Maybe you’ve been anxious all your life. Maybe the Covid-19 pandemic has taken it to an unprecedented level. Or maybe you don’t suffer from anxiety but work with people who do.
Even if you’re used to managing it on a day-to-day basis, it’s not always clear when anxiety is cause for concern. So I asked Dr. Ellen Hendriksen, a clinical psychologist and the author of How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety, about the warning signs that someone is really struggling.
Dr. Ellen Hendriksen
Matthew Guillory
Dr. Hendriksen offered advice on addressing heightened anxiety with humanity and compassion and, when the person struggling is a work colleague, discussing it without overstepping. Our conversation, which took place over email, has been edited for clarity.
What are the signs that your anxiety is reaching an unsustainable level?
We know anxiety has escaped its confines and is running wild when it surpasses the thresholds of distress or impairment. Distress means intense stress is overwhelming your usual ways of coping. Maybe you’ve always been able to manage your anxiety with yoga, a sense of humor, or some healthy perspective, but now nothing seems to keep the lid on. Impairment means the anxiety is getting in the way of living your life. For instance, you can’t focus, so you’re behind on your work, are losing sleep, or are so preoccupied that you can’t be present with your kids or partner.
What should you look out for in your boss, colleagues, or employees?
Problematic anxiety is mostly internal and therefore is hard to spot. However, clues include unmanageable worry or irritability, inability to focus or concentrate, and physical restlessness (pacing, being on edge). In conversation, or on a Zoom call, you can often sense the person has tunnel vision — they might be hyperfocused on a worry, keep coming back to a topic, or refuse to consider others’ points of view.
In addition, problematic anxiety often leads to under-control or overcontrol. People who under-control can be passive or all over the place. Their actions can be scattered, inefficient, and unhelpful — you might find yourself thinking, “What are they doing?” They either follow every impulse or give up altogether, bending as the wind blows.
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Overcontrol can take the form of micromanagement, rigidity, hypervigilance for potential threats, refusing to try new approaches or adapt, or insisting that there is a right way to do things. These are the folks who, during a time of high anxiety, throw themselves into work or anything else they can control, from financial planning to making a spreadsheet of their canned goods.
But remember: Overcontrol is a problem only when it causes distress or impairment to the anxious person or to those around them. Focusing on work is fine if it gets someone’s mind off the crisis, but if work becomes their only focus, and especially if their health or relationships suffer as a result, they have crossed the line into unhealthy overcontrol. Keep this in mind for yourself as well.
Pretty much everyone has a relatively high level of anxiety at the moment. How can you differentiate that from something more troubling?
It is important that someone’s response isn’t disproportionate to the threat. Before Covid-19, it would have been over the top to wear gloves and a mask while grocery shopping. These days everything has changed. A higher-than-normal level of anxiety is expected and appropriate. But the disproportion rule still applies: For example, refusing to go to the emergency room if your appendix bursts, or hitting the grocery store in full scuba gear, is still generally considered to be over the line.
Give everyone plenty of slack, understanding, and validation. Also, when someone seems especially anxious, keep in mind that you may not know the full context. Maybe their sister is a nurse on the front lines in New York. Maybe their spouse was laid off and they’re worried about paying the mortgage. Maybe they have an underlying condition that puts them in a high-risk group. Their anxiety may not be disproportionate at all.
What are some things you shouldn’t say to a colleague who seems anxious? And what can you do that might actually help?
Don’t try to offer quick fixes: “Have you tried yoga?” or “I hear lavender essential oil can work wonders.” Advice like that, while well intentioned, comes across as invalidating — “Oh, is that all I have to do? Silly me!” Worse, offering advice creates an expert/amateur dynamic, rather than a relationship of equals.
Likewise, dismissals like “Calm down,” “There’s nothing to be afraid of,” or “Just don’t worry about it” feel invalidating and unsupportive.
Many people feel uneasy about offering help to a colleague they’re not close to. But no matter the depth of your relationship, you can always validate their experience (“It totally makes sense that we’re all stressed right now” or “Trust me, nobody is doing their best work these days”) or make a workplace-appropriate disclosure of your own (“It’s been a real challenge to juggle everything” or “The worst part for me is not knowing how or when all this will end”).
Some worries are expressed as “what ifs” — “What if I get quarantined and can’t work?” or “What if my elderly parents get sick?” Know that the “what if” is rhetorical, but go ahead and inquire about an answer: “That’s a scary thought. What would you do?” Anxiety is driven by uncertainty, and generating a plan creates certainty, which in turn can reduce anxiety. Supporting your colleague as they think through a plan of action (without proffering advice — refrain from “I’ll tell you what worked for my brother”) can be helpful without invalidating their fears.
What should you do if you, a colleague, or an employee has a panic attack?
Panic attacks feel awful. It sounds silly, but remind yourself (or your colleague) that it’s a panic attack. It’s easy to get caught up in the feeling that you might be dying, are having a heart attack, or have finally snapped and lost it. But remember, it’s a panic attack, and panic attacks always end. What goes up must come down.
Next, if you or your colleague has prescribed medication for panic, this is the time to take it.
If you’re at home and have a panic attack, a nonmedication response is to fill a sink or a big bowl with cold water, add ice cubes if you can, and dunk your face in. Hold your breath and keep your face immersed for 30 seconds. This triggers the diving reflex, which is an evolutionary response that shuts down all nonessential body functions — including strong emotion — during a fall into cold water. It kicks in the parasympathetic nervous system and calms you down. Alternatives include taking a cold shower or putting an ice pack over your eyes and holding your breath for 30 seconds.
If you’re trying to help a colleague, don’t chatter anxiously at them or pepper them with questions. Stay as calm as you can and ask them to breathe deeply and — most important — slowly! Rapid breathing can mimic hyperventilation and make a panic attack feel worse. Ask them to inhale for a count of six and exhale for a count of 10. This takes advantage of a natural physiological phenomenon called respiratory sinus arrhythmia, which means your heart beats faster on an inhale and slower on an exhale. If you exhale for longer than you inhale, over time your heart rate will slow, which in turn will calm your other body systems.
What if someone’s workplace performance suffers over time because of continued anxiety? How should managers and employers respond?
Managers can’t and shouldn’t ask about private health information. But they can address specific tasks or behaviors. If deadlines are being missed or projects are falling perilously behind, you can start a conversation. Use the same tone you would in asking about a physical illness or injury — be caring and open. Tiptoeing makes things awkward and can backfire. Say: “I wanted to check in given the last few deadlines. I know this crisis has been a big challenge for everyone. You don’t have to navigate this all by yourself. Let’s talk about how we can support you.” Or say: “I want to acknowledge that things have been really stressful and uncertain lately. It’s not your style to let things fall behind, so I wanted to check in. You’re such a vital and extraordinary part of this team; let’s make sure you have what you need.”
This is a great time for both you and your employees to take advantage of any mental health benefits your workplace offers, like an employee assistance or behavioral health program. During this crisis, many therapists are offering telehealth sessions through health care–compliant platforms. And even though privacy can be hard to come by with kids and partners within earshot, enterprising folks have taken their laptops out to their parked cars for online therapy sessions, or talked to their therapists on the phone in our nearly empty streets.
What happens now that many of us are working from home? How can you stay on the pulse of your employees’ anxiety virtually, without being too invasive or violating anyone’s privacy?
It’s OK to be more direct than usual given the circumstances. Working remotely, it’s harder to pick up on the same signs you would see in person.
Be transparent — acknowledge that it’s a difficult time for everyone and you want to check in. Ask how they’re doing and how you can help. If they say, “I’m fine,” don’t respond with, “Great!” and mentally check off the box. Instead, respond with a spirit of flexibility and openness: “If that changes, let me know” or “I’m so glad — let’s keep checking in as the weeks go by.” Everything that makes you a good human — sincerity, flexibility, caring about your colleagues — will make you a good manager in this unprecedented time.The Big Idea