How can you as a manager support an employee with an anxiety disorder?

Anxiety disorders are very common: 8% of men and 13% of women in the Netherlands suffer from them. People who have an anxiety disorder suffer major anxiety about everyday situations, even when there is no real reason for this. They are not threatened and not in any visible danger, but continuously have major worries about day-to-day things. These worries are so strong that they suffer physical and psychological symptoms from them. The result is that they can no longer function properly, or maybe not at all; neither at work, nor in their private lives.

There are different types of anxiety disorders:

• panic disorder;
• generalised anxiety disorders (if someone worries at an extreme level for over 6 months);
• obsessive-compulsive disorder (obsessive thoughts and actions; someone, for example, has to touch the doorknob six times before opening or close the door);
• post traumatic stress disorder (PTSD);
• phobias (such as fear of needles, spiders, claustrophobia, flying), but also social phobias.

Symptoms caused by an anxiety disorder can include:

• breathing difficulties, feeling you will suffocate;
• dizziness, fainting;
• palpitations;
• hyperventilation;
• dry mouth, stomach pains, nausea;
• concentration problems, sleep problems, tiredness;
• sweating or cold shivers.

It is not easy to detect an anxiety disorder in an employee. People who suffer from them avoid situations that trigger them. Add to this, that they do not always recognise themselves that they have a disorder. They may well feel that they really dread things and have a lot of stress, but they ascribe that to the situation, or to themselves.

There are anxiety disorders of different types and levels. People who worry too much, for example, are also suffering from a form of anxiety disorder, but they are probably not aware of it. If they do know this and have probably already sought help, or even are already undergoing treatment for it, they dare not always talk about it. They are ashamed of themselves or are scared that other people will not understand.

As a manager you are not going to make a diagnosis, but it is useful to know that the following signs may indicate an anxiety disorder:

• frequent absences;
• no progress on re-integration following another physical or psychological ailment, such as burn-out or depression-related illness;
• avoidance behaviour, and behaviour with more anxiety than the situation warrants;
• many appointments with GPs and specialists;
• physical symptoms that cannot be properly explained by a medical cause (MUS).

Any employee who is suffering from a form of anxiety disorder will be highly inconvenienced by it. The disorder means that the employee has difficulty in functioning normally. The person is continually preoccupied by suppressing their disorder and avoiding situations that trigger it. This means that they may hugely dread activities that are totally normal and often just part of their job. It costs a lot of energy and it helps to create stress. Although people with an anxiety disorder usually just keep on working. However, their productivity and the quality of their work will suffer. The risk of absenteeism also rises.

If you suspect an employee has some form of anxiety disorder, for example because someone is displaying behaviour that does not really make sense, then talk to them. You don't have to tell them what you are thinking, but you can mention what you are seeing: that they are behaving differently, or are frequently absent, or any other signals you have picked up. Ask if you can help, and what you can do to ensure that your employee can continue to function as well as possible.

Offering positive support and trust are the most important things. To do this, there must be a secure atmosphere, so that your employee will dare to put themselves in a vulnerable position. If someone has just been absent, you can help by creating understanding among other employees. Because many people do not know what an anxiety disorder is and what it does to people, they do not understand what makes it so difficult to live with. Always discuss first with your employee what you can and cannot say to others, and always respect that.

It often is possible to keep working through an anxiety disorder, but as stated above, that can trigger lower productivity and more absenteeism. Luckily, anxiety disorders are often easy to treat with professional help, for example cognitive behavioural therapy. First of all a correct diagnosis is obviously important, after which stepped care is effective, as is a good explanation, offering alternatives and showing empathy. Sometimes specialist psychotherapy is needed and/or medication. It is up to the company doctor to provide a diagnosis and refer the employee to a source of specialist help.