How to Help A Friend With Anxiety (From People Who Have Anxiety)

Here are 5 tips my patients tell me help the most. Take it from them. Not me.

“I’m doing just fine,” explained my patient. It was late March 2020 and our lives had just been upended by COVID-19. I was relieved to hear she was okay considering the unbridled disruption, uncertainty, and fear that pervaded the early days of the pandemic. Our weekly Monday appointments were cancelled indefinitely and I had not seen my patient in over two weeks.

“Thanks to years of therapy, I have lots of tools in my toolbox to deal with constant worry,” she continued. “It’s like I have been preparing for this moment all my life.”

Having lived with anxiety for as long as she could remember, she found herself in the curious position of giving advice to friends who were experiencing overwhelming anxiety for the very first time. “After all these years, I have become an expert in uncertainty. I know what has helped me so I know how to be there for them.”

Most of us know someone who struggles with anxiety and knowing what to say and how to help isn’t always obvious. As a psychiatrist, I have treated many people who struggle with anxiety on a daily basis but I have learned as much, if not more, from my patients who live with anxiety as I have from training and textbooks.

Here are 5 tips my patients tell me help the most. Take it from them. Not me.

1 – Listen Deeply

Before offering any words of wisdom, hear them out. Resist the urge to interrupt, or to reassure, or to tell them they are overreacting. Give the person your full attention and compassion so that they feel understood and heard.

2 – Check In

Anxiety can be a very lonely experience so showing up means a lot. Give them a call, take them for a walk, or suggest watching a movie together. Be responsive when they call or text. Remind the person that they are loved and that you are there for them.

3 – Ask Them What They Need

“Just because meditation works for my anxiety doesn’t mean it works for everyone’s anxiety,” explained my patient. Instead of assuming you know what’s best or have all the answers, follow their lead. Anxiety manifests differently in everyone. Respect their experience.

4 – Be a Tailwind, Not a Mechanic

As tempting as it is to want to “fix” someone, remember that a person with anxiety is not broken. Support their goals, celebrate their wins, and remind them of their strengths. Instead of focusing on problems, tap into their capabilities.

5 – Set Boundaries

Setting limits doesn’t mean you are a bad friend, it means you are human and have your own life too. It’s okay to say, “I love you. I’m in the middle of something. Can we chat tomorrow morning?” If someone is asking for more than you can give, resentment sets in. Be open and honest. Clarity and communication are antidotes for guilt.

Bottom Line: Being there for someone with anxiety is about supporting their needs, not what you think they need.

I wish you all the best,

Dr. Samantha Boardman

Spot a Narcissist (Before You Marry, Hire, Date, or Befriend One) By Asking These 2 Questions

Healthy narcissism is real. So is toxic narcissism. Ask these two revealing questions to spot the difference.

Hands down, narcissism is the psychological disorder I get the most questions about. Rarely do people voice concern over their own narcissistic tendencies. In fact, nobody has ever come to my office and said, “Am I a narcissist?” though many have asked if they have depression or anxiety. What they would like to know about is how to deal with the narcissists in their lives. This week’s Dose is about how to spot a narcissist before you marry, hire, date, or befriend one.

It’s worth pointing out that narcissism isn’t always toxic and to a certain extent is adaptive. Desiring admiration, attention, and approval is part of being human and the motivation to maintain positive self-regard is perfectly normal. In fact, it’s healthy to think well of oneself. Interestingly, studies show that most of us think a little too highly of ourselves. Ninety-three percent of drivers believe they are “more skilled than most drivers.” Eighty-five percent of college students say they “get along better with others than average.” People think their kids are better than other kids.

Just because most of us have exaggerated perceptions of personal superiority doesn’t mean that we are all narcissists.

Normal narcissism is distinct from pathological narcissism. The two questions I always ask to assess for the presence of pathological narcissism are:

Those with narcissistic personality disorder can typically talk about themselves for hours on end but they have a hard time describing the other people in their lives. They happily provide lively, specific, and usually flattering details about themselves but when pressed to talk about other significant people in their lives, they have little to say.

In contrast to the rich depictions of the self, they typically provide shallow, vague, and oftentimes generic descriptions of the people they are supposedly close to. A narcissistic husband who cheats on his wife might describe her as “a bore” or “not fun to be with” without providing any nuance or depth of understanding of her inner life or acknowledging how his behavior is impacting her.

According to Eve Caligor, clinical professor of psychiatry at Columbia University, people with narcissistic personality disorder have relationships that are transactional and lacking in empathy. Their interest in others is self-serving and viewed through the lens of self-enhancement as in “how can this person elevate my social standing or help me look good?”

For a narcissist, getting ahead is more important than getting along and this exploitive mindset is captured by their inability to imagine or describe the feelings of others.

As insanely obvious as this sounds, this is a reliable way to identify a narcissist. A study found that how people rated themselves on a scale of 1 (not true of me) to 7 (very true of me) aligned closely with other validated measures of narcissism, such as the widely used Narcissistic Personality Inventory.

Brad Bushman, a co-author of the study and professor of communication and psychology at Ohio State University explained:

“People who are willing to admit they are more narcissistic than others probably actually are more narcissistic. People who are narcissists are almost proud of the fact. You can ask them directly because they don’t see narcissism as a negative quality — they believe they are superior to other people and are fine with saying that publicly.”

One of the many advantages of this simple narcissism litmus test is that it enables narcissist identification so quickly and easily. Of course, you could always ask someone to take the classic Narcissism Personality Inventory developed by Raskin and Hall but that might be a little awkward.

Bottom line: Healthy narcissism is real. So is toxic narcissism. Ask these two revealing questions to spot the difference.

I wish you all the best,

Dr. Samantha Boardman

Stealth Narcissists: How to Spot Them and 3 Sanity Preserving Tips for Dealing with Them

When we think about narcissism, certain qualities come to mind: status seeking, admiration requiring, self-glorifying, entitled, arrogant, and a lack of concern for others. The classic chest-thumping narcissist — the grandiose narcissist — is the one we’re familiar with. Without naming names, you know exactly who I am talking about. Certain celebrities and political figures come to mind. But there’s another type that’s worth knowing about that’s harder to spot but just as entitled: the vulnerable narcissist.

Unlike grandiose narcissists who tend to be bold and outgoing, vulnerable narcissists are shy, inhibited, and deeply insecure. They are prone to feelings of shame and are forever on the lookout for subtle slights or criticism. In stark contrast to their grandiose counterparts, they shun being the center of attention. They cling to the conviction that they have suffered more than others and that nobody can help them. From friends to romantic partners to colleagues to an Uber driver, everyone lets them down.

Vulnerable narcissists swim in a sea of exasperated disappointment. “If only everyone wasn’t so incompetent” is their inner monologue. Finger pointing comes naturally to a vulnerable narcissist and they love to rehash the past and romanticize how much better things could be if only people appreciated them more. They are excellent at finding fault in others but oblivious to their own. Grievance collecting is their full time job.

Also known as closet or covert narcissists, vulnerable narcissists do not wear their narcissism on their sleeve. Grandiose types do us the courtesy of practically announcing their narcissism with their brazen behavior and shameless attention-seeking. They’re the loudest person in the room whereas vulnerable narcissists operate under the radar but are masterful at guilt-tripping and manipulation.

Nikhila Mahadevan, Lecturer in Psychology at the University of Essex explains:

“While grandiose narcissists may be stars on the interpersonal stage, triumphantly capturing the spotlight, their vulnerable counterpart may be a bit player lurking on the sidelines, resentfully seeking, but failing to obtain, the applause they crave.”

If you are dealing with a vulnerable narcissist, here are 3 sanity-preserving tips:

1. Set boundaries

Vulnerable narcissists (and narcissists in general) will take as much as you can give. Reciprocity is not in their nature. Do not make yourself available to them 24/7. Practice saying no. “I wish I could but…” and “Unfortunately, that won’t work for me” are handy phrases to keep in your back pocket. As the old saying goes, “Never make someone a priority when all you are to them is an option.”

2. Consider a two person rule

Before saying yes to the person’s request or bending over backwards to accommodate their needs, get an unbiased perspective from someone else. A second opinion from a trusted friend or a therapist provides perspective and will prevent you from feeling used or manipulated by their neediness or guilt-inducing behavior.

3. Tap into their motivation

Vulnerable narcissists seek both status and belonging. They care desperately about being recognized and included. Frame feedback in terms of what they care about the most. Instead of confronting them head on, ask questions that help them see a situation from another’s point of view such as: “How do you think that person felt when you didn’t show up?” or “How would you feel if a friend didn’t show you and you were expecting them?” Accept that accountability does not come naturally to vulnerable narcissists but such questions might help them recognize that they bear some responsibility.

If you think you know a vulnerable narcissist (or think you might be one) The Three Minute Closet Narcissism Test is always an option. It includes questions such as:

  • I silently wonder why other people aren’t more appreciative of my good qualities.
  • I am often secretly annoyed when people come to me for sympathy and/or help with their problems.
  • I easily become wrapped up in my own interests and forget the interests or needs of others who are close to me.

On a final note, before you dismiss someone as a vulnerable narcissist, remember that humans are complex fragile creatures capable of extraordinary goodness and also selfishness and inhumanity. The tragic dimension of vulnerable narcissism is that the efforts put forth to achieve goals often have the exact opposite effect. The connection and validation they crave often go unmet and ultimately push people away. Instead of feeling anger, resentment, or hostility towards vulnerable narcissists, bear in mind the wise words of Brené Brown who reminds us to tap into the better angels of our nature:

“When I look at narcissism through the vulnerability lens, I see the shame-based fear of being ordinary. I see the fear of never feeling extraordinary enough to be noticed, to be lovable, to belong, or to cultivate a sense of purpose.”

I wish you all the best,

Dr. Samantha Boardman

Being Single May Make You Happier Than Ever

Contrary to popular belief, one is *not* the loneliest number.


Increasing numbers of people are single for one simple reason: they want to be. They don’t have intimacy issues, they are not selfish, and they are not single because they cannot find a partner. It’s a deliberate choice. While many may still believe that being single is synonymous with isolation and that the only on-ramp to happiness is marriage, research tells a different story.

Social scientists Natalia Sarkisian and Naomi Gerstel found that single people have more social connections and are more involved in their communities than their married counterparts. They are also more likely to socialize with neighbors and to reach out to their social network. Put simply, they are generous, happy, and satisfied with their choice. Moreover, they are a lifeline of the community and a reservoir of connection.

Related research suggests that single people are also healthier than their partnered peers. They work out more and are in better shape. On top of their physical fitness and active social lives, single people are more likely to experience a sense of personal growth and a feeling that their life is a continuous process of learning and discovery.

One thought to keep in mind: People change. We are ever-evolving. Daniel Gilbert, professor of psychology at Harvard University and author of the best-selling Stumbling on Happiness, puts it this way: “Human beings are works in progress that mistakenly think they’re finished. The person you are right now is as transient, as fleeting, and as temporary as all the people you’ve ever been. The one constant in our life is change.”

Stay flexible. Keep an open mind. You never know what your future self will think.

I wish you all the best,

Dr. Samantha Boardman

7 Ways To Make Love Last

We may live in a world that tells us to go it alone, but at heart, we are social creatures, longing for genuine connection and craving the company and love of our fellow humans. The data is beyond dispute: happiness doesn’t only come from within, it also comes from with. In the spirit of Valentine’s Day, celebrate connection and expand your circle of love.

While chocolates and flowers are nice, here are seven ways to provide what we all crave — the experience of “felt love.”

Showing you care isn’t just for Valentine’s Day. Research from UCLA shows that how we respond to one another significantly predicts the quality of our relationship. The next time a loved one shares news, look up from your phone, or even better, put it away. Genuinely engage. Give them your full attention. Say these three magic words: “tell me more.” And mean it.

Why do kids get to have all the fun making arts and crafts? Break out the glue and glitter and spend some time making a beautiful Valentine’s Day card. Plus, a handwritten note is so much more meaningful than a Hallmark cliché expression of love.

In The Myths of Happiness, Sonja Lyubomirsky suggests doing novel and exciting things together (skydiving, ballroom dancing, etc.). Couples who engage in new experiences report more satisfaction with their relationships than those who engage in routine activities like going to a movie or cooking dinner.

Walking hand-in-hand and side-by-side is a physical way to be more in sync with your partner and be attuned to their needs. Synchronized movement generates what psychologist Barbara Frederickson calls “positivity resonance” — a synthesis of shared positivity, mutual care and concern, plus behavioral and biological synchrony. These micro-moments of connection deepen our social bonds and satisfy our longing to love and feel loved.

Novelty wears off in life and love. Researchers call this process of getting used to things hedonic adaptation. As the old saying goes:

The first kiss is magic. The second is intimate. The third is routine.

Spontaneity makes a difference. People are reminded of their attraction to their partner when they see them in an unexpected context — like watching them give a speech if they never have before, or running a marathon for the first time. It reminds them that there is more to the person they brush their teeth next to in the morning.

Disrupt your routine — go to a new brunch place on Sunday mornings, switch the side of the bed you sleep on, visit a different bed and breakfast. Banish “we always…” from your vocabulary. As Lyubomirsky writes, “we are less likely to take our marriage for granted when it continues to deliver strong emotional reactions in us.”

Charge yourself with detecting one way in which your partner is different each day. Looking for subtle differences shifts your expectations and will remind you of what attracted you to them in the first place.

According to a study, couples who wrote about a recent disagreement from the perspective of a neutral third party had greater relationship satisfaction, passion and desire over the long term. No essay is required. Writing about conflict resolution for seven minutes every four months did the trick.
The art of love… is largely the art of persistence. – Albert Ellis

I wish you all the best,

Dr. Samantha Boardman

Your Partner Doesn’t Need to Be Your Best Friend

“My goal is to marry my best friend,” explained the young woman in my office. I have heard a version of this many times. There is tremendous pressure today to find a partner who is your “one and only.“ Indeed, it’s practically impossible to scroll through Instagram without seeing someone refer to their significant other as their #bestie.

Relationship expert Esther Perel addresses this contemporary cliche and cautions against searching for a romantic partner who checks every box in a 2018 SXSW talk:

 

 

We still want all the same things that traditional marriage was about—[family life, companionship, economic support, and social status]—but now [we] also want [our partners] to be a best friend, a trusted confidant, and a passionate lover to boot… What we have created in a romantic ambition is one person to give us what once an entire village used to provide.

While it’s cozy to think of your romantic partner as your best friend (who doesn’t like a package deal?), here are 3 reasons it’s important to nourish your platonic relationships too.

1. Friends Help Us Weather The Storm

An argument with your significant other is one of the most upsetting of daily stressors. As one patient told me, fighting with his partner in the morning sets a negative tone for the rest of the day. He described it as a dark cloud that hangs over him and follows him around until the issue is resolved.

In addition to taking an emotional toll, there is a physical cost to relationship disharmony. Negative interactions can impact the immune system and cardiovascular function.

A couple’s therapist might encourage a bickering couple to work on conflict resolution and to spend more quality time together. A study offers another important way to protect oneself from the harmful effects of conflict: having good friends.

Researchers at the University of Texas, Austin, asked 105 newlywed couples to keep a daily diary of marital conflict and to complete questionnaires about their social interactions outside of the marriage. The couples provided morning and evening saliva samples so the researchers could measure levels of cortisol, a hormone the body produces in direct association with physiological stress.

The findings indicate that having a few good friends to lean on can buffer against the stress of everyday conflict with one’s partner. Participants with high quality social support experienced lower levels of stress when marital conflicts arose. It is worth nothing that the number of friends didn’t impact the couple’s ability to handle conflict—it was the quality of the social interactions that counted. Knowing that someone has your back makes every challenge a little bit easier.

There is a lesson here. If you are in a relationship, don’t forget to make an effort with your friends. Having a shoulder to lean on that is outside of your relationship will enhance your connection with your one and only. When there is trouble in paradise, you can turn to your friends to help you weather the storm.

Friends don’t just make life better, they make romantic relationships better too.

2. Boundaries Strengthen Bonds

Contrary to how romantic relationships are depicted on Instagram, spending all of your time together does not deepen the connection. Poet Ranier Maria Rilke understood the tension between the longing for togetherness and the fundamental need for autonomy in ‘Letters to a Young Poet.’

A merging of two people is an impossibility, and where it seems to exist, it is a hemming-in, a mutual consent that robs one party or both parties of their fullest freedom and development. But once the realization is accepted that even between the closest people infinite distances exist, a marvelous living side-by-side can grow up for them, if they succeed in loving the expanse between them, which gives them the possibility of always seeing each other as a whole and before an immense sky.

While it is important to share the same values—having different interests, hobbies, and friends allows for the “possibility of always seeing each other as a whole and before an immense sky.”

Supporting your partner’s interests and encouraging their pursuit is known as “autonomy support.” In other words, if your significant other loves to go camping but it’s not for you, suggest they go on a camping trip. If your partner is passionate about Broadway but you cannot stand it, buy tickets for them and their best friend. People are happiest when they do things that matter to them and become frustrated when they cannot. Encouraging the one you love to pursue their interests is relationship-enhancing. I am not suggesting that you and your partner need to be totally independent. On the contrary, when you support another’s autonomy, it will bring you closer together. As Rilke observed:

A good marriage is one in which each partner appoints the other to be the guardian of his solitude.

3. Greater Health, Happiness, and Wellbeing

Friendships often take a backseat to other demands but the more we prioritize friendships, the happier and healthier we are and the better our romantic relationships will be. A study from Michigan State University found that close friendships predict day-to-day happiness, how long we’ll live, and even more so than spousal and family relationships. On days when individuals interact with friends, they report greater happiness and are in a better mood. In fact, people generally report more positive experiences with their friends than they do with their families, particularly in later life.

Bottom line: Invest in friendship.

I wish you all the best,

Dr. Samantha Boardman

1...171819...82Page 18 of 82
Facebook Instagram Linkedin TikTok Twitter

WELLBEING IS A VERB

This website is for informational and entertainment purposes only and is not a substitute for medical advice, diagnosis or treatment.
Copyright 2025 Positive Prescription. All rights reserved.