The Ultimate Guide to a Service Dog for Anxiety

If you have an anxiety disorder and love animals there are two paths to having a helping “paw.” One is for emotional support and the other, a service dog, provides more targeted help.

Animals can have a positive impact on your mental health.

If you manage anxiety, the symptoms may be no surprise to you but an attack disrupting your busy life might often catch you off guard.

Emotional support animals can reduce anxiety by providing a soothing, therapeutic presence.

Yet, emotional support animals are not the same as a service dog, that’s trained to anticipate and respond to your nuanced anxiety symptoms, anxiety disorder treatment needs, or oncoming anxiety attacks.

Yes, it seems that they can!

Studies, such as this 2014 study and this 2015 study, have suggested that the presence of a dog can reduce the subjective experience of stress and anxiety symptoms.

A 2021 study also found that interacting with an animal can reduce the physical markers of anxiety after a stressful situation. These physical markers include:

  • blood pressure
  • heart rate
  • levels of stress hormones

Positive interactions with animals can boost your oxytocin (the love hormone) levels, similar to social interactions with humans. It also seems to reduce cortisol (the stress hormone).

Pets don’t always help with anxiety. If you find having a pet to be stressful — a newly purchased puppy or pandemic-acquired rescue dog, for example — it could worsen your anxiety.

It’s up to you to assess whether the responsibility will help or hinder your mental health. It might be helpful to talk with a therapist about the possibility.

How emotional support animals help with anxiety

There have been few studies on the long-term benefits of emotional support animals (as opposed to pets in general, or service dogs).

However, a recent pilot study on the benefit of emotional support animals for people with mental health conditions found that they seemed to reduce markers of anxiety, depression, and loneliness. It included people with dogs and cats.

According to the study, ESAs seem to help by:

  • offering companionship
  • distracting their owners from symptoms
  • providing a purpose and focus
  • providing motivation and accountability

The study didn’t find any significant changes in the physical markers of anxiety, although cortisol levels decreased after the participants interacted with their pets.

For your pet to be considered an emotional support animal, it’ll need to be prescribed to you by a mental health professional who deems it necessary for your well-being.

For a dog to qualify for a service pet, however, you need a prescription plus additional criteria met.

What makes a dog a “service” dog?

The Americans with Disabilities Act (ADA) defines a service animal as a dog that’s been tailor-trained to do work or perform tasks for an individual with a disability. Those task(s) must be directly related to the disability. A mental health disorder is considered a disability if it impairs everyday functions.

There are service animals for different disabilities. Those trained to help people with mental health symptoms are called psychiatric service dogs (PSD).

A service dog for anxiety might do the following tasks:

  • calm a person by providing deep pressure therapy (placing his weight on the person)
  • soothe someone by licking their face or offering their paws
  • leading someone to the person in distress
  • bringing a phone or medication to someone in distress
  • reminding a person to take medication at certain times

One way service dogs differ from emotional support animals is because ESAs aren’t necessarily trained to perform tasks for you.


If you’d like a service dog, you can either purchase an already-trained service dog or train one yourself.

Legally, your dog doesn’t have to be trained by a professional in order to qualify as a service dog, so you can theoretically train it yourself. However, this can be a challenge.

Purchasing a trained service dog can be costly. The National Service Animal Registry says that the average cost of a service dog is around $15,000 to $30,000 upfront. Some may even cost over $50,000. The amount might vary depending on their capabilities.

If you’d like to train your dog yourself, there are various service dog training programs and certifications. Professional dog trainers can cost anywhere between $150 and $250 an hour, and it can take a year or two before the dog is fully trained.

It’s also important to budget for things like food, veterinary care, medication, supplies, and toys.

Certain organizations may be able to help you with the cost of a service animal.

It’s easiest to use a professional dog trainer. However, because these trainers are often expensive, many people opt to train their service dogs themselves.

The first step is to start socializing your dog and teaching it basic commands, as you would with any dog. Starting this early and practicing commands often will help.

Before you train a service dog for anxiety, consider how it can help you. Which tasks can it perform? You can make a list.

Start with one or two simple tasks and practice them. These tasks may include retrieving your meds or phone, performing deep pressure therapy, or cuddling you when you’re feeling an anxiety episode.

When the dog performs the task correctly, you can give positive reinforcement, such as petting your dog and giving them a treat.

It’s best to be patient, both with yourself and the dog, as training can take a while.

Where can an ESA be denied access?

It’s important to remember that an emotional support animal is not in the same legal category as a service animal. Accommodations that include service animals will not automatically include emotional support animals.

An emotional support animal or service dog might not be given accommodations if the:

  • Request for the animal is unreasonable
  • animal is trespassing on the rights of others
  • prescribing ESA letter or the PSD certificate (issued by some states) is invalid or expired

What about landlords and service pets?

The Federal Fair Housing Act and the ADA allow people who qualify for an emotionally support animal or service dog to keep a dog on the premises, even if the landlord has a no pet policy.

However, property managers or landlords don’t have to accommodate ESAs or service dogs if the property is:

  • A building with four or less units where the landlord occupies one of the units
  • Single-family housing sold or rented without a real estate broker
  • A private club

Additionally, you need to ensure that your ESA letter or PSD certificate (if applicable in your state) hasn’t expired and that the animal does not encroach on the rights of others.

Can a service pets fly for free?

Some airlines have banned emotional support animals from traveling with passengers in flight, while others will allow you to bring your ESA for a fee.

Service dogs, however, are allowed on flight, and typically at no extra charge. It’s important to check directly with the airline, as their policies can change.

Emotional support animals and service dogs are different. However, both can be used to help people with anxiety disorders.

In order to get an emotional support animal or a service dog, you’ll need a recommendation from a health professional.

As they say “to [that] much is given, much is required.” A psychiatric service dog is trained to provide specific tasks to help manage mental health treatment, episodes, or emergencies. As such, a service dog will be given more public access accommodations than an emotional support animal.

For more details on finding and registering a service dog or an emotionally supportive dog, you can take a look at the US Dog Registry or the National Service Animal Registry.

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