Supporting an employee with anxiety

Anxiety can be mild or severe and can include feelings of worry, unease and fear. Everyone experiences feelings of anxiety at some point in their life and it is perfectly normal. For example, some people can feel worried and anxious about sitting a test or a job interview. However, if these feelings persist and begin to interfere with daily activities, this may indicate a generalised anxiety disorder.

There are several disorders in which anxiety is the main symptom, including panic disorder, phobias, and post-traumatic stress disorder which can all cause severe anxiety. However, this guidance note is about generalised anxiety disorder.

About 1 in every 10 people will have troublesome anxiety or a phobia at some point in their lives.

How does it affect people?

Symptoms of anxiety include:

Apprehension
Panic attacks
Irritability
Poor sleeping
Poor concentration

These may be accompanied by other physical symptoms and employees with anxiety may be suffering from other health conditions such as depression, alcohol or drug abuse.

How is it treated?

In most cases anxiety is treated by an individual’s GP and will not require specialist (psychiatric) help.
There are two main types of treatment, psychological treatment and medication. Depending on the circumstances, individuals benefit from one of these two types of treatment or a combination of both.
A combination of lifestyle changes including physical activity, reduced alcohol intake, Cognitive Behavioural Therapy (CBT which involves talking through problems to change ways of thinking) and medication may be used depending on severity. Often these take a few weeks to make an impact, so improvements take time.
People with severe anxiety may be referred to the mental health team which is made up of a team of specialists such as psychologists, psychiatrists, specialist nurses and occupational therapists. They often provide intensive specialist talking treatments, such as psychotherapy.

How might it affect work?

You might notice changes in someone’s normal behaviour as an early sign that all is not well. Typically, these changes might include:

Appearing unusually worried or fearful.
Loss of confidence in their ability to do things at work.
Trying to avoid certain situations such as dealing with large groups of people or the general public.
Reduced concentration where the quality of work suffers.
Difficulty making decisions or the work takes longer.
Lack of energy, tiredness and complaints of fatigue.

Employees can take a long time to recover fully from anxiety disorders but should be able to work when they are recovering and work can often aid recovery. The length of time taken to recover will vary depending on the nature of their illness, how well they respond to treatment and the type of treatment prescribed. For example, CBT is a common and effective form of treatment. If prescribed this is usually completed within 4 months of commencement.

What do I need to do as the Manager?

Firstly, and most importantly, if you notice changes in behaviour as outlined above then raise this with the employee and encourage them to take advice from their GP. Early treatment is more effective, but denial is common, so recognition that there is a problem is very valuable.

Discuss how their anxiety is affecting their work. Identify what tasks they can and cannot perform and the length of time that they can perform them. It may be necessary to make some modifications to their work, either to allow them to remain at work or to help them to return. These kinds of conditions resolve relatively slowly, and the employee will have ‘good’ and ‘bad’ days, so review the situation weekly. Make sure that they are able to cope with their work tasks and increase their work in stages to help them to get back to their normal duties.

Examples of modifications that could help include:

Reducing the demands of the role.
Reducing hours to accommodate tiredness.
Modifying duties if they are having difficulty with a particular task, such as dealing with the general public.
Moving from night shift to day shift.

Key points to consider when managing an employee with anxiety:

Individuals do get better and stay better.
Involving individuals with decision-making improves outcomes.
Focus on supporting the employee. If they are well enough, help them to remain at work or to return to work as rapidly as possible.
Employees do not need to wait until they are completely better before they return to work.
Evidence supports an early return to work or continuing at work as a normalising influence to encourage recovery and a return to normal duties.

Points to Remember

Fit Notes – If an employee produces a fit note indicating that they require modified duties, discuss this with them and consider if the modification recommended can be reasonably accommodated.

Job Tasks and Risk Assessments– Review the risk assessment for the employee’s job role and work tasks including the ability to drive safely where required. Take into consideration any temporary modification that may be required to accommodate their reduced ability to undertake certain tasks.

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