Have you ever woken up in the middle of the night in a sheer panic, not understanding why, unable to draw a deep breath, shaking all over? Or feeling as though the walls are closing in on you? How about experiencing feelings of fear so strong they were debilitating? If I have just described a few symptoms you have experienced, you may struggle with anxiety, but my guess is you probably already know this. If I did not describe you, you need to know that while you don’t necessarily struggle with anxiety, you know someone who does—whether you are aware of it or not—and these are just a few of the ways in which anxiety can rear its ugly head for your friends or family members.

Anxiety is tricky to comprehend in that everyone experiences some form of anxiety on a mild to moderate basis at some point in life. The truth is, most people experience some form of worry daily, if not hourly. We worry about our bills, our friendships, our families, our jobs. And all of that was before COVID-19 descended upon the world and increased rates of mental health diagnoses worldwide. While the majority of humanity experiences milder symptoms of anxiety, when a person experiences anxiety on a severe level, oftentimes his or her experience becomes unacceptable and unacknowledged. Worry on an everyday basis for any of us is allowable, and yet, when it becomes debilitating, those who experience symptoms can also experience feelings of shame, denial, grief and even hopelessness. These can then lead to a downward spiral into even greater symptoms of anxiety.

While there is much to be said to individuals who struggle with anxiety, this article is for those individuals who have the honor and privilege of being friends, roommates or spouses with someone who struggles with an anxiety disorder. Here is a short list of ways you can help support them:

1. While many choose not to talk about the difficulties of their mental health, the shame often accompanied with a mental illness can make them feel lonely. Ask questions. Ask, “What was it like the last time it was bad?” And then let them talk. Let them describe the physical sensations, the thoughts, the feelings and the worries. When they have talked about everything else, ask what happened when it was over. How did it end? Just being able to have someone hear their story and validate their experience is a powerful gift to give someone.

2. Another option to help someone talk about their anxiety is to simply ask, “And then?” over and over again. The “and then” question allows a person to work through their own thoughts and feelings and come to the end of the worry and fear. Usually when a person is struggling with worry, it means they are stuck on a specific image or fear. Asking “And then?” allows people the opportunity to recognize where they are stuck and how they can mentally move past it. This question also allows an individual to face his or her fears in a safe environment. Many times, acknowledging the fear or worry takes the power away from it.

3. Once you have asked the person what it was like the last time their anxiety was bad, there is now room to ask how you can be helpful if things get bad again. Hang out in this space. Listen. Ask thoughtful questions. Make a plan so that you are able to be a touchstone for your friend.

4. Get help. If you are in a relationship (romantic or otherwise) with someone who struggles with severe anxiety, or any mental illness for that matter, you also need support. You cannot be a calm presence if you are not taking care of yourself. You cannot give from an empty well. Don’t try to be the hero. Don’t feel as though you are untouchable. In order to provide the best support you can to your person, you have to be doing the work of self-care, self-soothing and mental health wellness.

5. Last, but most importantly, if you are unaware of what to say or do, a simple apology works. Saying to a person, “I’m so sorry this has been your experience” works. DO NOT ever say to someone that he or she should simply just pray about it, snap out of it or stop being so uptight. These are thoughts and feelings they have on their own and please believe, if someone could just snap out of it, they would. If your friend asks you to pray with them regarding the anxiety, do so. Prayer is our greatest tool! But please, don’t use the phrase, “You should pray about it” as an easy out for yourself.

If you are a person who experiences anxiety on any level of severity, please share your experiences with a friend, a family member, a doctor or anyone else you can trust. Advocate for yourself and for your mental health. You are worth it. And you are not alone. Please talk to your loved ones about your needs and how they can be helpful to you.

Joy Mikles works in the mental health field practicing Marriage and Family Therapy as well as working for the Bay Ridge Brooklyn Salvation Army Corps. She currently resides in Brooklyn, NY with her family.