Most of us know/love someone who struggles with anxiety or depression.

It can be confusing to know what we can do or say that will help them in times of need. Here are some ideas of how you can show your support to your loved one.

Idea #1: Validation

While you may not completely understand why someone is depressed or exhibiting anxiety, you can still validate their concerns. Oftentimes, the worries may not seem logical to you, but to your person, it makes perfect sense in their head. Basically, each person has their own “stuff,” which means each person perceives things differently. That being said, you can help by validating your loved one by first acknowledging to yourself that this anxiety/sadness makes sense given their contextual outlook on life and personal history.

Phrases like “I know this is really hard,” “Your feelings are valid,” “I can see you are anxious, I am here for you,” can really help your loved one. Oftentimes, we want to jump into “fixing mode” when we see someone we love in distress; however, by being an active listener and validating their experience, you can still make a positive impact.

Idea #2: Menu of Ideas

Asking, “how can I help?” can be a great way to communicate with someone experiencing anxiety and depression, but oftentimes the answers are, “I don’t know,” or they are deeply anxious/depressed they cannot come up with a response at all. When someone is anxious, their nervous system is in SOS mode. Due to this, logical and clear thinking gets overridden; therefore, it can be hard for the person to know what helps or to communicate what could help.

If you love someone who has anxiety or depression, it can be a great idea to come up with a “menu of ideas” for when they are anxious or in a depressive episode, BEFORE they are experiencing high anxiety or severe depression. Essentially, at a time when they are not anxious/depressed, ask them what tends to help and what they like or dislike when they are feeling this way. At first they may have a difficult time coming up with this, but with more communication you can come up with a list of items to add to a menu.

This menu can be simple, like 3-4 things that usually help with anxiety or sadness. Or it can be more complex by breaking it down into categories such as 1. Physical/Sensory comforts 2. Words/Phrases that help 3. Prompts for coping skills 4. Care task help.

For example a menu for Jane could be:

1. Use weighted blanket
2. Sit outside for fresh air
3. Do a guided meditation
4. Hug or cuddle
5. Watch a funny movie

An example menu for Michael could be:

1. Physical Sensory Comforts:
   • Weighted blanket
   • Lights off
   • Changing into comfy clothes
   • Lighting a scented candle
2. Words/Phrases That Help:
   • “I am here with you”
   • “We don’t need to be doing anything for me to still want to hang out with you”
   • “Your feelings are valid”
   • “I want to hear and listen to what you are worried about”
3. Prompts for Coping Skills
   • “I can see you are anxious, would you like me to play your favorite guided meditation”
   • “I notice you seem stressed, would you like to go for a walk”
   • “It seems like you are feeling some anxiety about this, do you want to practice noticing 5 things we see, 4 things we hear, 3 things we feel, 2 things we smell, and 1 thing we taste?”
4. Care Task Help
   • When Michael is anxious for a period of time he tends to not make himself meals, so you could offer to make him a meal or pick up his favorite one. You two can discuss what meals are good go-tos in times of stress when creating the menu.
   • When Michael is in a depressive episode, his room and apartment get messy because he does not have the energy to upkeep it. You can help him take out the trash or do a load of laundry.
   • When Michael is depressed or anxious, he gets overstimulated by his dog’s energy. You could offer to take his dog for a walk or to the park to expend some energy.

There are no right or wrong ways to create this menu, and it can change over time!

By creating this menu, two things happen. First, you know what helps sometimes and can offer specific help during times of stress. Then, it can be easier for the person to answer a close ended question such as, “Do you want me to get your weighted blanket?” instead of an open ended question like, “What can I do to help?”.

Idea # 3: Checking In & Staying Connected.

You can show your ongoing support for the person by consistently checking in. They may not want to talk about how they are doing but you asking still shows that you care. You might be worried that asking about their anxiety or depression will remind them of their current struggles; however, people do not forget that they struggle in these areas. Thus, you bringing it up will not “remind them.” Even if the person seems to be doing okay, it can be good to directly ask, “how has your anxiety/depression been lately?” Contrastingly, we often use the phrase “How are you?” as a polite courtesy, so it may not feel like a true invitation to share how they are feeling. You do not need to push them into talking about it, but it is still good to ask.

Similarly, even if your person has turned down plans 6 out of 7 times, it is still good to invite them. While you may know they are not up for an outing at the moment, it can still mean a lot to be invited. You can also offer low stakes plans, like watching a movie at their place, or just sitting together and splitting a pizza.

Idea # 4: Have Your Own Support System

Loving someone who is struggling can be hard. Make sure you have your own support system and are taking good care of yourself. As flight attendants always say, “put your oxygen mask on before helping others,” because you cannot help others if you are not helping yourself.

Supporting someone with depression and/or anxiety can be complex and these are just some suggestions on how to help your loved one. If you are looking for more support or suggestions, please reach out to set up an appointment with one of our therapists at OMHG.

Having a chronic illness is hard, there is no way around that. It takes a tremendous amount of time and energy; it’s a full time job.

While most people can see some of the more surface level difficulties of having a chronic illness, those are just the tip of the iceberg.

Original Illustration by Katie Lawliss, Psy.D.

There are so many parts of having a chronic illness that impact emotional wellbeing. Here are just a few:

Struggle #1: Not Being Understood

Someone without your condition may know what they read about it on Google. Some may do more research and work to understand how your condition affects you specifically. However, living with a chronic illness is different than knowing about it. Oftentimes, feeling like others cannot understand what you go through on a day to day basis can feel isolating, sad, and frustrating.

To help cope with this, a phrase I often use is, “What a privilege it is to not understand chronic illness.” The people in your life are lucky to not have the insider scoop on what it’s like to be sick all the time. That does not mean it isn’t painful when the people you love don’t understand your struggles. It also doesn’t mean it’s okay for them to invalidate your experiences and not make an effort to understand as best as they can.

Coping Strategy: Finding an Understanding Community.

It’s helpful to find a community of people (online or in person if your condition allows for that), who can understand what it’s like to live with a chronic illness. This can be people who have the same chronic condition or people who have a general chronic health issues that you can relate to on some levels. Additionally, sometimes following social media accounts can be helpful to know you are not alone in your struggles. Some accounts to check out on Instagram include: @thechroniccommunity, @fourmorespoons, and @how.u.feeling.

Struggle #2: Impacts on Social Relationships

Another difficult part of having a chronic illness is how it affects each relationship in your life. For example, there can be many times you make plans with friends and family and then need to cancel them because you don’t feel well. This is hard for a few reasons. Firstly, it can be hard because you may have been really excited to go do something and then can’t go, either because you don’t feel well, or because you feel that going would be bad for your health. Consequently, perhaps the disappointment that you feel is strong when this happens.

Although you may have loved ones who understand your situation, it can still be hard to see their disappointment when you can’t attend something they were hoping you could. Additionally, those who don’t know you as well or are not as understanding of your condition may express negative feelings about how you are “flakey” without realizing how badly you wish you could follow through on plans. Ultimately, these cancelations may then lead to not being included in plans as often because people assume you will not be able to attend anyway. All of these outcomes hurt in their own way and impact social relationships.

Coping Strategies: Transparency and Self-Compassion

It’s important to communicate with others as well as yourself. It may feel difficult to be open about how your illness affects your ability to make and stick to plans, but allowing yourself to be vulnerable and have these conversations can help your friends and family understand more. They will then be able to understand that you still want to be invited even if you are not sure if you will be able to attend.

Likewise, it’s also important to practice self-compassion. It’s hard to be sick and it’s hard to see it affect your relationships. Remind yourself of this and give yourself some love.

Struggle #3: Medical- and Self-Gaslighting

Unfortunately, many people with chronic illness spend years trying to figure out their diagnosis. Some may know their diagnosis, but be told their symptoms don’t match up with it and, therefore, must be related to anxiety or depression instead. Oftentimes, people hear that so often from multiple sources that they start to question themselves and wonder if they are making it all up. Having your lived experiences be dismissed or not believed is harmful and takes a toll on your wellbeing.

Coping Strategy: Self-Validation

To avoid second guessing yourself, work on validating yourself. You can use affirmations such as, “I know my body better than anyone else;” “I know I don’t feel well even if others don’t believe me;” and, “I deserve someone to believe me.” Additionally, while it does take extra energy, it’s okay to seek second or third opinions, to ask as many questions as you need to, to your providers, and to end a relationship with a provider who invalidates your concerns. Remember that you are your own independent person and are allowed to make your own choices about your health.

Struggle #4: Self-Advocacy

Frustratingly, self-advocacy is crucial in chronic illness, and it’s exhausting! There is a burden to having to advocate for yourself on a consistent basis to providers, friends, family, employers, and more. While it’s important to do, as mentioned above, it’s also hard to do especially when in pain and exhausted.

Coping Strategies: Preparing a Script and Asking for Help

To ease the burden of constant and possibly repetitive self-advocacy, you can write out a gist of your circumstances and needs and re-use it in different settings so you do not need to reinvent the wheel each time you need to advocate for yourself. You can also ask your friends or family members to advocate for you when you need a break from doing it yourself. Remember: it’FFs good to remind yourself that you are worth advocating for.

Struggle #5: Planning

Furthermore, there’s a ton of planning required when it comes to having a chronic illness. “The Spoon Theory” by Christine Miserandino discusses how chronic illness requires planning due to fatigue and pain. If someone wants to go to their best friend’s birthday party, they need to account for energy expenditure for each “small” task for the week in advance, including, decisions about when to expend energy on showering, preparing food, and more. You can read more on “The Spoon Theory” here. I encourage you to read the article and use it to give yourself credit for all you do and to use the language when explaining chronic illness to people in your life..

Additionally, outside of planning for energy expenditure, you likely are managing planning medical appointments and keeping up with prescriptions, which includes going to the pharmacy, keeping track of what you are low on, making sure your doctors have sent in prior authorizations for medications, and the dreaded long phone calls with both insurance companies and mail order pharmacies. These are just two of the many logistical planning tasks required of having a chronic illness.

Coping Strategy: Organization Tools

Using systems that work for you including setting reminders on your phone, keeping a planner, and enlisting the help of a loved one can help with this burden.

Struggle# 6: Uncertainty

Lastly, in addition to all of the struggles above (and more that are not listed) there is the heavy weight of uncertainty when having a chronic illness. Life is not certain for anyone, but with chronic illness you are faced with a tremendous amount of uncertainty. Chronic illness affects everything in life so you live every day not knowing what your symptoms will be like tomorrow, next week, or a year from now. You may not know the prognosis of your condition, or maybe you know the statistics but are not sure where you fit into the statistics. On top of that, you may not know what treatments will help, which will have side effects, and which treatments don’t exist yet but could be life changing. These are just a few examples of the many ways in which chronic illness is uncertain.

Coping Strategy: Keep Pursuing Your Passions

Coping with uncertainty is difficult and it requires you to think about what matters most to you. Reflect on what gives your life meaning and do things that are in line with that. Perhaps you love helping animals and when you were young you wanted to open an animal sanctuary, maybe that would be too much for your body now; however, you could volunteer at a shelter once a week or once a month. Alternatively, maybe social justice is important to you and you can’t be on the front lines of a protest, but you can make phone calls or send mailers to encourage people to vote.

You can still pursue long term goals and exist with the discomfort of not knowing what the end result will be. It’s still worth engaging in these goals even if it’s not exactly how you originally pictured it. Pursue a degree if that is important to you, start the business you want, or volunteer for something you are passionate about! It’s okay to do these things even if you don’t know how long you will do them for or what it will look like. Contrastingly, it’s also okay to grieve. Living with a chronic illness includes grief, especially when it comes to uncertainty.

In conclusion, coping with chronic illness looks different for everybody but I hope you can give yourself credit for all you do, even when others don’t understand. I hope you allow yourself to grieve. More importantly, I hope you find a way to live a meaningful life even if it looks different than what you planned or what you see others doing.

Do you struggle with chronic illness? We can help.

Orchard Mental Health Group is a large Maryland-based private practice with offices in Rockville, MD and Frederick, MD, providing affordable, accessible, research-informed counseling, assessment, and medication management services to children, adolescents, and adults.

Our team provides a safe, nonjudgmental space to process emotions, build resilience, and develop practical coping strategies. Whether you’re managing stress, addressing feelings of grief or isolation, or seeking ways to improve your quality of life, we’re here to help you find strength and hope. Together, we’ll work toward a path of healing and empowerment tailored to your unique journey.

Intuitive eating has many benefits including higher self-esteem, well-being, optimism, body appreciation and acceptance, as well as psychological hardiness, life satisfaction, and many more.

Oftentimes, when someone first learns of Intuitive Eating and hears “eat what you want, when you want” their gut reaction is worry about weight gain and poor health. Embracing intuitive eating will require you to challenge these thoughts and beliefs, or at least acknowledge their existence and be willing to experience discomfort while trying something new.

In the United States, we are surrounded by diet culture everywhere we look.

Can you remember the first time you noticed the societal pressure to eat and look a certain way? Maybe it was hearing a parent step on a scale and judge the number they saw, perhaps it was a comment about needing to work out to “earn” a slice of pizza later that evening, or maybe it was government programs aimed at “fighting obesity”. We are constantly getting messages that all have the same underlined and bolded idea, “fat is bad, thin is good.” This message is so ingrained in our culture that our health system practices outdated science which reinforces fatphobia, the negative beliefs and ideas we have about fat people and fat bodies.

BMI (body mass index) was never intended to be used in healthcare.

BMI was constructed by Adolph Quetelet in the 1830’s intending to find the “perfect human.” It was based on French and Scottish men, but then adopted by healthcare professionals as the “best” tool to assess health not for its accuracy, but for its ease of use in medicine and research. The BMI does not consider health behaviors or body composition. Therefore, it does not give an accurate picture of health. In your intuitive eating journey, you will learn to challenge these beliefs, which in turn is better for your health.

The principles of intuitive eating include honoring hunger, discovering the satisfaction factor, respecting fullness, making peace with food and gentle nutrition, challenging the Food Police, coping with your feelings with kindness, respecting your body, and joyful movement.

It may seem simple but two crucial principles of intuitive eating include honoring your hunger and respecting fullness. Unfortunately, most messages we have heard related to hunger and fullness include things like “don’t eat past 7 PM”, “drink a glass of water to feel more full so you do not eat more”, etc. This “advice” has made us less in touch with our biological feelings of hunger and fullness. Because of this, we need to relearn what hunger and fullness truly feel like. These feel differently for everyone and there are different levels of being hungry and full. The scale below shows the Hunger and Fullness Scale (image from Lauren Cadillac):

The goal of intuitive eating is to eat when you are in the hungry sweet spot, before getting to the too hungry end of the spectrum, and to finish eating when you are in the sweet spot of fullness, rather than the too full end of the spectrum when you feel ill.

This requires practicing mindfulness within your body. By honoring your hunger and fullness, you are taking care of your body by giving it the energy it needs. The other principles like making peace with food, challenging the “food police”, and coping with emotions with kindness all help with honoring hunger and fullness. This is because there are a lot of reasons why we may not be in touch with our hunger/fullness cues and many reasons why we may not listen to these cues when we are aware of them.

Below are some ways that can help you be aware of your cues:

1. You can pay attention to what foods are appealing to you and notice if you “allow” yourself to eat these foods or not. “Allowing” yourself means that you eat without guilt, shame, restriction on the amount you are eating and without a plan to “exercise it off” later.
2. Give yourself permission to eat what is appealing to you. Notice if it is as satisfying as you imagined and begin to be mindful of what satisfies you while permitting yourself to eat those things.
3. Be present while eating and notice how you talk to yourself during your meal. Step away from distractions and notice each bite and the thoughts that you have while you eat. This can give you a clearer picture of what Food Police thoughts you need to challenge and the areas that you can attend to with self-compassion.

Intuitive eating is a very different way of eating than you are likely used to!

It’s a journey. The benefits are well worth it and it can be uncomfortable along the way. It is important to remember there is no version of perfect in your pursuit of eating intuitively and to practice self-compassion as you try to unlearn messages you have received your whole life.

You can dive more into the practice of intuitive eating by reading Intuitive Eating: A Revolutionary Anti-Diet Approach by Evelyn Tribole and Elyse Resch, following social media accounts like @feelgooddietitian (Lauren Cadillac) on Instagram, or finding a therapist who has an understanding of intuitive eating and can help guide you through the principles and process the experience in therapy sessions.

References:

School of Public Health. Addressing weight stigma and fatphobia in public health | School of Public Health | University of Illinois Chicago. (n.d.).

Tribole, E., & Resch, E. (2020). Intuitive eating: A revolutionary anti-diet approach. St. Martin’s Essentials.