Talk to your friend about what activities are soothing, as well as what the things they really need to hear from you are. Encourage them to write these things down, with the goal of giving you the piece of paper to keep, so that you can say or do helpful things when they are having a hard time. Note: it is also very important that they make a similar list for them to refer to.
Some of the things you can say that might make a difference are:
Breathe slowly. You’re going to be okay. You’ve always gotten through this is the past, all you have to do is wait it out. I know you are strong. This will be over soon.
You are so loved, I care about you deeply, and I will help you any way you need if you tell me how.
We can get you out of this situation if we need to. (Make sure you can follow through on this.)
You are not in danger. This is your anxiety trying to take you over. I am here to help you feel safe. (If they will not respond positively to you saying that their reaction is coming from their anxiety, just promise them you will keep them safe.)
Some actions you can take to help are:
Try to remove your friend from the situation that is causing the anxiety response, like a social or family situation, the store, the mall, or a party/formal event. Go outside with them and encourage them to breathe in slowly through the nose while counting, and breathe out for half as long out of the mouth. This physically slows their heart rate. You can count out loud for them to help them concentrate, and feel cared-for. You can also offer them the option of leaving the situation entirely, if possible. It’s okay to cancel plans with friends and family in order to help your friend function. It’s something that they will need sometimes. If their friends and family can’t be understanding or supportive, they are going to lose those people eventually anyway.
Remind them to eat. Low blood sugar can trigger an episode. When you go somewhere with them, keep a piece of fruit with you.
Encourage your friend to get in to see a therapist if they don’t already. If they can’t afford it, there are some therapists who offer sliding-scale pricing, which means your friend would pay according to what they make. When they see the therapist, they should go in with goals in mind. These goals could be “I want to be calmer in public places.”, “I want to feel less anxiety.”, or “I want to struggle less with my daily life.” The therapist will then help them build tools and skills to use every day that are aimed at lessening their pain. If your friend is reticent to go to therapy, offer to help them find a therapist and to drive them to their first appointment.
Remind them often that they are loved and supported, in and out of anxiety episodes.
Remind them to do any of the activities they wrote down as “soothing”. It’s easy to forget your tools when you’re in crisis.
Please remember that your friend can get better and experience less anxiety, but they will probably never fully recover. The goal is not to be cured, the goal is to learn to live successfully, in as little pain as possible. Most of the responsibility to get better rests on your friend’s shoulders, not on yours. Make sure you take care of your own mental health before reaching out to help your friend. It’s okay to sacrifice a little for them, but if you find yourself slipping into a depression because of their situation, take some time to yourself to get better, and then return to your friendship refreshed. Since your friend has a mental illness, they should be understanding if you express the need to take care of your own mental health for a while.
It is very loving and honorable that you want to help your friend. If you have a very close relationship and you are willing to take on more responsibility, this has more ways you can help: How Outsiders Can Help – The Goldfish Painter