Caring about someone who is anxious can be confusing. You can see that the fear is bigger than the situation, and you can also see that saying so changes nothing. You may be worn out from answering the same worried question, or unsure whether stepping in is kind or is making things worse.
This article gathers what the National Institute of Mental Health (NIMH), the Anxiety and Depression Association of America (ADAA), a federal mental health agency and family researchers say about helping. It is honest about where the research is thin.
What helps?
Start with attention and patience. NIMH's advice to people who are worried about someone is to "set aside a time to talk with them to express your concern and reassure them of your support." The federal Substance Abuse and Mental Health Services Administration (SAMHSA) says much the same in its general guidance for friends and family: express your concern and support, and remind the person that help is available and that mental health problems can be treated.
The ADAA's list for friends and relatives includes:
- "Learn about the disorder." The ADAA says understanding what the person is going through will help you give support and keep your own worry under control. What does anxiety feel like? is a short place to begin.
- "Encourage treatment." Its examples are offering to drive the person to an appointment or to attend a therapy session with them.
- "Be tolerant, supportive, and non-judgmental." It adds that you can respect the person's feelings even if you do not understand exactly what they are going through.
- "Ask how you can help. Listen carefully to the response."
What is accommodation?
Accommodation is the word researchers use for the adjustments families make to spare an anxious person distress. A 2016 review of 121 papers defined it this way: "Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder."
In daily life that might look like answering the same reassurance question many times a day, making the phone calls the person dreads, or dropping plans so they never have to face a feared situation. Those examples are illustrations, not items from the review. Every one of them comes from care.
Can accommodation make anxiety worse?
It might, and the research cannot yet say. What it shows is that more accommodation goes with worse anxiety. The same review found that family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders and "is associated with more severe psychopathology and poorer clinical outcomes."
Read that carefully. It is an association. It does not show that accommodation makes anxiety worse. People with more severe anxiety may simply ask more of their families. Most of the studies involve parents of anxious children or families living with OCD. No study of adult partners was found for this article.
One randomized trial tested a treatment built around the idea. In 2020, researchers assigned 124 children aged 7 to 14 with anxiety disorders either to CBT for the child or to a program called SPACE that was delivered to the parents only. The parent-only program was noninferior to child CBT on anxiety outcomes, and family accommodation fell significantly more in the SPACE group. It is a single trial, in children, with no untreated comparison group.
Should you stop reassuring them?
Not suddenly, and not on your own. Nothing in the research reviewed for this article supports withdrawing support abruptly, and none of it was done with adult partners or friends.
The official advice points toward staying close. SAMHSA's list includes reassuring your friend or family member that you care about them, and the ADAA's includes asking how you can help and listening carefully to the response.
What follows is a general suggestion, not a research finding. If answering the same worried question again and again is wearing on both of you, you can say so kindly at a calm moment and ask the person how they would like you to respond. If they are in therapy, their therapist is the right person to plan any change with. In the SPACE trial, parents made changes as part of a treatment program, not on their own.
How do you look after yourself?
By treating your own limits as real. The ADAA says: "Being supportive all the time is difficult, so make sure you have someone" to support you, too, and it suggests a friend, a family member or a counselor. It adds that this support may be especially important if the person is not seeking treatment. NIMH's advice is similar: "Be kind and patient with yourself and others."
Beyond that, the sources give no rules. As a general suggestion, it is reasonable to keep up your own sleep, friendships and plans, and feeling frustrated at times does not make you unsupportive.
If the strain is showing up between the two of you, that deserves attention too. Dr. Rabin's practice has a page on relationship therapy.
When should you encourage professional help?
When the anxiety is getting in the way of ordinary life. NIMH says that when your anxiety, or the anxiety of a loved one, "starts to cause problems in everyday life," such as at school, at work, or with friends and family, it is time to seek professional help. Not everyone who is anxious needs therapy, and Do I need therapy for anxiety? sets out how to think about it.
Offer help with the step, not a verdict. The ADAA suggests offering to drive the person to an appointment. SAMHSA suggests finding out whether the person is getting the care they need and want and, if not, connecting them to help. For Massachusetts residents, the state's Behavioral Health Help Line, by call or text at 833-773-2445, connects individuals and families to treatment services for mental health and substance use. The state says it is free and available to all Massachusetts residents, even without insurance.
For someone who would like to talk with a psychologist, Dr. Rabin offers anxiety therapy in Brookline and by secure telehealth across Massachusetts. A free consultation of about 15 minutes can be requested through the contact page. The decision belongs to the person who is anxious.
What if it looks like an emergency?
Treat it as one. If the person has chest pain or trouble breathing that is new, severe or unexplained, call 911. Do not assume it is a panic attack, even if they have had panic attacks before. The National Heart, Lung, and Blood Institute says to call 9-1-1 any time you think you might be having a heart attack, even if you are not sure.
If the person talks about wanting to die or about suicide, take it seriously. NIMH's guidance is to call or text the 988 Suicide and Crisis Lifeline at 988, or chat at 988lifeline.org, and to call 911 in life-threatening situations.
Keep reading
Sources
- National Institute of Mental Health, Generalized Anxiety Disorder: What You Need to Know (revised 2025)
- Anxiety and Depression Association of America, Helping Others (accessed 2026)
- SAMHSA, For Friends and Family Members (last updated 04/24/2023)
- Lebowitz ER, Panza KE, Bloch MH, Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update, Expert Review of Neurotherapeutics (2016)
- Lebowitz ER, Marin C, Martino A, Shimshoni Y, Silverman WK, Parent-Based Treatment as Efficacious as Cognitive-Behavioral Therapy for Childhood Anxiety (SPACE), JAACAP (2020)
- Mass.gov, Behavioral Health Help Line (BHHL) FAQ
- National Heart, Lung, and Blood Institute, Heart Attack: Symptoms (last updated March 24, 2022)
Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in crisis, call or text 988, or call 911 in an emergency.
