Whether or not you live with anxiety or depression, there’s a good chance someone you care about does: In a 2022 study, around 1 in 5 adults experienced symptoms of one of these mental health issues in the two weeks before being surveyed.
Watching a loved one struggle can leave us feeling helpless. While professional assistance may be the most effective long-term approach for addressing mental health issues, there are plenty of ways we can support our friends and family in their daily lives.
It’s important, though, to show care in ways that land effectively, which isn’t always as intuitive as we may think. For instance, when talking to someone with depression, licensed psychologist and founding director of the Manhattan Therapy Collective Peggy Loo advises against leading with how worried you are.
“While it may be valid, this centers your anxiety instead of prioritizing how to actually understand what’s happening and be supportive,” Loo told Nice News. “It’s really hard for us to watch the people we love struggle emotionally — so it’s very common for us to jump into solutions or want to rescue as a way for us to deal with our own discomfort.”
How to Recognize Anxiety or Depression
Some people may not actively share their struggles with you, but you can still look for indications that something is off. According to Loo, feeling sad or down, crying more easily, experiencing difficulty enjoying things they used to, and appearing “more irritable, emotionally reserved, or even checked out” can all be signs of depression.
“Depression can often cause people to withdraw in relationships. So if all of a sudden a friend or loved one stops responding to texts, doesn’t leave their room or home often, or says no to social invites when they used to say yes, these could be clues that they’re not feeling themselves,” she said.
She added that “depression can also have a strong physical impact,” noting that someone may describe feeling lethargic or losing their appetite, or they may experience insomnia or sleep a lot more than usual. Watch for any of these signs lasting the majority of the day for over two weeks. Loo clarified, though, that this advice doesn’t apply if someone is or is suspected to be actively struggling with thoughts of suicide (learn what to do if that is the case here).
In terms of anxiety, symptoms include sweating, rapid breathing, trembling, shortness of breath, and experiencing a sense of panic or danger. While it’s normal to be stressed sometimes, the National Institute of Mental Health says that generalized anxiety disorder occurs when people “find it difficult to control worry on most days for at least six months” and experience at least three of the following symptoms: restlessness, fatigue, difficulty concentrating, sleep issues, tense muscles, or irritability. (But, of course, only a medical professional can make that diagnosis.)
How Can I Help in the Short Term?
Offer Support When Noticeable Anxiety Appears
If a loved one is showing signs of anxiety, such as a panic attack, there are several ways you can help in the moment. Melissa Lewis-Duarte, a stress management coach with a Ph.D. in organizational psychology, recommends directing their attention toward physical sensations, like their breath, which can help regulate their nervous system.
“Extending the exhale activates the parasympathetic nervous system, which promotes a sense of calm,” she said. “A helpful starting point is inhaling for four seconds and exhaling for eight seconds.” You can also encourage them to engage in grounding techniques that activate their senses, such as breathing in a comforting scent and looking at a horizon.
In some cases, however, acute anxiety may just have to run its course, according to Neda Gould, associate director of Johns Hopkins Bayview Medical Center Anxiety Disorders Clinic. Offering a “gentle verbal statement (‘I am here with you. It will be OK’) or a gentle touch can be very soothing,” she said in an email. If these episodes occur periodically, you may want to also ask your friend or family member ahead of time what you can do to help.
Open a Line of Communication
Talking to your loved one about their depression or anxiety can create a safe space for them to open up — but broaching the topic for the first time can be intimidating on both sides. For those with depression, Loo recommends keeping it simple with an earnest “How are you doing?”
“It may seem basic, but always start by expressing your care and a desire to listen,” she added. “It does make a difference to initiate a conversation by saying ‘I really care about you and want to know how to be here for you.’”
And for those with anxiety, Gould suggests expressing curiosity without judgment. “Gently let them know that you have noticed that they have seemed anxious and that you are here if they’d like to talk about it,” she said. “This may not be a one-time conversation as it may take time for people to share.” Lewis-Duarte added: “Start with acceptance, not advice.”
Conduct Conversations That Help
Despite our best intentions, we may mistakenly say something unhelpful (or worse, hurtful) during these delicate conversations. “If your loved one is anxious, the goal is to help them feel safe, understood, and not judged,” Lewis-Duarte said. Here are a few ways she suggested you can reframe your wording so that your loved one feels your support:
- Refrain from sounding dismissive: “Everyone feels anxious” becomes “You’re not alone”
- Show acceptance: “Why is this such a big deal?” becomes “There’s no reason to feel ashamed”
- Validate their feelings: “I don’t want you to feel this way” becomes “It’s OK to not feel OK”
- Resist offering unsolicited advice: “You just need to …” becomes “How can I help?”
- Avoid judgment: “I don’t think that’s necessary” becomes “I support your decision”
If someone you care about is depressed, Loo also advises asking them how you can support them. If they’re not sure, try something with their permission and follow up to see if it helped. “A lot of times with depression, there’s low hope for change and everything feels like a ton of effort,” she explained. “Taking things off of someone’s plate can be incredibly helpful, whether that’s making dinner or helping them find a therapist. It’s OK not to know how to help at first — the more important thing is that you can figure it out together.”
How Can I Provide Long-Term Support?
When it comes to long-term care, the most important themes are listening, understanding, validating, and avoiding judgment. You can support friends or family members with anxiety by checking in consistently to normalize mental health conversations, Lewis-Duarte said. Then, “build trust through reflective listening by repeating back what you hear.” And if they’re amenable, join them in healthy activities like exercising, getting outside, and connecting with others.
Loo echoed the importance of staying connected for those with depression: “Without people, it’s very easy to lose perspective and hope, which only deepens depression. Keep checking in, keep offering a listening ear, keep trying.” However, she also emphasized caring for yourself as the person providing support, “whether that’s having your own outlets, space, relationships, or communities where you are getting refueled.”
Ultimately, Gould noted, everyone is different — so taking the time to understand your loved one’s unique triggers and needs is important. And as valuable as your one-to-one support is, consider helping them find professional mental health services and resources as well.
Here’s a good place to start: Through the Johns Hopkins Mindfulness Program, Gould offers a variety of free online guided meditations and relaxation practices. Take a look.
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