What is Anxiety and when should I offer help?
Anxiety can be good for us. Moderate levels of anxiety make us alert and improve performance, and even high levels of anxiety will be appropriate when they are consistent with the demands of the situation (eg sporting events, job interviews, or dangerous situations- enabling ‘fight or flight’ responses).
The problem is that high anxiety can reduce a person’s capacity to think, plan and do complex tasks that also need attention in difficult situations. It is normal for a person’s current level of anxiety to affect their ability to perform.
However, when someone you know experiences very pronounced and often disabling states of anxiety (often against a background of constant fear and worry), it’s time to open a sympathetic and practical dialogue.
On average, one in four people – one in three women and one in five men – will experience anxiety at some stage in their life. In a 12-month period, over two million Australians experience anxiety.
Anxiety disorders involve unhelpful thinking patterns. People with anxiety disorders have fears and worries about ‘what might happen if …’, and those fears and worries persist on and off for months and years, causing distress and disability. Bear in mind that anxiety is often linked to conditions you know your loved one/s are already suffering from including depression, obsessive compulsive disorder, and post-traumatic stress disorder. Unfortunately, this can make understanding how to help someone with anxiety complicated.
The below are common anxiety symptoms listed by beyondblue:
- Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up or edgy.
- Psychological: excessive fear, worry (‘what might happen if..’), catastrophising, phobias, or obsessive thinking.
- Behavioural: avoiding situations (impacting study, work, and social life) that cause anxiety.
I’ve heard panic attacks require immediate help
In order to know how to help someone with anxiety, it is important to know what they could be experiencing. To put things in context, there are three main anxiety disorders your friend/loved one may be suffering from and are characterised by specific thoughts and behaviours:
• Panic disorder – sudden attacks of fear or anxiety (usually brief, but which may be so severe that the person thinks they might collapse or die), concern about the attacks recurring and avoidance of situations in which they might recur.
• Social anxiety disorder (SAD) – fear and avoidance of situations where the person thinks they might be the centre of attention, concern about doing or saying something embarrassing, and that others might notice the anxiety and be critical.
• Generalised anxiety disorder (GAD) – months of excessive worry over everyday things, avoiding or seeking reassurance about situations where the outcome is uncertain, and being overly concerned about things that could go wrong.
Yes, immediate action can help with a panic attack, unless you suspect that your loved-one may be having a medical emergency (call 000):
If they have a history of panic attacks, the following may help:
- Remind them to take slow, deep breaths and breathe with them. This can often help as they start to mirror your actions.
- Ask them to count backwards slowly from 100.
- Help them to get comfortable (have them sit or lie down).
- Ask them to name five things they can see, hear, smell or feel.
- Reassure them that they’re experiencing panic and that it will go away.
- If the symptoms continue, become worse, or they don’t improve call 000.
How can I help with less acute anxiety problems?
There are multiple ways to support your loved one in coping with anxiety:
- Think about THEIR support preferences
Ask rather than guess, even though you may have an intimate understanding of a loved one’s anxiety patterns. Some people are likely to respond best to strong displays of concrete practical support (eg helping them break tasks down into manageable steps or talking through options for how to deal with a difficult situation). Other people are more likely to prefer emotional support (eg comforting statements like “this is tough but I care about you and we’ll get through this together”).
- Think about THEIR knowledge/awareness of their anxiety
More beneficial if your loved one is insightful, you can help them (best to have them agree to the process beforehand) identify when their anxiety-driven patterns are occurring (or keep a journal if they don’t react well ‘in the moment’).
- Think about THEIR thinking
Try some ‘home-style’ Cognitive Behavioural Therapy (CBT- see below). Typically, anxious people have patterns of distorted thinking (‘all-or-nothing’ thinking, overgeneralising, disqualifying the positive, jumping to conclusions, ‘mind-reading’, and ‘worst-case scenario’ thinking, to name but a few). To help them in their coping with anxiety and get some perspective on this, you can use a cognitive therapy technique where you ask them to consider three questions:
What’s the worst that could happen?
What’s the best that could happen?
What’s most realistic or likely?
- Set an example (they might join in!)
Lifestyle is an important part of anxiety treatment:
Regular exercise or any type of physical activity.
Mindfulness meditation and deep breathing.
Progressive muscle relaxation.
Limiting alcohol and caffeine.
- Know what is unhelpful
Offer support, but don’t ‘enable’: avoidance is often a feature of anxiety, so sometimes we may feel pulled to “help out” by doing things for our avoidant loved ones, when really we are just feeding their avoidance. Support means helping someone to help themselves, not doing things for them. It may be challenging, but it is a crucial part in helping them learn how to deal with anxiety.
Trivialising can be just as bad as stigmatising: saying ‘don’t worry about that because…’ is not actually helping, even if comforting; make your support their reassurance. Remember also, that you don’t always know what’s best for someone else; if you find yourself becoming frustrated at their responses, step back and…
- Take care of YOURSELF
Set boundaries and don’t take on too much. If you become unwell yourself you won’t be able to support them or yourself in the same way. It is also important to decide what your limits are and how much you feel able to help.
Share your caring role with others, if you can. It’s often easier to support someone if you’re not doing it alone.
Talk to others about how you’re feeling. You may want to be careful about how much information you share about the person you’re supporting, but talking about your own feelings with someone you trust can help you feel supported too.
Find support for yourself. The organisations in useful links below are there to support you as well. You may find peer support or therapies are a good outlet for your feelings.
What about professional help?
We encourage support people to accompany anxiety sufferers when visiting our Centre to better learn how to help someone with anxiety; a spacious and calm waiting room and friendly staffing are available to dispense information and perhaps a nice cup of tea or coffee.
The attending psychologists offer effective evidence-based treatments for all types of anxiety. Initial assessment and treatment should be selected in collaboration with the client, based on the severity of the disorder, previous response to treatment, availability, and the person’s preferences. Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), Relaxation Therapy, focused psychodynamic psychotherapy, and Eye Movement Desensitisation and Reprocessing (EMDR- one of the mainstays of treatment at this Centre), are just some of the techniques tailored for optimal outcomes. The client can generally expect to see positive changes in 3-6 weeks.
Contact us today if you or a friend/loved one need help working through anxiety.
References & Useful Links
Australian & New Zealand Journal of Psychiatry 2018, Vol. 52(12) 1109–1172. Andrews et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder
Beyond Blue https://www.beyondblue.org.au/the-facts/anxiety
APS https://psychology.org.au/for-the-public/psychology-topics/anxiety
Qld Health https://www.health.qld.gov.au/news-events/news/mental-health-explained-anxiety-disorder-queensland
https://greatergood.berkeley.edu/article/item/seven_ways_to_help_someone_with_anxiety
https://www.beyondblue.org.au/the-facts/supporting-someone/looking-after-yourself