What Partners of Anxious People Need to Know

If you love someone with disordered anxiety, your most loving instincts are often what's keeping their disordered anxiety alive. I unpack the research on family accommodation, why reassurance is a long-term harm even when it feels kind in the moment, and the caregiver burden conversation we shy away from. Includes real examples from my own recovery and how my partner showed up alongside me. If you're an anxious person who has been trying to figure out how to talk to your partner about all this, send them this one! 

SOURCES:
-Spouse and Partner Help - Anxiety & Depression Association of America https://adaa.org/finding-help/helping-others/spouse-or-partner
-Measuring Family Accommodation of Childhood Anxiety: Confirmatory Factor Analysis, Validity, and Reliability of the Family Accommodation Scale - Anxiety: https://pmc.ncbi.nlm.nih.gov/articles/PMC6881529/
-Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysishttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247143 

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Transcript

SPEAKER_00 0:28

Welcome to the 18 Minutes Podcast. I'm Amanda, and this is the show where we take everything that is confusing, isolating, and scary about disordered anxiety and turn it into something you can actually work with. If you're listening to this because you love somebody who suffers with disordered anxiety and you've been trying to support them and care for them in all the ways that seem obviously loving, this episode is for you. I'm going to tell you something that might be a little uncomfortable, which is that some of the most loving instincts you have are actually keeping your partner stuck. I know that's not the news you were hoping for, but stay with me for a few minutes because there is a real teachable way that you can be a supportive partner of someone with disordered anxiety without accidentally fueling the fire. Let's get into it. Today's episode is one I've wanted to do for a while because we often forget about the person standing next to the person with disordered anxiety. The partners, the ones who are trying to figure out how to help while watching someone they love go through something that they probably don't understand from the outside. Real quick before we dive in, I have another episode on the same topic where I actually sat down with my partner who went through the worst of my anxiety disorder and the whole recovery journey with me. And that episode is called Supporting an Anxious Partner. Tom talks a lot on that episode about his experience and his perspective as someone supporting an anxious person, what he learned during that process, and what he wished he would have known sooner. If you are the partner of someone with an anxiety disorder, I cannot recommend that episode enough. This episode is going to cover more of the framework for how to support an anxious person. And that episode is about real experience and perspectives as a partner of someone with disordered anxiety straight from the horse's mouth. On that note, I am not a therapist or a medical professional. Everything I share in this podcast is based on my own experience with disordered anxiety, my recovery journey, and the research that I do for the show. This is not a replacement for therapy, so please only take what's helpful to you, leave what isn't, and listen to your medical and mental health professionals first. If you're new here, welcome. So glad you found us. Please follow or hit subscribe wherever you're listening because a new episode drops every Friday morning, and I don't want you to miss the next one. If you're a regular, welcome back. Then, my typical housekeeping, if you haven't yet, grab your free recovery guide at the18minutes.com. Signing up for the free guide also adds you to my Monday morning newsletter, which is a real highlight in my week, and based on what you've told me, a great way to start yours as well. Okay, let's talk about what partners need to know. I want to start with what I think is the most important concept of this whole episode. That's not typical podcast format. I'm supposed to save the big stuff for the end so that you listen to the whole thing, but this is really important and it I do think it sets the foundation for the following points. It's called family accommodation. Family accommodation is when people who love an anxious person adjust their behavior to help the anxious person avoid panic triggers, feelings of panic, or general discomfort. It is almost by definition motivated by love. Examples would be canceling your plans because your partner had a bad day, going to the grocery store because they don't have the energy to do it, driving the long way to avoid the freeway because that's one of your partner's triggers, and answering the question, am I okay for the seventh time this evening? If any of that sounds familiar, you are not in trouble. All of that is you trying to help your partner because you care about them. The thing that I bet no one has told you is that continuing those behaviors in the long run is actually helping your partner's anxiety continue on. There's a researcher named Dr. Eli Lebowitz out of Yale who's done a lot of research on this. He developed a treatment called Space, Supportive Parenting for Anxious Childhood Emotions. The original work is focused on child-parent relationships, not adult partnerships, just an FYI for now. What his research has shown is that when parents reduce their accommodating behaviors, like the ones I just mentioned, and replace them with supportive responses, their children improve in the context of their disordered anxiety, sometimes even as much as they did in cognitive behavioral therapy. So, like I said, the original research is the parent-child relationship. But why this matters in the context of adult partner relationships is because the mechanism, the loop, is the same. It's the same across all close relationships where one person has disordered anxiety. And the brain is doing the same thing. It's learning through avoidance and rescue that there actually was danger present to begin with, and that the accommodating behaviors from the other person are what kept them safe from that danger. When the accommodating behaviors from the partner continue, that pattern gets reinforced and the anxious person's world starts to shrink. So every time you go to the store instead of letting your partner go, or every time you cancel dinner so they don't have to experience the discomfort of sitting in a restaurant, and every time you tell them you're fine, you're just having a panic attack, I promise, when they ask you if they're okay, you are providing them short-term relief and teaching their brain a long-term lesson. So here's what might feel impossible to you. The loving thing to do is to actually do less of that. Not all at once and not in a way that feels cold or like a punishment, but you want to do less of it gradually while communicating about it. I want to give you an example from my own journey because the line between supportive and accommodating can get fuzzy. When I was deep in recovery, there were some days where going to the grocery store by myself felt like too big of a task. I would either avoid it altogether or I would ask Tom to go on his way home from work instead of me having to deal with it. If Tom had just gone every single time, that would be straight up accommodation. And sometimes he would. If I was having a really tough time, he would go to the grocery store for me. Sometimes he would suggest the two of us going together instead of avoiding the situation entirely. Or I'll get the groceries, but why don't you go into the grocery store and just grab one thing really quick and leave? What he was doing without having any clinical words for it at the time was lifting some of my burden without erasing the practice and the benefit altogether. Not every interaction was perfect. This takes trial and error. Sometimes he was just being kind to me and wanted to give me a break, and that's fine. What he wasn't doing was building a structure around me that felt like you cannot do this on your own without help. He was actually finding ways to help me approach my fears when I was feeling exhausted. That's how you can practice this. It's not never help your partner ever again or make them suffer through every situation alone, but lifting some of the burden without taking the work away from them entirely. Sometimes you'll get it wrong, both of you will, and that's part of it. If you take one thing away from this episode, let it be this. Your job is not to make your partner's anxiety go away. Your job is just to be present alongside them while they do the work that ultimately does allow them to recover. Okay, so the flip side of stop accommodating is actually understanding what your partner is working on. Because if you don't know what they're trying to do, you can't support it, right? And if both of you are not on the same page about what's going on, then not accommodating is going to get really hard really fast. As I was working through my recovery, I made sure that Tom understood what I was working on. Not because he's responsible for it, but because it helped him be more supportive. I told him all about exposure and response prevention and what it was and how it worked. I told him what exposures I was working on. I told him how they went, how I was feeling that day. Most days he had a really good sense of where I was at mentally and physically. What that meant for us is that on days where I felt tired and like I wanted to bail on the plan, Tom had enough context to be able to say, hey, let's do a smaller version of the exposure that you're working on instead of skipping it entirely. He had the context because we were building it together in a way. And he knew that skipping it entirely was an avoidance behavior that would probably cost me. He also learned over time how to recognize when I really was at my limit and when I needed a break. And again, that happened through trial and error. We did not always get that right, but gradually he was able to be more and more supportive as we learned and worked through this process together. Because we do need breaks sometimes. Every human on earth has a finite mental capacity. We don't have unlimited energy, and when we're severely anxious, that capacity is much smaller. That's a real normal part of life, and it is okay to take breaks and to let your partner have a break. So that's the thing I think partners need: a shared language and a shared roadmap. If you are the partner of someone who has an anxiety disorder, sit down with them at some point when they're not in panic mode and ask them some questions. What are you working on? What are your triggers lately? What is helpful to you in the long term when you're in the middle of a panic episode and what isn't? Some of the answers might surprise you and they might change over time, and that's okay. The point is to build the language together. And one thing I want to say about knowing your partner's triggers, the point is not to understand them so that you can have a running list of every single thing that causes them anxiety. That would be accommodation. But understanding some of the things that will cause them to have a panic attack and maybe which types of things cause a bigger reaction or a milder reaction, so that when you witness your partner approaching one of those triggers, you can help them approach it instead of avoiding it. You can also know then on the harder days where they have a bigger exposure, not to schedule a dinner with their in-laws or a doctor appointment or a long drive out of town. Anxious people in recovery are not made of stone. We have a capacity. The good news is once both of you have this shared roadmap, a lot of the confusion and misreading each other goes away. You don't have to guess anymore, and they don't have to keep translating for you. Some of the most important work in recovery, in my experience, were in the conversations that Tom and I had about what was helpful and what wasn't. So this next thing I think partners need to know is something that I have covered before in an episode about reassurance seeking. It's a really important concept for people who have disordered anxiety. So I do recommend, even if you are the partner of someone who's anxious, um, to go listen to that episode as well, just to get a bigger grasp of what this is. But because this episode is for the partners, I wanted to come at it from your side of the dynamic. The common pattern looks something like this. Your anxious partner turns to you and they ask you, Do you think I'm okay? Or are you sure I'm not having a heart attack? Or is it weird that I have chest pain right now and I'm a little short of breath? Or is this really just a panic attack, or is something more serious happening? Because you love them, you say, Yes, you're fine, I promise. And they get a little bit of relief. And you feel like you did the best, most loving thing for them in that moment. What's actually happening underneath in the longer term is that their brain, their anxious brain, the fear center of their brain, the fight or flight system, the amygdala, uh, just got evidence that the only way that they can be saved from danger, which their brain currently thinks that a panic attack or anxiety symptoms are dangerous, is to get your reassurance that they're okay. The next time they get those same feelings, or they're in that same situation, and their anxiety spikes, their need to ask you, just to be sure if they're okay, is going to increase. And it'll be even more intense the time after that, and the time after that, and the time after that. Their brain is doing what all brains do, which is learning what works. The relief reinforces the asking for reassurance, and the reassurance creates more dependency. To make matters worse, this pattern could be causing some slow damage to your relationship from both sides. Research has actually linked excessive reassurance seeking to declining relationship quality and increased anxiety and depression in both partners. The way out of this cycle, just like accommodation more broadly, is to stop offering these short-term relief reassurances and instead provide something else. There's a few phrases that come up in clinical research that you can use instead when your partner asks you if they're okay. Instead of assuring them, yes, you're fine, I promise you're okay, everything's gonna be okay. You can say, It sounds like you're feeling really uncertain right now, and that makes sense because you're uncomfortable. It's validation without answering their question. Or you can say, I know you want reassurance right now, but I'm gonna hold off on giving it to you because reassurance is not what's going to help you in the long run, and I want you to get better. You could ask them, what's another way I could support you right now that's not giving you reassurance? Or my favorite, I trust you to handle this on your own right now. I want to talk to the anxious person listening for one second. When your partner starts doing this, it is going to feel terrible at first. You might feel abandoned. You might feel like what they're doing is not loving at all. And I can tell you, as someone who has been on both sides of this cycle, that not giving you the reassurance you're asking for is absolutely the most loving thing that they could be doing at that moment. They're trusting you to do the work because they believe in you. They're betting on you. That is love, even if it doesn't feel like it. If you are the partner of someone with disordered anxiety and you are feeling worn out, resentful, tired, anxious yourself, depressed, lonely, or just kind of flat at the end of most days, that makes sense. There's quite a bit of research on this, on what gets called caregiver burden. It is well documented that the partners and family members of people who have anxiety disorders experience real measurable strain. They experience higher rates of anxiety and depression themselves, lower marital satisfaction, and exhaustion. You feeling like your partner's mental health struggle is taking a toll on you is not a sign that you love your partner less than you should. It's an unfortunate consequence of the situation that you both are in. And it matters because if you aren't paying attention to these feelings, you will run out of the bandwidth you need to be present for the work that both of you are doing. A few specific things come up in the literature for partners and caregivers that I want to share with you. First, find someone you can talk to who is not your partner: a friend, a therapist, a family member. Anxiety within a relationship is a hard thing to carry alone, and it does not have to be the topic of every single conversation that you have. Second, have things that are your own. Hobbies, friendships, time alone, things that are not revolved around your partner's anxiety. You can set what one source called off-duty windows, times where you are explicitly not a caregiver and they are explicitly not a patient. Self-care is not selfish here. It's necessary for you to be able to stay in this while your partner is in active recovery. The Anxiety and Depression Association of America has a specific resource for spouses and partners of people with anxiety disorders, and I'm gonna link that in the show notes. I found it really helpful. It's a practical guide, and I think you would really appreciate that if you're the partner of someone with disordered anxiety. If you haven't gone looking for resources because you don't think there are any out there for you as the partner, there definitely are. So just do a quick Google search and you'll find a lot of resources for you too. You are allowed to be tired. You're allowed to need a break. You're allowed to want some of the conversation in your life to be about things other than anxiety. None of that means you don't love your partner. It means you're a regular person. Two more quick things before we close. First, if your partner is in therapy or considering therapy, I recommend looking into whether you can be involved. Some of the current treatment approaches actively recommend partner involvement even for just a session or two, so that both of you have the same language and their therapist can help you build that shared roadmap that we talked about earlier. Some therapists work with the partner as a sort of co-coach. Even just doing one session together can make a huge difference in how you communicate. I mentioned this quickly at the beginning, but I think it's worth saying again. This work, the recovery work, is not all on you as the partner to figure out just because you might have more capacity. Your role should be to support and to validate without accommodating and to be a steady presence. Your partner's role is to do the actual exposure work, to sit with discomfort and to take accountability for their own recovery journey. If you find yourself doing more of the work than they are, that's information and probably something worth having a conversation about. Recovery from disordered anxiety can work so much better with supportive people around us, but the anxious person has to be willing to do hard things too. You both have to want it for this dynamic to work. Okay, so here's three things I hope you take away from this episode today. One, your most loving instincts, reassuring, accommodating, rescuing, are part of what is keeping your partner stuck in a disordered anxiety cycle. The loving behavior is to support without rescuing and to validate without reassuring while your partner does the work. Two, both of you need to be on the same page. Learn what they're working on, build a shared language, ask what helps, what doesn't, and then revisit it over time. And three, take care of yourself. Caregiver burden is real. The version of you who has rested, has friendships outside the relationship, and has a life of your own is the version of you who can continue to show up for your partner. And if they have an issue with any of that, tell them to listen to this episode because I said so. On that note, that's all for today's episode on what partners of anxious people need to know. And on the note of support, I'm so glad you found this resource. I hope that what I shared here today is genuinely useful to you. I also want to recommend, if you're in a position to do it, that you help your partner look for a therapist who specializes in exposure-based cognitive behavioral therapy or CBT. I know that therapy is not available to everyone financially or otherwise. And I recovered from disordered anxiety after listening to lots of podcasts and reading lots of books and doing my own practice. So I'm not telling you that your partner absolutely needs to see a therapist to be able to recover because I don't think that's necessarily true. But there are some really important principles to understand about exposure-based work to not only make it more effective, but to prevent more anxiety and more damage from happening. A therapist who specializes in exposure-based practices, like ERP, for example, can help your partner build a plan that's specific to them, their fears, and their life. Especially if they've been working at this for a while and they haven't seen meaningful change, a therapist might be the thing that moves the needle. If you're listening today, as someone who is a partner of someone with disordered anxiety, special thank you for being here and listening to this episode. This is hard on you too. And the fact that you took time today to listen to this episode about your partner's anxiety and how you can be supportive says a lot about who you are. Having a supportive partner during my recovery made a world of difference for me. And I know that your partner is going to feel the effects of you doing this work too. If you have questions about today's episode or you have another topic that you want me to dive into on the show, send me an email at amanda at the18minutes.com or you can send me a DM on TikTok and Instagram at the 18 Minutes. If today's episode was helpful to you, please follow or subscribe. And if you have a second, please consider leaving a rating or a view. They're genuinely the most helpful thing in other anxious people finding the show. Thank you again so much for being here today, and we'll see you next time.