How to Help Someone With Anxiety: A Step-by-Step Approach

When someone you care about is struggling with anxiety, it can be tough to know how to support them or where to begin. Whether it’s a friend, spouse, child, or other family member, understanding their experience and determining how to help someone with anxiety is essential. As a therapist with years of experience treating clients with anxiety, I’ll walk you through a step-by-step approach to providing the compassionate support they need.

What is anxiety?

First, let’s go over what anxiety is and how it manifests in the body, so you can understand how to help someone with anxiety. Anxiety is how we respond to dangerous situations. It triggers a “fight or flight” response and releases a flood of chemicals and hormones into the body. In turn, this sets off physiological changes such as a rising pulse and breathing rate to prepare the body to respond to this dangerous situation (for example, run fast or fight). 

Imagine how you’d feel if a grizzly bear started running toward you. In this instance, your feelings of anxiety and your body’s fight-flight-freeze response are appropriate for the danger. Anxiety becomes a mental health condition when someone experiences this kind of intense reaction over longer periods of time about situations that aren’t especially dangerous. For example, someone may feel anxiety around flying, social situations, or school, but the body responds the same way and kicks into fight-flight-freeze mode.

Common anxiety symptoms

Before you can learn how to help someone with anxiety, you’ll need to be able to spot common symptoms. 

Physical 

• When someone’s body goes into a fight-flight-freeze response, they might start shaking or sweating, or experience a racing heart and shortness of breath.
• If they stay in this state of heightened alert over time, they may develop persistent headaches, chest pain, muscle tension or pain, or digestive issues. 

Behavioral

• You might notice increased irritability or anger in someone who externalizes their anxiety or goes into “fight mode.” 
• Someone who internalizes their anxiety or goes into “freeze mode” may withdraw or become agitated. 
• People with anxiety might avoid the situation that’s causing it.

Cognitive

• You might notice your loved one’s thought processes are less logical than usual. For example, they might make generalizations or view situations in the extreme. 
• When the body enters a fight-or-flight response, the part of the brain responsible for logic and higher-level thinking goes offline and gives way to the reptilian or “lizard brain,” which helps us respond quickly to danger. 

A step-by-step approach for how to help someone with anxiety 

If you notice concerning signs in someone you care about, consider these tips for how to help someone with anxiety. These steps include coping strategies that have helped my clients manage their anxiety. 

Step 1: Remain calm

To help someone with an anxiety attack or other signs of anxiety, the most important thing you can do is stay calm yourself. As we interact with others, we take positive cues from one another on how to regulate our emotions. This is called co-regulation and it’s effective in helping someone with anxiety. 

So pause, take a few deep breaths, and regulate your emotions. If you can’t stay calm, take a short break and come back to help your loved one when you’re more relaxed.

Step 2: Help them identify the emotion

The next step in how to help someone with anxiety is to identify the emotion they’re feeling. In therapy we say, “name it to tame it.” Sometimes just by naming the emotion, we give the brain some resolution.

Every emotion wants to be acknowledged, relay a message, and motivate us for action. Anxiety alerts us to risks, whether real or imagined. So it’s important to acknowledge the emotion, listen to its message, and decide if we need to take action. In a truly dangerous situation, we will need to act. We don’t have to try to “fix” anxiety, but rather learn to sit in it.

Step 3: Ask them to rate their anxiety on a scale of 1-10

Once you’ve acknowledged the emotion, ask your loved one: What are you feeling and how intense is it on a scale of 1-10? If they rate their anxiety intensity anywhere from 7-10, it’s likely their body is in fight-or-flight mode and their lizard brain is in high gear. 

Step 4: Investigate the risk 

Next, check the facts. Is there any real and probable danger? For example, for someone with a fear of flying, our investigation may reveal the following facts. All forms of travel come with some level of risk. Air travel is safer than driving to the airport, and a disaster (while possible) is not probable. We want to be aware of risk, so we can take reasonable precautions like wearing a seatbelt and safely stowing our belongings. However, intense fear while flying doesn’t keep us safe and could actually make us forget emergency procedures.

If your loved one’s fear is disproportionate and unhelpful, you can help them engage in a few coping exercises to lower the intensity and ease their body out of fight-flight-freeze.

Step 5: Implement coping strategies 

There are several coping strategies that can help someone with anxiety slow down the fight-flight-freeze response and awaken the higher-level thinking part of the brain.

• Do a deep breathing exercise: Deep breathing helps calm the nervous system and return the body to its rest state. Ask your loved one to inhale for four seconds, hold for four seconds, and exhale for six seconds. Do this breathing exercise with them a few times. This will help slow their heart rate (and yours) and reverse the physiological symptoms of anxiety.
• Do a progressive muscle relaxation exercise: Either sitting or lying down, ask your loved one to tense different muscle groups and release—first their toes, then calves, and up their body. Pair this with deep breathing and ask them to visualize something peaceful. The brain can’t differentiate between the real and imagined, so visualizing a peaceful setting like a beach or forest can help their body relax. By tensing and relaxing the muscles, you’re helping someone with anxiety work those stress hormones out of their system.
• Apply something cold: You can also ask your loved one to dip their face in ice cold water or use a frozen spa mask. The ice cold helps the body slow down the breath and reverses the physiological effects of fight-or-flight.
• Engage in grounding exercises: Return the brain to the present moment by helping someone with anxiety engage all five senses with grounding exercises. Ask them to name all the sounds they can hear around them right now. Then ask them to name all the blue things they see. When someone has anxiety they’re often time-traveling to an imagined future, so bringing them back to the present reminds them they’re safe.
• Do some mental exercises: Thinking exercises can help reboot our rational brain. Ask them to do math problems, like count back from 1,000 by 3. Or ask them to make a list of all the cereals or all the vegetables they can think of. This is one way to help someone with anxiety reactivate the thinking part of the brain.

Step 6: Process the situation

Once you help someone with anxiety bring their body out of its fight-flight-freeze response and awaken their thinking brain, they’ll be able to engage in more logical thinking. Then you can try and challenge their thoughts and talk through the situation with them. 

It can take time to learn how to manage anxiety. If these steps don’t help, don’t despair—they’re often most effective when done with a trained mental health coach or therapist. Sometimes the most caring thing you can do to help someone with anxiety is encourage them to talk with a mental health provider or help connect them to professional support. 

What NOT to do when someone has anxiety

Here are two important things to avoid when learning how to comfort someone with anxiety:

• Don’t invalidate them. Many people mistake anxiety for manipulation or attention-seeking. Instead, acknowledge and validate their feelings.
• Don’t enable them. For example, if a child worries about going to school, this doesn’t mean you should let them stay home. Why? Doing so confirms there’s real danger at school. If they have anxiety about flying or going to parties, you should still fly or attend parties to prove it’s safe. In doing so, you’re also creating healthy boundaries for yourself. 

When to see a therapist

I’ve shared a few tips for how to help someone with anxiety, but I want to emphasize that it’s not your job to treat someone’s mental health condition. If your loved one’s anxiety significantly affects their life—for example, their worries lead to canceling plans,  disengaging from school or work, or avoiding leaving the house—encourage them to seek professional support. Often, people helping a loved one with anxiety may also need professional support to ensure they’re setting boundaries and practicing self-care to safeguard their own mental health.

You’re not alone.

Supporting a loved one with anxiety can be challenging, but your care and compassion can make a real difference. Remember, you’re not alone in this journey—professional help is available for both you and your loved one. By following these steps, you can provide the invaluable support they need to manage their anxiety.