Shooting Down the Triggers for Anxiety Disorders

May Is National Mental Health Month.

According to the National Alliance on Mental Health (NIMH), anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. During times of exceptional environmental stress, such as a pandemic, anxiety can become overwhelming.

What Does Having an Anxiety Disorder Look Like?

Six common anxiety disorders share features of excessive fear and anxiety and related behavioral disturbances. While fear is the emotional response to a threat (whether real or perceived), anxiety is the anticipation of a threat.

Regardless of the type of anxiety, one thing is common: a relentless and ongoing fear in situations that are not typically dangerous or threatening. This fear can immobilize a person. People usually have one or more emotional and physical symptoms when an anxiety is triggered. Symptoms vary across individuals and can include:

Feeling uneasy or experiencing a sense of alarm
Feeling tense, jittery, or high-strung
Feeling restlessness or irritability
Anticipating the worst will happen
Continually watching for danger coming one’s way
Experiencing shortness of breath, excessive perspiration, a pounding or racing heart
Having body tremors
Experiencing headaches, fatigue, and insomnia
Experiencing an upset stomach, frequent urination, or diarrhea

What Are the Most Common Types of Anxiety Disorder?

The most common anxiety disorders and their definition, cited by the NIMH include:

Generalized Anxiety Disorder: An excessive anxiety or worry, most days for at least six months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances.
Social Anxiety Disorder: A general intense fear of, or anxiety toward, social or performance situations.
Panic Disorder: Recurrent unexpected panic attacks, which are sudden periods of intense fear that come on quickly and reach their peak within minutes.
Phobias: An intense fear of—or aversion to—specific objects or situations
Separation Anxiety Disorder: Fears about being parted from people to whom they are attached. They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated.
Selective Mutism: Failing to speak in specific social situations despite having normal language skills. Selective mutism usually occurs before the age of 5.

Finding Employment for an Individual with an Anxiety Disorder

Discuss how the anxiety disorder affects their daily living and how it might likely impact success at work. Based upon this open and honest exchange, your genuine interest will convey your compassion and understanding and begin a trusting relationship with the job seeker.

It is important for an employment specialist (ES) or Vocational Rehabilitation Counselor (VRC) to work closely with the individual’s therapist/support team, if possible, to plan effective methods for addressing a participant’s fears. Because individuals with anxiety disorders tend to avoid situations that have potential for sparking their symptoms, you should discuss any triggers they may encounter in a work setting. Uncovering possible triggers beforehand will make for an easier determination of an appropriate work place, especially when social interaction is expected.

Anxiety will not “stay at the front door” once a person begins working. Once employed, the person’s symptoms may even magnify. The Job Accommodation Network (JAN) offers specific information on their website to work with employed individuals who have an anxiety disorder. JAN suggests key accommodations may include a flexible schedule, a modified break schedule, a private space for the individual to manage a panic attack and/or a support animal or person to accompany the individual on the job.

Remember, the goal is to maintain employment, so consult the employee to determine if further accommodations are necessary. The consult will afford you the opportunity to evaluate the effectiveness of the accommodation and to determine whether any other arrangements are necessary. It is also important to determine if the supervisory staff or other employees, including natural supports, require any training from you. As you move along, you can determine whether on-site or off-site visits will be more helpful to the individual.

What Are the Treatments for an Anxiety Disorder?

Primary treatments for anxiety disorders are medication, counseling and psychotherapy, and learned self-management strategies. Medications require continual monitoring and adjustment, so encourage the job seeker to follow their clinical team’s treatment program.

We are all experiencing chaotic times during our mandate for social distancing, so keep in mind that these guidelines may accentuate fears for those who have anxiety disorders. The Employment Technical Assistance team offers the following resources to support you in your efforts to work with those who have this mental health diagnosis.

Resources Specific to Anxiety Disorders:

American Psychiatric Association: What Are Anxiety Disorders

Anxiety and Depression Association of America Generalized Anxiety Disorder

Anxiety and Depression Association of America Living with Anxiety

Anxiety and Depression Association of America Mobile Anxiety Apps Ratings

JAN Accommodations for Anxiety

NIMH Generalized Anxiety Disorder: When Worry Gets Out of Control

NIMH Panic Disorder: When Fear Overwhelms

NIMH Social Anxiety Disorder: More than Shyness

General Mental Health Resources:

KEY Consumer “Warmline” – Non-crisis line staffed by peer recovery specialists 1-800-933-5397

National Alliance on Mental Illness – Call the NAMI Helpline at 800-950-NAMI, or in a crisis, text “NAMI” to 741741