High cost of anxiety (Guest commentary)

Anxiety disorders more common than depression and have large impact on workplace
By Katy Kamkar
|Canadian HR Reporter|Last Updated: 12/14/2008

It is well-established depression is associated with a significant burden of illness that includes disability, productivity loss and immense costs to employers, insurers and health-care systems.

While reducing this burden is important, anxiety disorders are, in fact, more common and responsible for at least as much personal suffering, disability, economic loss and cost to health-care systems as depression. In any given year, 12.2 per cent of Canadians meet diagnostic criteria for an anxiety disorder, according to Health Canada, making these problems much more common than mood disorders, schizophrenia and eating disorders.

Anxiety disorders encompass six main categories: phobias, panic disorder with or without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, acute stress disorder and post-traumatic stress disorder.

One in four individuals suffers an anxiety disorder sometime in their life and one in 10 is likely to have had an anxiety disorder in the past year. They are often seen with other mental disorders, in particular depression and substance-use disorders.

Anxiety is a natural emotion experienced by everyone. It is often referred to as the fight or flight response that protects us when we perceive a threat or a danger. Anxiety can vary in severity from mild uneasiness to panic and vary in frequency from occasional distress to constant unease. When anxiety becomes frequent, intense and severe, it becomes dysfunctional and compromises our quality of life and our ability to do our job and function effectively in our relationships.

Workplace stress occurs when we perceive the challenges and demands of work as excessive and don’t think we can cope with the demands. Although some stress is normal, problems occur when the stress becomes overwhelming and interferes with our ability to do our work and return to a relaxed state.

Signs and symptoms

Anxiety in the workplace is associated with: elevated fatigue; exhaustion; increased stress; irritability; memory, attention or concentration problems; increased worrying and anxious thoughts; emotional and physical symptoms such as moodiness, agitation, restlessness, irritability; muscle tension; abdominal distress; feeling overwhelmed; feeling isolated, decreased well-being and depression; as well as behavioural symptoms such as changes in appetite and sleep, neglecting certain responsibilities and nervous habits such as nail biting or pacing.

Anxiety can emerge in the workplace as social phobia, obsessive-compulsive disorder and generalized anxiety disorder.

While being shy is not a problem, a person with more extreme social anxiety or social phobia — a disabling fear of being watched, judged or embarrassed — might encounter problems in a workplace when he avoids attending or speaking up at meetings, giving formal presentations, conversing with colleagues or clients and interacting with the boss or manager.

While workers who are highly organized, conscientious and responsible are often praised and appreciated for the high quality of their work, excesses in this domain might be signs of maladaptive perfectionism or obsessive-compulsive disorder. An employee who is constantly staying late, repeatedly checking his work or asking for reassurance might be struggling with obsessive-compulsive disorder.

Worry is another type of anxiety that ranges from normal to extreme. Normal worry is functional and often includes thinking about finances, health, work and relationships. This can lead to healthy planning, preparation and communication. Excessive worry, however, leads to increased anxiety and interferes with productivity and could be a symptom of generalized anxiety disorder. People with this disorder catastrophize everything and have trouble functioning.

Normal anxiety can be motivating and even productive, but extreme levels of anxiety are not. It is important for individuals not to suffer in silence, but to take measures to recognize it and get appropriate help.

Seeking social support among family and friends, attending support groups, accessing self-help materials and consulting with health professionals are possible helpful interventions. Other strategies include communicating with employers, stress-management programs and employee assistance programs if available.

What employers can do

In order to promote a healthy work environment, employers need to recognize factors contributing to workplace stress and anxiety. Management training can be an important element addressing the link between employees and organizational goals. Effective managers are sensitive and strive to increase employees’ personal growth, build trust, foster healthy communication and show respect for diversity. With regard to anxiety, effective managers could work to provide on-site educational workshops and training on various health-related topics, including stress reduction, communication skills, nutrition counselling, exercise and fitness, meditation and access to treatment services as needed.

Attention to individual needs such as role definition, flexible work hours, learning opportunities, advancement and regular feedback on job performance and factors affecting it are also essential elements of a healthy work environment — which leads to increased job satisfaction, employee retention and increased productivity and well-being.

Katy Kamkar is a psychologist with the Work, Stress and Health Program at the Centre for Addiction and Mental Health in Toronto. For more information, visit www.camh.net.

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