When someone you care about is struggling with anxiety, the instinct is to help. To fix it. To say the right thing. But anxiety is not a problem that can be talked out of in one conversation, and the pressure to get it right can leave both of you feeling more stuck than before.

This piece is for anyone who loves, lives with, or works alongside someone with anxiety — and wants to understand what actually helps, and what, despite the best intentions, can make things harder.

You do not need to be a therapist to make a difference. But it helps to know a little of what you are dealing with.

First: what anxiety actually feels like from the inside

Before thinking about what to do, it helps to understand what the person you care about is experiencing. Anxiety is not worry in the everyday sense. It is not something that can be resolved by thinking more clearly or looking on the bright side.

Anxiety is a nervous system state. The body has moved into a threat response — heart rate elevated, muscles braced, attention narrowed — in anticipation of something going wrong. The anxious mind is not being dramatic. It is doing what it learned to do: scan for danger, rehearse worst cases, prepare for what might happen next.

This means that logical reassurance — “there’s nothing to worry about,” “it’ll be fine” — often does not land. Not because the person isn’t listening, but because the body is not persuaded by argument. The nervous system needs something different. You can read more about this in our piece on the functional freeze response — what happens when the nervous system has been on high alert for long enough.

Understanding this changes everything about how you show up.

What actually helps: the things that make a difference

Listen without trying to fix

The most useful thing you can offer is usually not an answer. It is attention. When someone with anxiety feels truly heard — without the listener jumping to solutions, reframing, or minimising — something shifts. The nervous system begins to settle.

This is harder than it sounds. Most of us are trained to respond to a problem with a solution. But for someone in an anxious state, the experience of being listened to without being redirected is itself regulating. It tells the nervous system: this person is here, this is safe, I do not have to manage this alone.

Try: “That sounds really hard. I’m here.” Not: “Have you tried breathing exercises?” (at least, not yet).

Ask what they need rather than assuming

Different people need different things at different times. Some want to talk. Some want company without conversation. Some want help making a decision they are paralysed on. Some want someone to simply sit with them.

Asking — “what would be most helpful right now?” — gives the person agency at a moment when anxiety has made them feel out of control. It also prevents you from offering something well-meaning that doesn’t land.

Stay consistent and predictable

Anxiety thrives on uncertainty. One of the most stabilising things you can offer is consistency — following through on what you say you’ll do, keeping plans where possible, being someone who shows up reliably. This is not dramatic. It is steady. And for someone whose nervous system is scanning for what might go wrong, a person who is consistently there is deeply regulating.

Validate the experience without confirming the fear

There is a balance to hold here. Validating someone’s anxiety — “I understand why this feels scary” — is different from confirming that the feared thing is as dangerous as they believe — “yes, that does sound really awful and it might go very wrong.”

You can acknowledge the emotion without reinforcing the anxious thought. “That sounds frightening” is different from “you’re right to be scared.” One says: your feeling is real and makes sense. The other amplifies the threat.

“You do not have to understand anxiety to be helpful. You just have to be willing to stay.”

What tends not to help — even when it’s well-meant

None of these come from cruelty. They come from helplessness. But it is worth knowing that they tend to land badly, so you can catch yourself before they come out.

On accommodation — and when it becomes a problem

It is natural to want to reduce the distress of someone you love. This can lead to what clinicians call accommodation — adapting your behaviour to help the anxious person avoid their feared situations.

This might look like: always being the one to make the phone call they dread, cancelling plans to reduce their anxiety, changing the subject whenever a difficult topic arises, never challenging them because you’re worried about how they’ll cope.

In the short term, accommodation reduces distress. In the long term, it can reinforce anxiety — because it signals to the nervous system that the feared thing really is too dangerous to approach. It also, quietly, erodes the relationship.

The aim is not to force exposure or push too hard. It is to stay warm and supportive while gently holding the expectation that the anxious person is capable — with the right support — of facing hard things. This is one of the things a CBT therapist or anxiety specialist can help both of you navigate.

“Supporting someone with anxiety is not about removing every source of difficulty. It is about helping them feel safe enough to face it.”

The cultural dimension — when anxiety has no name

In many families from Vietnamese, Chinese, South Asian, East African, and Eastern European backgrounds, anxiety is not spoken about directly. There may not be a word for it, or there may be a strong cultural expectation that you manage your feelings privately, or that seeking help is a sign of weakness or a source of shame for the family.

If you are trying to support someone from this background — or if you yourself grew up in a household where feelings were managed quietly — some of this may feel unfamiliar or even disloyal to name.

It is worth knowing that anxiety often expresses itself physically in these communities: stomach problems, fatigue, headaches, difficulty sleeping. These are not separate from the anxiety. They are the anxiety, showing up in the language the body has learned.

Approaching the conversation through the physical — “I’ve noticed you haven’t been sleeping well” — can sometimes be less threatening than naming mental health directly. Our team at Talking Counselling works with clients in multiple languages, including Vietnamese, Cantonese, Mandarin, French, Tagalog, Yoruba, and Hausa, and understands these cultural dynamics from the inside.

Looking after yourself too

Supporting someone with chronic anxiety is not a small thing. It can be exhausting, isolating, and occasionally frightening. You may find yourself walking on eggshells — monitoring their moods, avoiding triggers, managing your own behaviour around their anxiety. If that phrase resonates, our piece on growing up walking on eggshells may be worth reading — it speaks to what it costs to adapt yourself to someone else’s emotional state over time.

Your feelings about this situation are also valid. It is possible to love someone and find their anxiety genuinely difficult. Naming that — ideally with a therapist of your own — is not a betrayal. It is necessary maintenance.

This is not a sign that you are unsupportive. It is a sign that the dynamic has become unsustainable — and that support for both of you would help. Our couples therapy service is one route for addressing this together.

When to suggest professional support — and how

One of the most helpful things you can do is gently, consistently, and without pressure, raise the idea of professional support. Not as a solution to your problem with their anxiety. As something that might help them.

Some phrases that tend to land better than others:

• “I’ve been reading a bit about anxiety and there are people who specialise in this — would you ever want to talk to someone?”
• “You don’t have to figure this out on your own. A therapist might be able to help in ways I can’t.”
• “I’ll help you look into it, if that would make it easier.”

The NHS Talking Therapies service allows self-referral without a GP referral. For those who want to avoid waiting lists or prefer a practitioner with a specific cultural or linguistic background, our anxiety counselling service is available online from £50, with practitioners who speak a range of languages and understand multicultural and migrant family dynamics. If cost is a concern, our guide to affordable therapies in London outlines the full range of options.

And if you yourself are struggling with what it means to carry someone else’s anxiety — that is also something worth speaking to someone about. Our piece on what individual therapy involves is a good starting point.

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Further reading

• Bowen, M. (1978). Family Therapy in Clinical Practice. Jason Aronson. — on family systems and how anxiety moves through relationships.
• Foa, E. B. & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35. — foundational work on anxiety and avoidance.
• Lebowitz, E. R. & Omer, H. (2013). Treating Childhood and Adolescent Anxiety. Wiley. — on accommodation and what family support that helps actually looks like.
• Porges, S. W. (2011). The Polyvagal Theory. W. W. Norton. — on the nervous system basis of anxiety and the regulating effect of safe relationships.
• Mind (2023). How to support someone with anxiety. mind.org.uk

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This article is for educational and informational purposes only and does not constitute medical, psychological, or therapeutic advice. Reading this content does not create a therapeutic relationship with Talking Counselling. If you are concerned about your mental health or someone else’s, please seek support from a qualified healthcare or mental health professional. If you need someone to talk to, you can contact Samaritans on 116 123 (available 24 hours a day). For urgent medical advice, contact NHS 111. If there is an immediate risk to life or an emergency, call 999.