mental health support are still stigmatized by many people and cultures, making it difficult for some people to accept help. While not everyone will dismiss the idea of professional mental health services, some may be resistant. 

The thought of receiving therapy can make people feel defensive, judged, like they’ve failed or like there’s something wrong with them. It can cause them to push you away if handled poorly. Encouraging someone to go to therapy should be approached from a place of care and concern.

Dennis recommends asking the person to start with a self-assessment. That assessment should include questions such as:

• What have you noticed has changed about you since you started feeling anxious or depressed? 
• Are you having difficulties at work/school? 
• Do you feel that your relationships have changed because you feel anxious, depressed, nervous or worried?

“Typically, when there’s some functional impairment, then that’s when it’s time to say, ‘Maybe it’s time to seek out assistance. I can go with you. Would you like me to be there to support you in this? Would you like me to drive you?’” says Dennis. “Even if you’re not sitting in with the person for the appointment, offering the assistance that you can and showing that you’re caring and non-judgmental is helpful.”

Here are other tips for approaching the conversation that may be well received:

• Choose the right time and place: Choose a time when they are relaxed and in a safe space to have a one-on-one conversation. They’ll likely be more open to hearing you out. Then give them the space they need to process the conversation.
• Be compassionate, not judgy: It’s important to show your friend or family member that you care about their happiness and health. Keep the focus on how their behavior is impacting their life rather than your own. Remember to also talk about the qualities you admire about them. 
• Share your own experiences with therapy: If you’ve ever gone to therapy, you can share how it helped you. Not everyone’s situation is the same, so keep that in mind, but it can be helpful to hear about positive therapy experiences and insight into how it works.
• Offer help and support: Finding a therapist may seem like an insurmountable task for them, especially if they’re depressed. If you have the capacity, then you could offer to help them figure out what mental health services their health plan covers and match a therapist that fits their needs. Most importantly, offer to listen if they ever want to talk about what’s going on.
• Respect their autonomy: If someone isn’t exhibiting symptoms of a mental health crisis requiring emergency care (see more information below), then whether they go to therapy or not is ultimately their own choice. Tactics such as ultimatums or trying to trick someone into attending therapy can backfire and cause them to push you away. If you’re truly concerned, share that concern with them, but don’t try to force the issue.

Supporting a loved one without burning yourself out

Supporting a loved one with depression or anxiety can take a toll, especially if you’re their main source of support. To continue to help your friend or family member, you need to take care of your own mental health. Burnout can cause feelings such as loneliness, guilt, sadness, negativity, fatigue, dread, denial, anger, frustration, anxiety or fear. 

“First, you have to understand how much you can tolerate, because in some cases, multiple family members or friends may have some of the same conditions,” Dennis says. “When you notice it’s more of an irritant to you, that means it may be time for you to step back a little bit and say, ‘Hey, maybe I need to focus on how I can help myself and get my thoughts together before I can help someone else.’”

There are several steps you can take to prevent and manage burnout:

• Take time for yourself to do something you enjoy
• Keep living your life by maintaining your own routines, friendships and hobbies
• Set boundaries by letting them know if you’re not in a place for a serious or heavy conversation
• Be clear about when and how you can help rather than overextending yourself
• Share the responsibility with other friends or family members who are willing to help
• Accept that you aren’t a therapist but a person supporting them on their mental health journeyEncourage professional mental health support

Warning signs that need immediate attention (and crisis resources)

While anxiety and depression are conditions that people can live with long term, it’s important to know the signs of a mental health crisis that require immediate help.

Other symptoms of a mental health crisis include:

• Self-harm or active thoughts, plans or attempts of suicide
• Aggression or active thoughts, plan or attempts at violence against others
• Visual or auditory hallucinations or delusions (strong false beliefs)
• Extreme confusion
• Manic episodes
• Paranoia
• Substance crisis or overdose
• Severe insomnia
• Severe medication side effects
• Extreme weight loss caused by an eating disorder and other disordered eating behavior

Dennis explains that if the person is not going to work or school, not socially engaged or not participating in activities that they normally participate in, then that means it’s time for mental health assistance.

Seek immediate emergency help if you or someone you know is experiencing suicidal thoughts or thoughts of harming yourself or others. If you live in the U.S., call or text 988 to contact the 988 Suicide & Crisis Lifeline. You can find their chat function here. You can also go to the emergency room in the event of a mental health crisis.

Finding mental healthcare with Priority Health

If you have a Priority Health plan, first check to see what kind of mental health coverage your plan offers. You can call 800.673.8043 (TTY 711) to chat with Priority Health staff and gain a better understanding of your benefits and treatment options. The behavioral health team also is available 24/7 to provide crisis support. More information about Priority Health’s mental health services can be found here.