Help for partners and families

Anxiety Disorders: An Information Guide

What happens when someone you love has an anxiety disorder?

When someone in a family has an anxiety disorder, everyone is affected. Having someone with an anxiety disorder in the family brings added pressures. Because most people experience some degree of anxiety in life, it may be quite some time before your relative receives an accurate diagnosis and begins to receive treatment. Your relative may have heard well-meaning advice, like, “You worry too much. Relax.” Or, “What’s the problem with going out of the house? Just do it!” You may even have said these things to your relative. To a person without an anxiety disorder, these statements would be good advice, but having an anxiety disorder involves more than the usual worry. Your relative may require professional help to get better.

It is natural for families and partners to feel resentful or disappointed when anxiety interferes with normal family life. Acknowledging the illness can be the first step toward understanding and making the family work again.

When your relative is first diagnosed

When a member of your family is diagnosed with an anxiety disorder, you may experience varied and conflicting emotions. Often when a family learns that an anxiety disorder is the cause of their relative’s worry and behaviour, they feel relief to finally know what the problem is, but they may also feel uncomfortable emotions, such as sadness, fear, guilt or anger. You may fear how the illness will affect the future for your relative, and for you.

If you are the parent of a child or young adult who has been diagnosed with an anxiety disorder, you may feel guilty and blame yourself for the illness. You may fear that you have done something to bring this on, even when health care professionals tell you that this is not the case. Not surprisingly, you may feel angry that an anxiety disorder has disrupted the life of your family.

It is normal to experience this wide range of feelings. Understanding this, and learning to accept and manage your feelings, will reduce your stress and help you to be more helpful to the person who is struggling with the anxiety disorder.

How to relate to your family member

1. Learn as much as you can about the symptoms of and treatments for your relative’s anxiety disorder. This will help you understand and support your relative as he or she makes changes.

2. Encourage your family member to follow the treatment plan. If you have questions about your relative’s treatment, ask your relative if it would be possible to speak to a member of his or her treatment team.

3. Try to keep anxiety from taking over family life. Keep stress low and family life normal as much as possible.

4. Be supportive of your relative, without supporting his or her anxiety. Your relative may look to you for reassurance when he or she is anxious, or ask you to arrange things to help him or her avoid an anxiety-producing situation. If you have helped your relative to reduce or avoid anxiety in the past, it may take time and practice to change this pattern. When you resist supporting your relative’s anxiety behaviours, such as avoiding anxiety-provoking situations or performing a ritual to try to block feelings of anxiety, you are supporting his or her efforts to get well.

5. Communicate with your relative positively, directly and clearly. You may see things differently from your relative, who may become overwhelmed by fears. Avoid personal criticism even when disagreeing. For example, if your relative does not wish to seek treatment at the time that you think it is needed, take time to listen to his or her concerns. Express your point of view, while respecting your relative’s concerns.

6. Remember that life is a marathon, not a sprint. Progress is made in small steps. Applaud your relative’s progress at confronting anxiety and encourage him or her to use skills learned in treatment to manage symptoms.

Partners and families need to take care of themselves

When family members or partners are caught up in caring for a relative with an anxiety disorder, they may neglect to take care of themselves. At times they may give up their own activities and become isolated from friends and colleagues. The isolation could go on for some time before they realize how emotionally and physically drained they are from caring for their relative or partner. The stress can result in disturbed sleeping patterns, feelings of irritability and/or episodes of exhaustion.

Family caregivers or partners need to be aware of their personal signs of stress and know their personal limits. They need to take actions to maintain their physical and mental health. Taking time out for oneself and keeping up interests outside of the family, and apart from the relative with an anxiety disorder, can help the family caregiver to recharge. Recovery from an anxiety disorder can be a long process. Caregivers need to set aside feelings of guilt, or of pressure to focus always on the relative who needs help.When caregivers take the time to have their own needs met, they have more energy and patience to support their relative, and are less likely to feel resentful or overwhelmed.

Family and friends can offer valuable support. However, when seeking such support, it is important to be aware that some people are more informed and understanding about mental health problems than others. It is wise to be selective when choosing who to confide in, and what advice to follow.

Family caregivers are encouraged to seek professional support that is specific to families of people with mental health problems. Support could include individual or family counselling, family support and education groups to improve understanding of their relative’s anxiety disorder, and self-help groups where families of people with anxiety disorders provide support to each other. Counselling and groups may be offered by a community hospital, clinic or mental health organization.

Explaining anxiety disorders to children

It can be challenging to explain anxiety disorders to children. Sometimes parents will not tell their children that a family member has been diagnosed with an anxiety disorder because they do not know how to explain it to children or they think children will not understand. In an effort to protect children, they sometimes continue with family routines as if nothing was wrong.

The strategies of saying nothing and continuing with routine activities are difficult to maintain, and over time will only be confusing to children trying to understand their relative’s problem. Because children are sensitive and intuitive they will notice when a member of the family has emotional, mental and physical changes. Parents should avoid being secretive about the relative’s anxiety disorder, as children will develop their own—often wrong—ideas about their relative’s condition.

Children from three to seven years of age tend to see the world as revolving round them. As a consequence they blame themselves for unusual and upsetting events or changes in the family, or for unusual changes that occur with other people. For example, if a member of the family has a fear of heights, and becomes upset when a child climbs a ladder, the child may assume he or she is the cause of the person’s unusual behaviour.

To explain anxiety disorders to children, it is important to provide them with only as much information as they are mature or old enough to understand. When providing information to toddlers and preschool children, parents should use simple, short sentences. That is, the sentences should be worded in concrete language and be free of technical information. For example, “Sometimes your father doesn’t feel well and it makes him upset.” Or, “Your father has an illness that makes him feel upset when he sees someone climb a ladder.”

Children in elementary school can process more information. They are more able to understand the concept of an anxiety disorder as an illness; however, too much detail about the nature of the illness and how it is being treated could overwhelm them. One way to explain anxiety disorders to elementary school children is to say, “An anxiety disorder is a kind of illness that makes people worry a lot about heights and getting sick. Worrying so much makes them avoid tall buildings.”

Teenagers can manage most information, and often need to talk about what they see and feel. They may worry about the stigma of mental health problems and may ask about the genetics of anxiety disorders. Teenagers will engage in conversations about anxiety disorders if information is shared with them.

There are three main areas that are helpful for parents to cover when speaking with children about anxiety disorders:

1. The parent or family member behaves this way because he or she has an illness. It is easiest for children to understand an anxiety disorder when it is explained to them as an illness. Tell children that a member of the family has an illness called an anxiety disorder. You may explain it like this: “An anxiety disorder is like a cold, except that you don’t catch it, and rather than giving you a runny nose, it makes you worry a lot, sometimes for no reason. This worry makes people with an anxiety disorder avoid heights, or stay away from things that bother them, or check things over and over. Sometimes, they want others in the family to act the same way that they do. An anxiety disorder takes a long time to get better. People with an anxiety disorder need help from a doctor or therapist.”

2. Reassure the child that he or she did not make the parent or family member get this illness. Children need to know that their actions did not cause their loved one to develop the illness. People with anxiety disorders may become depressed as they struggle with their symptoms. It is important to reassure children that they did not make their loved one fearful or anxious.

3. Reassure the child that the adults in the family and other people, such as doctors, are trying to help the affected person. It is the responsibility of adults to take care of the family member with an anxiety disorder. Children should not worry about taking care of anyone who is ill. Children need their parents and other trusted adults to protect them. Children should be allowed to talk about what they see and feel with someone who knows how hard it is for a relative to struggle with the symptoms of an anxiety disorder. The changes that occur in a loved one because of an anxiety disorder are often scary to children. They miss the time spent with the person who is ill. Participating in activities outside the home helps children as it exposes them to healthy relationships. As the relative with an anxiety disorder recovers, and he or she gradually resumes family activities, this will help to improve his or her relationship with the children in the family.

If the relative with an anxiety disorder is a parent, he or she and the other parent should talk with the children about explaining the anxiety disorder to people outside the family. The support of friends is important for everyone. However, because anxiety disorders can be hard to explain, and some families worry about the stigma of mental illness, family members will have to decide how open they wish to be about their situation.

Some parents who are affected with an anxiety disorder may find that they are less patient and more easily irritated than usual. They may find it hard to tolerate the loud, messy, chaotic play of their children. For them, the family may have to design and develop structured routines to ensure that the parent with an anxiety disorder has quiet and restful time away from situations that might trigger symptoms of the illness. Times should be planned to allow for children to play outside the home, or for the parent with an anxiety disorder to rest for part of the day in a quiet area of the home.

When the relative with an anxiety disorder is in recovery, it helps for the person to explain his or her behaviour to the children. The recovered relative may need to plan some special times with the children to re-establish their relationship and reassure the children that he or she is now more available to them.

 

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