Almost one in three people will experience an anxiety disorder during their lifetime. This means if you’re not personally suffering from anxiety, one of your loved ones probably is. You likely already know that anxiety disorders are associated with really unpleasant physical symptoms and chronic stress. You might also know that women are two times more likely to have an anxiety disorder than men. What you may not realize is that anxiety disorders also massively impact the economy. In 1990, anxiety disorders cost the United States over 40 billion dollars (that’s more than 78 billion dollars today). About 4 billion dollars of those costs stemmed from presenteeism at work.
This article will discuss three types of anxiety (generalized anxiety disorder, panic disorder, and social anxiety disorder) that may be holding you back at work. I’ll provide a basic overview of each disorder and how the symptoms may play out in the office. More importantly, we’ll talk about the many resources that can help.
1. Generalized Anxiety Disorder (GAD)
What is GAD?
People with GAD worry a lot — and about a lot of different things. It is important to note that most of us will worry when we’re experiencing major life changes. For example, every new mom I know (including me!) was pretty freaked out about returning to work. I’ve also had my share of evenings worrying about credit card bills or sick family members.
There a few key differences between worrying about specific situations and GAD. First, the worrying associated with GAD lasts a long time. In fact, in order to be diagnosed with GAD, a person needs to be worried most of the time for at least six months. Second, people with GAD experience other cognitive and physical symptoms along with the worrying. These can include sleep issues, general tiredness, difficulty focusing, aches and pains, or feeling tense or irritable.
How Does GAD Look at Work?
If you have GAD, you may spend a lot of your work day worrying. Of course, there are plenty of legitimate reasons to worry about work. The pay gap between men and women is real, and our national parental leave policies are flat-out unhealthy for families. The #MeToo movement has highlighted how frighteningly common sexual harassment is in the workplace. These issues are even more complex and difficult to navigate for women of color. In addition to these systemic issues, you may have a horrible manager or work in a company going through layoffs.
Worry can be a useful signal that something in your work life needs to change. However, getting stuck in an endless cycle of anxiety can feel paralyzing. All that tension may also make it more difficult to focus, or even leave you snapping at coworkers. It may also be hard to let go of job-related worries when you get home. This can turn into a downward spiral where worrying all the time is actually making a bad situation even worse.
Resources That Can Help
Here’s the good news: There are things you can do to reduce your anxiety. Two excellent books on this subject are Feeling Good: The New Mood Therapy (by David Burns) and The Anxiety and Phobia Workbook, Fifth Edition (by Edmund J. Bourne). Both books offer practical suggestions and exercises for combating counter-productive thinking and behaviors. There is also increasing scientific evidence that developing a mindfulness practice can reduce worrying. This article shares some quick tips for developing a mindfulness practice at work. If you want to learn even more about the benefits of mindfulness, check out these two books: Mindfulness for Beginners, by Jon Kabat-Zinn and Real Happiness by Sharon Salzberg.
There are also a number of treatments for GAD that are highly effective. The stigma around getting help for mental health problems, unfortunately, continues to exist. However, even though asking for help takes courage, it can change your life for the better. Two promising therapies for GAD are cognitive behavior therapy (CBT) and acceptance and commitment therapy (ACT). CBT tends to focus on teaching people to combat counter-productive thought patterns, as well as to face scary situations. ACT is more focused on mindfulness and teaching clients to live their best lives even when they have difficult emotions.
If you’re interested in trying therapy, your primary care physician can help you find a provider. Your insurance company’s member services department can also help. Psychology Today also provides a directory of therapists, as does GoodTherapy.org.
2. Panic Disorder
What Is Panic Disorder?
People with panic disorder have frequent and unpredictable panic attacks. Panic attacks can be terrifying; many people having a panic attack believe they are having a heart attack. Even when someone knows that they are having a panic attack (and not dying), the symptoms can be extremely intense and distracting. About 30 percent of people with panic disorder also have agoraphobia or a more general fear of being in public places. Agoraphobia can make the world feel incredibly small and severely limit a person’s opportunities and social interactions.
How Does Panic Disorder Look at Work?
Having a panic attack at work can be a scary and embarrassing experience. It is also almost impossible to be productive in the middle of a panic attack. Agoraphobia can make it difficult to come into work or to take jobs that involve traveling away from home.
Resources That Can HelpTwo good books on panic disorder are When Panic Attacks, by David Burns, M.D. and Panic Attacks Workbook: A Guided Program for Beating the Panic Trick by David Carbonell, Ph.D. Both guide the reader through techniques that can make panic attacks feel less intense — or prevent them entirely.
If you’re considering therapy, CBT, which was discussed in the last section, is an effective treatment for panic disorder. Just as with GAD, CBT for panic disorder focuses on helping people change counter-productive thoughts and behaviors. CBT therapists are also likely to teach breathing and relaxation techniques to people with panic disorder. That’s because deep breathing and muscle relaxation can reduce the intensity of panic symptoms.
CBT for panic also often involves a technique called interoceptive exposure. “Interoceptive exposure” simply means, “getting a client to increase his/her heart and breathing rate.” Clients usually do this by blowing into a paper bag or doing intense exercise during a therapy session. Although it might look and feel silly, interoceptive exposure is incredibly effective at helping people overcome panic attacks. This is because it mimics the symptoms of a panic attack in a safe environment. Clients thus learn that the physical symptoms of panic attacks are not inherently dangerous. So, when they hyperventilate or their heart races during an actual panic attack, they are better able to calm down.
3. Social Anxiety Disorder
What is Social Anxiety Disorder?
People with social anxiety disorder worry that other people will judge them in social settings. This can make parties, public speaking, or going on a date extremely painful. It can also limit people’s opportunities to form meaningful relationships.
How Does Social Anxiety Look at Work?
Social anxiety can complicate a huge number of work-related activities. Interviews are stressful for most people, but they can be absolutely excruciating for someone with social anxiety. Social anxiety can also make giving a presentation, or even speaking up in a meeting, pretty terrifying experiences. It is also hard to network if you worry about being judged or rejected whenever you’re introduced to new people.
Resources That Can Help
You may have already guessed that CBT is an effective treatment for social anxiety disorder. Treatment will generally have three main components. First, a therapist will likely work to combat counter-productive thoughts about social situations, like, “Everyone is constantly judging me.” Second, they will teach skills that help make social situations more tolerable. This can include things like how to make small talk, or how to gracefully leave a conversation. The last part of treatment involves facing anxiety-provoking situations, like going to parties or speaking in public.
If you’re interested in reading more about social anxiety disorder or techniques that can help, check out Overcoming Social Anxiety and Shyness: A Self-Help Guide Using Cognitive Behavioral Techniques by Gillian Butler or Living Fully with Shyness and Social Anxiety: A Comprehensive Guide to Gaining Social Confidence by Erika Hilliard.
Anxiety disorders can cause a lot of suffering and make working incredibly difficult. If you’re suffering from anxiety, it’s important to remember not to fear because you’re not alone, and effective help is available.
Anxiety symptoms are wide ranging, whether it's post-traumatic stress disorder (ptsd) from some traumatic event, shortness of breath, OCD, intense fear, irrational fear, chest pain, some phobia or something else entirely, anxiety and depression (and ensuing anxiety attacks) can be debilitating to one's mental health. While there are different types of anxiety disorders, there's one thing in common: All anxiety and depression has the potential to impact your career unless you're able to get your anxiety symptoms under control.
Rebecca Fraynt has a PhD in Clinical Psychology and is an all-around healthcare nerd. She lives near Seattle with her husband, toddler, and two rescue chihuahuas. When she's not working or chasing her dogs or child around the house, she's guzzling coffee, reading, or binge watching Star Trek.
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