Most often the people who will try to fake a service dog claim they have a mental illness because they cannot be proven wrong by the public. We obviously never see those dogs do task work so what do psychiatric service dogs actually do — the real ones?

There isn't only one answer to this question as each person with a mental illness experiences different severities in symptoms and exhibits variations of anxious behaviors. Some of these include, but are not limited to: skin picking that could lead to scars, foot tapping, leg shaking, nail/lip biting, etc.

"One of Bucky's tasks is to alert to, and interrupt, skin picking. It's a nervous tic and I don't always realize I'm doing it. It doesn't seem like a big deal to most people, but it has left me with a lot of nasty scars. Having Bucky interrupt that behavior could save me from getting an infection and ending up with more scars."

Professor Alexandra Horowitz, a dog-cognition researcher at Barnard College, wrote that "while we might notice if our coffee has had a teaspoon of sugar added to it, a dog could detect a teaspoon of sugar in a million gallons of water, or two Olympic-sized pools worth." Since dogs are able to smell so well, us humans can teach them to sniff out specific people/objects/foods. By detecting the levels of cortisol in our breath, our dogs' sniffers are the first to know when our anxiety is about to spike and can alert by nose bumping or pawing at the handler.

"When I pick or scratch at anywhere on my skin, Weasley will paw at my hands or my leg if I'm standing to interrupt the behavior. Afterward, he usually provides a good distraction by trying to get me to play with him."

Some psychiatric service dogs will immediately try to distract an anxious handler by playing because it changes the person's focus. Instead of thinking about a flashback or a panic attack they just had, they can begin doing something else. And what is a better distraction than a cute dog wanting to play?

Another way for a psychiatric service dog to calm an anxious handler is by sitting in the handler's lap or across the chest. Many people just think we like to sit down in the middle of a shopping mall to have our dog cuddle in our lap. However, with as cute as they may look, they are actually doing a very important task that is used by many psychiatric service dog handlers. This is called DPT, deep pressure therapy, causing serotonin and dopamine to be released in the handler's brain. The pressure is also calming because it helps lower heart rate and blood pressure, both of which rise during a panic attack or anxiety spike.

"He (Anders, service dog) keeps me focused on my task at hand so I don't overwhelm myself needlessly and dissociate. He responds to increasing heart rate, change in pheromones with oncoming anxiety and physical movements. Without his help, my bipolar and anxiety would make it impossible for me to work."

Everyone is familiar with daydreaming or "zoning out" but a far more intense and debilitating version is called "dissociation." It is a coping strategy for most people with anxiety, panic or depression disorders. When people daydream, they may be thinking about their day or something that happened last Tuesday. However, when someone dissociates, they feel detached from their body, as if they're not real and are disconnected from everything happening around them.

This is extremely dangerous for a person to experience in public as they fear being taken advantage of or walking into life-threatening situations. Not only can a psychiatric service dog guide the handler to a known safe-zone, but their nose can also sniff out a family member or specific person they were taught to find in cases of an emergency.


"This photo was taken after he (Asher, service dog) naturally responded to a severe panic meltdown after a really wretched morning. His DPT task grounds me when I'm hyperventilating and having trouble settling my heart rate. I have dissociation issues that can be interrupted when he nudges under my hand to ground me back into reality."

During dissociation, the dog will try to bring the handler back to reality; this could be done by face-licking, pawing the handler or jumping in the handler's lap. This is calling "grounding."

"In this picture, she (Nami, service dog) looks like she is just being needy. However, she was alerting to an anxiety spike and responding to minute anxious behaviors I didn't know I was doing. What I couldn't see, she saw and she tried to let me know. Sure enough, a few minutes, later I had a panic attack that left me locked in the bathroom terrified to leave. She performed her breathing alert as well as grounding in that bathroom."

Many people assume that psychiatric service dogs are another name for "ESA: emotional support animal," which is not only false but also a completely different thing. Emotional support dogs are not taught any of the tasks listed above and in most cases, not any tasks at all. Granted, they may naturally learn to alert by picking up on the handler's anxious behaviors, but they do not require any training and are denied public access rights. ESAs are purely for emotional support, just how it sounds, and existing for the handler's comfort is their only job.

"A long time ago, before I had a service dog, I disassociated, walked off and ended up getting hit by a car; It was an incredibly scary situation. I also live in a very dangerous town, unfortunately. Because of this single task, I was able to make so much progress in my lifetime long recovery."

As mentioned earlier, dogs cannot only smell when chemicals are fluctuating in our bodies, but they can also detect increased heart rate and changes in blood pressure, making it possible to alert to anxiety spikes or panic attacks. Additionally, people also experience increased heart rate and changes in blood pressure during night terrors as well. In that case, the dog can wake the handler up and save them from having to re-live their trauma over, and over and over every single night, waking up screaming and hyperventilating in a pool of sweat.


Service dog, Saxon, practicing automatic "nose-bump" in a night-terror reenactment training session.

Just being in public around other people is enough to make someone with anxiety feel like someone is sitting on top of them, making it difficult to breathe. Psychiatric service dogs are taught to set a divider between the handler and people around them, keeping others out of the handler's space at all times. The dog can cover or block (stand in front of or behind the handler) horizontally, crossing the front/back of the handler's body.


"Block is definitely one of my most important tasks. This ensures that no one startles me by coming from behind and also acts as a buffer so I have more space between myself and other people. Both of these keep stress levels lower, which also keeps my seizure count lower."

When the dog is blocking/covering, they can be taught to nose-bump the handler when someone is approaching. This helps many paranoid, terrified handlers feel safe with their service teammate.

Top view photo of service dog, Nashville, covering his handler in the front. "She stands in front of me when people approach and stands behind me when I'm in line. As somebody who panics when a stranger touches me or gives me even the slightest glance, it helps to have a barrier between myself and my triggers."

Paranoia and anxiety don't only occur when psychiatric handlers are out of their house, but even when they're entering. In this scenario, the handler commands the dog to check out an entire space before entering. The dog will let the handler know if it is safe to come inside, helping ease the anxious mind.

Service dog, Yanna, performs many tasks to help her handler, one being the room check task. "[Yanna goes] into rooms in my house before I enter to make sure there's no one in there."

The withdrawal symptoms from forgetting to take an anti-depressant medication can be brutal, including: mood swings, dizziness, balance problems, flu-like symptoms, headache, loss of coordination, muscle spasms, nausea, tremors, trouble sleeping and vomiting. Most of the time, spoonies (a person living with a chronic illness) have reminders set to take their medication. Even with the reminder, it is easy to instantly forget or even hit snooze. Service dogs alert their handler to the alarm and are persistent until they take the medication. In some cases, the dog may not even need an alarm to remind them. The dog can also retrieve the medication for the handler.

"Beatrice assists with my bipolar disorder, anxiety and agoraphobia. She is trained to notice tactile signs of anxiety like skin picking or a tapping foot and interrupt the behavior. Doing this notifies me that my anxiety is rising and it may be time to take my medication. She also provides me with medication reminders morning, noon and night. Often times when I'm manic, I simply don't remember to take them."

Is it easy to fake a psychiatric service dog because: "no one will be able to prove you don't have anxiety" Maybe. But remember that there are many psychiatric service dogs that are real and not equivalent to an emotional support animal or therapy dog.

A psychiatric service dog provides more than just comfort and helps people with debilitating mental illnesses. Not just "anxiety" but crippling anxiety, which makes it hard to live a normal life or leave the house. Psychiatric service dogs go through training to help the handler's specific anxious behaviors and often learn how to smell chemical changes in their handler's body, unlike an ESA.

Whether or not you believe in mental illnesses, it is not your place to determine if psychiatric illnesses qualify as disabling enough to have a working dog. This is especially true if you have never had to suffer through the trauma, the horrifying night terrors, the embarrassing panic attacks in the middle of a grocery store or having a conversation with someone and not even noticing your skin is bleeding from scratching so hard. It is not your place to judge another person's pain just because you can't see it.

Just because you have never had a seizure, would you say they aren't real?