Mental Health First Aid for Anxiety Disorders

You can offer mental health first aid to anyone who struggles with a mental illness, including anxiety. Learn more about how to provide anxiety first aid, here.

Affecting 40 million American adults every year, anxiety disorders are the most common mental illnesses in the country. These conditions are different from temporary anxious feelings or occasional bouts of worry and panic. Anxiety disorders are diagnosable mental illnesses involving intense, recurring symptoms that significantly disrupt a person’s daily life.

People who face anxiety disorders may struggle with uncomfortable physical, behavioral and psychological symptoms like excessive fear, high heart rate, digestive issues and distress in everyday situations. An anxiety disorder also makes someone more likely to abuse drugs or alcohol to cope with overwhelming thoughts and feelings, but substance abuse only worsens their condition. Without proper treatment, anxiety disorder symptoms like frequent mental health crises can last indefinitely.

Sadly, mental health crises like panic attacks, suicidal thoughts and self-injury are common among people who have anxiety disorders. However, crises are manageable if a person receives mental health first aid, and this type of compassionate intervention can be the first step toward professional treatment for an anxiety disorder.

Mental health first aid is a type of immediate assistance that you can learn how to provide to someone who experiences a mental health crisis. It cannot take the place of emergency medical attention or long-term counseling, but as a first aider, you can help someone regain a sense of calmness after an anxiety attack. To take a first aid course in your area, visit Mental Health First Aid USA.

Types of Anxiety Disorders

There are many different types of anxiety disorders, but some of the most frequently diagnosed conditions include:

• Post-traumatic stress disorder
• Phobic disorders
• Generalized anxiety disorder
• Panic disorder
• Obsessive-compulsive disorder

While each anxiety disorder is unique, they all share similar symptoms. As a mental health first aider, familiarize yourself with the risk factors and warning signs associated with anxiety disorders so that you can identify an anxiety crisis and respond appropriately.

Anxiety Disorder Risk Factors

General feelings of anxiety may occur from perceived environmental threats, but anxiety disorders usually do not stem from a single root cause. Many types of long-term anxiety disorders develop from a complicated set of risk factors like:

• Feelings of anxiety and severe shyness during adolescence
• Traumatic life events or experiences
• A sensitive emotional nature
• Seeing the world as threatening
• Abuse during childhood, including domestic violence
• Complicated medical conditions, including cardiac and respiratory diseases

People who face the highest risk of developing an anxiety disorder:

• Have a family history of mental illness
• Have a family history of drug or alcohol abuse
• Struggle with another form of mental illness, like depression
• Struggle with drug or alcohol abuse
• Are female (compared to men, women are twice as likely to struggle with anxiety disorders)

Anxiety Disorder Warning Signs

Anxiety disorders are mental illnesses, but they can affect every part of the body and all aspects of a person’s life. Warning signs and symptoms of anxiety disorders include:

• Physical symptoms: chest pain, hyperventilation, stomach pains, muscle aches and tremors.
• Psychological symptoms: excessive or irrational fear and worry, racing thoughts, decreased concentration and memory, confusion, restlessness and sleep difficulties.
• Behavioral symptoms: avoidance of people or social situations, compulsive behaviors, specific phobias and unexplained distress.

Panic Attack Warning Signs

As a first aider, you should also be familiar with the symptoms of panic attacks, which are sudden episodes of overwhelming fear that can occur with any anxiety disorder. You can provide mental health first aid for panic attacks if you notice that someone is experiencing:

• Pressure-relieving tactics like pressing temples, holding head or closed eyes
• Hyperventilation, or shortness of breath
• Sweating
• Trembling, shaking or rocking back and forth
• Nausea
• Dizziness, lightheadedness or fainting
• Chills or hot flashes
• Crying   

These external signs are often accompanied by internal panic symptoms like:

• Rapid heart rate
• Numbness
• Chest pain
• Abdominal distress
• Feelings of detachment from reality
• Fear of losing control
• Fear of dying

Early Intervention for Anxiety Disorders

Many anxiety disorders develop in childhood and adolescence but are not recognized or treated until years later. If left untreated, anxiety disorders worsen, and may even lead to the development of other mental illnesses, substance use disorders or suicidal thoughts.

If a person’s anxiety is unnoticed or disregarded by loved ones, mental health first aid may be the only compassionate intervention that someone receives. As a first aider, you can provide support and comfort, but most importantly, you can encourage someone to get professional help before their condition worsens.

How to Provide Mental Health First Aid for Anxiety Disorders

If someone is experiencing a mental health crisis, you can provide mental health first aid following the five-step ALGEE approach, which is a mnemonic for:

• Assess for risk of suicide or harm
• Listen non-judgmentally
• Give reassurance and information
• Encourage appropriate professional help
• Encourage self-help and other support strategies

Using the ALGEE plan, you can comfort someone who is experiencing a panic or anxiety attack until appropriate help arrives or can be sought.

Assess for Risk of Suicide or Harm

With anxiety disorders, there are several main types of mental health crises. If the person you are assisting is actively experiencing a panic attack, having suicidal thoughts or intentionally hurting themselves, you can provide:

• First aid for panic attacks
• First aid for suicidal thoughts and behaviors
• First aid for non-suicidal self-injury
• First aid for traumatic events

However, in any of these situations, if the person has a weapon and threatens to harm themselves or others, call 911 immediately and do not attempt first aid until after help arrives. If the person is not in an immediate crisis and there is no harm to anyone’s safety, you can begin a conversation with them and follow the rest of the steps in the ALGEE plan.

Listen Non-Judgmentally

One of the most important parts of mental health first aid is compassionate listening. This lets the person know that speaking up about their illness is acceptable and encouraged, and that there are people who care about the struggles they face.

To initiate mental health first aid, approach the person in a private setting and express your concerns about their anxiety in a respectful manner. Ask open-ended questions like, “How have you been feeling lately?” and, “How long have you felt this way?” Be prepared to listen quietly and patiently to what they say, if they are willing to speak with you.

At this stage, it’s imperative that you are an active listener and show compassion and understanding. Tips for being an active listener include:

• Maintaining comfortable eye contact and open body language
• Restating what the person has said
• Using minimal verbal prompts, like, “I see,” and “Ah”
• Asking clarifying questions, which shows that you want to understand
• Allowing silence and pauses in the conversation
• Practicing patience

During this conversation, be aware of how you think and act. Be mindful to:

• Withhold judgmental thoughts and feelings
• Not be critical of the person and their emotions
• Not try to correct the person, or convince them that their beliefs are misguided
• Not give flippant or unhelpful advice like, “You’ll get over it”
• Not fidget or look at a smartphone

Give Reassurance and Information

An anxiety disorder can make someone feel uncharacteristically fearful. They may feel like they are losing touch with reality, fear that their loved ones despise them, worry that they are unworthy of love or fear that they are a failure.

These fears are often unfounded, but they are still intrusive and harmful. As a mental health first aider, do not try to reason with the person or convince them that what they feel is inaccurate. Do not dismiss their fears as unrealistic or trivial, as this is unhelpful, can make them feel guilty and can deter them from explaining their anxiety further. Instead, respond to the person’s fears with empathy. Reassure them that:

• They are not to blame for their mental illness
• Their anxiety doesn’t make them any less lovable
• Their anxiety is an illness that deserves treatment
• Recovering from anxiety is possible
• You are available to listen if they need to talk again

In addition to providing emotional reassurance, offer the person information about anxiety disorders and how to get help. The Recovery Village offers different types of educational blogs and resources about coping with anxiety disorders, including:

• Resource: What You Should Know About Depression and Anxiety
• Resource: Understanding Anxiety in Recovery
• Recovery story: How I Manage My Anxiety
• Recovery story: How Drinking Hid My Anxiety and How I Manage It Sober
• Blog: 5 Ways to Cope With Holiday Anxiety

Encourage Appropriate Professional Help

Many people do not realize how detrimental anxiety disorders can be, and they may believe that anxiety fades over time. However, people who struggle with anxiety disorders do not have to suffer in silence or wait for their condition to go away. Professional treatment is available to people who struggle with anxiety.

As a first aider, you can refer someone to mental health experts and therapy options like:

• Primary care doctors
• Mental health counseling, including cognitive behavioral therapy
• Certified peer specialists
• Psychiatrists
• Medication therapy with anti-anxiety medications like benzodiazepines
• Substance abuse counseling, if necessary

To help someone find appropriate care options in their area, including mental health specialists and specific programs, you can recommend the treatment locator tool from the Substance Abuse and Mental Health Services Administration.

What If the Person Doesn’t Want Help?

If you notice that the person is resistant to the idea of seeking professional treatment, ask if they have any specific concerns about getting help. They may misunderstand how treatment works or be fearful of telling anyone about their feelings. Reassure them that they deserve to heal from their anxiety disorder and remind them that it may only get worse without professional help.

However, remember that it is not your place to fix their anxiety, and you cannot force them to get treatment. If they are still hesitant after this conversation, let them know that you’re available to help if they change their mind. All you can do is be supportive and recommend viable treatment options. It’s up to the person who faces anxiety to decide how to proceed after receiving your aid.

Encourage Self-Help and Other Support Strategies

Fortunately, there are plenty of self-options available to people who struggle with anxiety disorders. One of the most beneficial strategies is seeking out the support of other people. Although your help is invaluable as a first aider, encourage the person to speak up about their anxiety disorder and talk with friends, family members or other people they trust.

You can also recommend that they try self-care activities and self-help strategies that build healthy coping mechanisms, including:

• Engaging in daily exercise
• Eating a variety of fruits and vegetables
• Reading self-help books
• Practicing meditation
• Building an anxiety crisis kit
• Practicing minimalism and daily gratitude
• Practicing managing anxiety attacks at home
• Strategies for managing anxiety at work
• Taking a mental health day

Helpful Hotlines for Mental Health First Aiders

When you provide mental health first aid, you can always refer someone to a free, confidential national helpline. Representatives on these helplines are often trained counselors and can help someone locate anxiety disorder or drug abuse treatment resources in their area.

• National Suicide Helpline: 1-800-273-8255
• Substance Abuse and Mental Health Services Administration’s National Helpline: 1-800-662-4357
• American Psychiatric Association Answer Center: 1-888-357-7924
• American Psychological Association Public Education Line: 1-800-964-2000
• The National Mental Health Association: 800-969-6642
• The National Poison Control Center: 800-222-1222
• Alcohol and Drug Abuse Helpline: 1-800-821-4357
• National Institute on Drug Abuse Hotline: 1-800-729-6686

If you provide mental health first aid to someone who struggles with co-occurring disorders like anxiety disorder and substance abuse, you can refer them to The Recovery Village hotline at 855.463.5905. This line is toll-free, confidential, obligation-free and available 24 hours a day. The Recovery Village offers comprehensive co-occurring disorder treatment at centers across the country, and representatives are well-versed in mental health and addiction.