The World Health Organization estimates that 470 million people had an anxiety disorder in 2023, making anxiety disorders the most common of all mental disorders, and that only about 1 in 4 people in need (27.6 percent) receive any treatment. Behind those numbers are friends who are quietly struggling, and friends who want to help and fear saying the wrong thing.
World Mental Health Day falls on 10 October, and the most practical question it raises is a personal one: how do you help a friend with anxiety without making it worse? This guide covers what to say, what to avoid, how to support someone in a panic attack, how to raise the idea of professional help, and how to protect your own wellbeing while you do it. It is general guidance, not a substitute for professional care.
Why Helping Is Harder Than It Looks
Anxiety is more than ordinary worry. It can bring racing thoughts, physical symptoms, avoidance and exhaustion, and it often comes with shame. NAMI notes that anxiety often brings shame and social withdrawal, which is why the first job of a supportive friend is to make it safe to talk.
Well-meaning comments are the most common way people make things worse. Reassurance such as everyone feels like that can sound like dismissal, and advice such as just calm down can increase pressure. The sections below give you replacements that validate, ask and listen. If your friend also seems low, our guide to the signs of chronic stress helps you spot when strain is building.
What to Say: Five Phrases That Help
NAMI’s guidance lists five things to say to a loved one with anxiety, with the reasoning behind each. Use your own words, but keep the intent.
| Say this | Why it helps | Watch out for |
|---|---|---|
| You are not alone | Reassures them that their struggle is valid | Do not imply everyone feels this way; occasional worry differs from an anxiety disorder |
| There is no reason to feel ashamed | Frames anxiety as a health condition, not a personal weakness | Avoid pity or drama |
| It is ok to not be ok | Validates the current experience without pressure to feel better | More supportive than telling them they are fine |
| How can I help? | People usually know what helps them cope | Offer specifics, such as keeping them company on a walk |
| I support your decision | Encourages treatment without judgment | You do not need to be the expert |
Our guide to healthy relationship communication covers listening skills that apply to friendships as well as partners.
What Not to Say or Do
NAMI warns against dismissing or minimising the experience, such as saying we all feel that way, because it undercuts their suffering. Saying you are ok can feel invalidating when they are not. Telling someone to just relax or take a deep breath can increase pressure and make them feel worse. Lecturing or prescribing solutions rarely helps, since people in distress seldom want advice they did not ask for. Questioning a friend’s need for treatment or medication also does harm, because judgment discourages people from seeking help.
| Instead of | Try |
|---|---|
| It is not a big deal | That sounds really hard. Tell me more |
| Just relax | Would it help to sit down together for a few minutes? |
| Everyone gets nervous | I can see this is more than nerves for you |
| Have you tried yoga or herbal tea? | What has helped you before, and can I help you do it? |
| Do you really need medication? | I support whatever you decide with your doctor |
The overall principle in NAMI’s guidance is to respond with acceptance, curiosity and love rather than judgment.
How to Help During a Panic Attack
A panic attack can feel like a medical emergency, with a racing heartbeat, chest pain, shortness of breath, dizziness and a feeling of dread. The NHS says attacks usually last 5 to 20 minutes, and some last up to an hour, and that they are frightening but not dangerous. Many of the symptoms can also come from other conditions, so if the person has chest pain and you are unsure, seek medical help.
The NHS self-help steps are to stay where you are if possible, breathe slowly and deeply, remind yourself that the attack will pass, and focus on calm images. You can support a friend by staying with them, speaking in a calm voice, offering to breathe slowly together and reminding them it will pass. Do not argue with the fear or crowd them. Afterwards, offer water and quiet, and check in later. Our guide to managing anxiety without medication lists techniques your friend may want to practise before the next episode.
Everyday Ways to Support Them
Small, steady actions help more than grand gestures. Keep invitations open without pressure, and accept a no without making it personal. Offer practical help on hard days, such as walking together, sharing a meal, or sitting with them while they make a phone call. Stay in touch even when they cancel plans, because isolation can deepen anxiety. Keep confidences, unless you believe they are at risk of harm.
Healthy routines support mood too. Encouraging, not nagging, regular sleep and movement can help, and our article on science-backed habits for better sleep gives you ideas to share if they ask. If they are working long hours, you could also mention that our guide to mental health days explains how to ask for time off.
Encouraging Professional Help
WHO says psychological interventions are essential treatments for anxiety disorders, and that cognitive behavioural therapy has the strongest evidence across anxiety disorders. Therapy can be individual or group-based, in person or online, or delivered through self-help manuals, websites and apps. Antidepressants such as SSRIs can help adults, while WHO says benzodiazepines are generally not recommended because of dependence risk and limited long-term benefit. WHO also names stigma and lack of awareness as barriers to care.
You can raise the subject gently by saying what you have noticed, expressing care, and asking whether they would like help finding support. Offer to help book an appointment or sit with them while they call. If you are worried that your friend may harm themselves, do not wait: contact local emergency services or a crisis line in your country, and stay with them until help arrives.
Looking After Yourself While You Help
Supporting someone with anxiety can be draining. Set realistic limits, make time for your own rest and friendships, and avoid becoming the only support. You are a friend, not a therapist. If you feel overwhelmed, talk to someone you trust or a professional. A friendship that includes honest boundaries lasts longer and helps more.
