Welcome to the second article in our Managing Mental Health series. In this series, we’ll be de-mystifying a number of mental health conditions by drawing on real people’s experiences to find out what living with a condition is really like. In this article, we explain what it’s like to live with anxiety and how the condition can be managed.
Different types of anxiety
There are several different types of anxiety including generalised anxiety disorder (GAD), specific phobias, and post-traumatic stress disorder (PTSD). We’ll focus on generalised anxiety disorder here and cover other forms of anxiety in separate articles.
The effects of anxiety
I spoke to Cathy, a woman living with anxiety about how it affects her:
‘With the anxiety, a lot of it’s around the fear of meeting new people or socialising with people or just generally being around people, especially in new situations. In work situations also, I get quite a lot of anxiety around meeting new people – so that can make work quite difficult.’
Everyone is likely to have experienced anxiety at some point. Taking an exam, giving a speech or having a job interview are just few examples of typical anxiety inducing situations. And it is normal and understandable to feel anxious at these times.
Anxiety disorder, however, is a feeling of fear and worry that is severe and long-lasting.
‘I think sometimes people try and normalise it by comparing it to their own feelings. They say, “oh yes I know what it’s like to be anxious because I was anxious before a job interview”, but it’s not really the same because yes we all get anxious before a job interview but that’s not like having an anxiety condition where you might be anxious about a different thing everyday or about nothing or nothing you can identify its just a sort of constant worry and constant feeling of anxiety. Its not really the same as what I’d call normal, everyday anxiety which is attached to a specific event.’
Anxiety is usually brought on by situations a person perceives as threatening, or from being in an environment where a person feels they don’t have any control. This feeling of fear is part of the fight or flight response. This response prepares our body to either run from danger or to fight it. We breathe faster, our heat rate increases, our blood pressure goes up and we’re on high alert. It’s a useful thing to have and it’s kept us safe in the past, but not if it is triggered at the wrong times.
So a certain amount of anxiety is normal, but someone with anxiety disorder might experience levels of anxiety that are disproportionate to a non-threatening situation.
Imagine you have a meeting to attend and it’s a few miles away. On the drive there, you make a wrong turn. Many people will be annoyed, but accept that they’ll be a bit late. But someone living with anxiety might experience a chain of negative thoughts about how they have failed. About how they always make mistakes. About how they will probably lose their job. And they may associate driving to any future meetings with this bad experience and avoid driving to meetings in the future. In this case, the ‘flight’ response is causing this person to avoid future situations that they perceive as threatening.
Let’s explore the symptoms someone might experience when living with anxiety
What are the symptoms?
To explore the symptoms, I asked Cathy to describe some of the symptoms of anxiety:
With the anxiety some typical symptoms might be feeling sick, feeling kind of panicky inside, feeling a tight chest and breathless and wanting to run away from the situation and having racing thoughts and racing, rising adrenaline. Feeling like I’m not going to be able to calm down. Not being able to sit still. Constant worrying. Sometimes not even sure what I’m worrying about. Just this fear that something terrible is going to happen and I won’t be able to cope with the situation. Even when I know in my mind it’s not really rational and there’s nothing genuine to be afraid of. It’s just as though the adrenaline keeps on rising and rising.
Symptoms can also include:
- A feeling of fear or panic
- Butterflies in the stomach
- A desire to escape a situation
- Shortness of breath
- Poor coordination
- Increased heart rate
- Increased breathing rate
- Reddening of the skin
- Feelings of aggression
- Poor concentration
- Poor memory
- Feeling dizzy
The may also experience depersonalisation, which is feeling detached from your body and your thoughts. Or maybe derealisation, which is feeling that the outside world is just unreal.
I spoke to Angela about having this experience:
‘There were many times where I just felt like I was having an out of body experience. I was sat on a cloud somewhere and there was just an empty shell of a person that was going through the motions of cleaning, cooking, washing, ironing.’
The pop star, Adele, who lives with anxiety and panic attacks, describes her experience like this:
‘I have anxiety attacks, constant panicking on stage. My heart feels like it’s going to explode because I never feel like I’m going to deliver. Ever.’
The signs of anxiety
So what might you observe in someone who has anxiety? Signs to look out for include:
- Nervy and twitchy movements
- A tense posture
- Shaking and sweating
- Difficulty in speaking
- Performing day-to-day actions harder
- Vocalisations such as moaning or screaming
I asked Cathy what she thought a manager could look out for:
‘I think a manager can look out for signs of poor mental health in an employee by really noticing changes in their usual behaviour. It might be avoiding certain activities, particularly for people with anxiety, if they’ve got an anxiety around travelling or talking in front of people they might noticeably avoid those a activities. Or it could be being withdrawn infant of colleagues. Or working long hours but not seeming to get very much done, or not being very productive or missing deadlines that’s unusual for them. Anything really that seems different that seems like they’re unhappy or they’re struggling. Any of this changes could signify a mental health problem in that person.’
Possible causes of anxiety
Genetics can influence someone’s predisposition to anxiety, but other factors are important too. If you haven’t read our article on the biopsychosocial model, it is worth checking out to understand how a combination of factors influence a person’s mental health. Although the genetic component to anxiety is important, it’s not the only factor.
For example, past experiences where a person has had to deal with a stressful situation can cause anxiety for similar future situations. So a fear of losing control of your life can also produce symptoms of anxiety. A poor diet with excessive stimulants can exacerbate anxiety and you might notice if you drink lots of tea or coffee that you feel a bit more on edge and alert.
Supporting someone living with anxiety
There are self-help options:
- Relaxation and mindfulness
- Joining support groups
- Researching the condition
There is also professional support:
- Cognitive behavioural therapy (CBT)
- Graded exposure therapy
- Medication such as anti-depressants or benzodiazepines (diazepam or valium)
I asked Angela about the help she received:
The doctor said it was quite normal. I was put on anti-depressants to help and I’ve been on and off them since 2004.
As with depression, finding the right treatment for someone takes time and they might not find the right one immediately.
Some of the things that you can do to support someone with anxiety include:
Being aware of their triggers
If you know someone has specific triggers for their anxiety (such as driving to meetings), then be aware that asking them to do these things or be in those situations might cause anxiety. Don’t force people with anxiety to do the things that make them anxious. Although it is a good thing for them to confront their fears to overcome them, no one should force them to do it. However, discussing ways you could support them may lead to them attempting the task and realising they can overcome the situation. But they should not be made to do it even if you think it’s for their benefit.
Don’t compare their fears to your own
To someone dealing with anxiety, the perception of danger feels very real – even if it’s non-threatening to everybody else. So even if you think it is unreasonable to feel anxious about whatever the person finds threatening, you should show understanding that for the other person it is very real and therefore don’t make a judgment about the legitimacy of their anxiety.
I asked Cathy what she thought managers could do to help:
‘There’s a lot of different ways in which you could support someone with a mental health condition at work. One of them would be to make adjustments in their role, which might involve part-time working or might involve flexible working. Or perhaps reassigning some of the things that they do to another colleague. That could be on a permanent or temporary basis. Obviously from a business point of view not every single change that they might ideally want would be possible. I can understand that for small businesses particularly, it’s difficult to just change people’s roles, so there may be limits to how flexible you can be, but I think even if there are certain things that the employee’s going to have to do, I think you can still support them. For example, if they’ve got to travel somewhere or go to a conference, you could ask them how you could make this experience easier for them and find out what their fears are. You could ask if there is anything you can practice with them or reassure them about. Is there any training that you can give them? There’s a lot of different ways you can help but will depend on the nature of the job and the business and the employees particular needs and their circumstances.’
You now know a lot more about anxiety. You might not remember it all, so here are the key points:
- Anxiety is a persistent feeling of nervousness or fear
- It is disproportionate to the situation
- It is linked to our evolution
- Don’t force someone to confront a source of anxiety
- Don’t measure their fears against your own
If you’d like to learn more about mental health, you can get started with our bite-size Mental Health Awareness online course.
Delphis also offers on-site mental health workshops delivered and developed by highly educated business managers, academics and teachers. We guide companies along the path to creating mentally healthy, productive and rewarding working environments for their staff. The financial argument is compelling and caring for your employees is the right thing to do.
One major multi-national client says this about our workshops:
“Very relevant and informative with an engaging and inclusive style. Worth spending a whole day on. Loved the takeaway workbook, pretty much perfect, we need to roll out to whole company.”
Get in touch to discuss how we can provide customised mental health training for your organisation that fits your needs.