Women at Work - When Anxiety Interferes with Work

Episode Date: November 4, 2024

Worrying is a fact of life; it comes and goes, usually. A clinical psychologist explains how to better manage anxiety at work, whether you have an anxiety disorder, suspect you might, or want to support a colleague who does.

Harvard Business School Executive Education develops leaders who make a difference in the world. In their programs, experience the power of fresh perspectives and connect with a world of new ideas. Learn more at hbs.me slash learn. That's hbs.me slash learn. You're listening to Women at Work from Harvard Business Review. I'm Amy Bernstein. And I'm Amy Gallo. I imagine many of us have been feeling anxious lately with everything going on in the world, like the U.S. presidential election and the war in the Middle East and artificial intelligence, and I could go on, but I won't.

Then there's everything going on in our personal lives. For me, it's the upcoming holidays and ongoing work pressures. Me, my daughter's college applications and my mom's recent fall and health scare, plus a ridiculous battle with my health insurance to cover a medication I need. Worrying is a fact of life. It comes and goes, usually. Because another fact from the US Food and Drug Administration is that women are twice as likely as men

to develop an anxiety disorder at some point in their lives. As highly treatable as anxiety disorders are, the FDA also says that most adults aren't treating theirs. I would wake up and cry and just count the minutes until I had to start work. That's Mary, one of our listeners, whose mornings went on like that for a couple of months before she saw a therapist. And it was that therapist who said that I have generalized anxiety disorder. So I believe what triggered that really low point was now a former colleague who at the time was being let go from the company.

So I would be taking on their responsibilities, having more responsibilities of my own to really lead the team I had been part of for several years. And so, you know, looking back on it, I think it was really imposter syndrome that was showing up in the most severe worst way. In hindsight, I think I did that role quite well and all my prior work had been leading up to these expanded responsibilities. So it wasn't such a stretch, but for some reason, the anxiety just would not let me see it in that positive way as this is a normal career growth next step. But at the time, I didn't know how to process or how to handle the feelings

that didn't really match up with the facts of what I could do and how I could succeed at this role. Ten years later, Mary exercises to keep her symptoms from becoming severe again. In her job as a risk and compliance lead, she takes regular breaks, she journals, and she's careful to get enough sleep. When something disrupts those preventative measures, like insomnia or too many meetings... My emotions are higher and I can become tearful. I then worry that I'm not coming across as strong as I want to be, but I can't help it because I'm so tired and so drained that the tears will just come out. You know, also in meetings, another way anxiety can show up is I might freeze and not

readings, another way anxiety can show up is I might freeze and not say the thing I really wanted to say. Anxiety likewise messes with Cody, another listener of ours, who is a diagnosed disorder. She's a nurse who used to treat patients in the emergency department until the stress of those shifts was more than her body could bear. I had trembling, nausea, chest pain, headaches, all of that. For the sake of her health, she moved into management. As a nurse manager, an upside to her anxiety is that it pushes her to get things done and fast.

But sometimes if I become overwhelmed with a lot of ass and I feel like I can't think about one thing at a time or what do I need to get done first if I start having to triage a lot of things, it can start to become overwhelming. I think dealing with crucial conversations can sometimes make me anxious and it comes across as irritability. I hate that I have to deal with this thing. I hate that this person may not take this constructive criticism well. And sometimes, I mean, I have responded very shortly in an email because I've just been

so irritable with somebody and it's the anxiety of I want to control this situation. I want it to go this way because you're not doing a thing that I need you to do and you're not hearing me. You're not doing a thing that I need you to do, and you're not hearing me, you're not understanding. And so I might say, per my last email. But now Cody knows to let her irritation settle before pressing send because therapy. I see a therapist once every six weeks,

and I've been through a few therapists, but this is the first therapist who really knows anxiety and has given me action items of what to do if I'm having a panic attack or just having anxiety period. Because anxiety manifests in so many different areas. Like once you become a leader, it shows up different. Once you become a mom, it shows up differently. And so she's been able to help recognize how it's showing up in different aspects. So if you've been worried for a while, wondering, is this healthy? Should I see someone, take a sick day, a sick week? Tell my boss. Let's talk these questions through with an expert.

Michelle Drapkin is a clinical psychologist and behavioral scientist who specializes in anxiety and panic disorders. Michelle has a lot of experience advising people how to cope at work, not only with physical symptoms like shortness of breath and dizziness, but also with negative habits like repetitive and catastrophic thinking, those habits that make the workday harder. She's here to share that advice so that you can understand how to better manage anxiety at work. Whether you have an anxiety disorder, suspect you might or want to support a colleague who does.

Michelle, help us understand the difference between run-of-the-mill anxiety and anxiety disorders. So there's some interesting nuance there. But the real short answer is everyone's stressed. But if that stress starts to pop over into dysfunctions that really impair your life, so you're not enjoying life, you're avoiding things, you're not sleeping, you're having some physiological challenges like gastrointestinal challenges, now all avoiding things, you're not sleeping, you're having some physiological challenges like gastrointestinal challenges. Now all of a

sudden we're talking about a disorder. And that's really when we would give you a diagnostic code and when it seems more clinical and likely needs treatment, although I would argue that everything else leading up to that probably could react to treatment as well. So, is there a time box around that at all? I mean, you know, I've had moments before giving a big speech or something where, you know, I definitely had intestinal disorders. Does that push me into the anxiety disorders category?

Probably not, because if it's really unique and specific, although it's a little different with phobias. And so the short answer is it really depends on what we're talking about. You really want to be looking at a two-week period or a 30-day period. Are you really struggling for most of the days? And so in general, I would think about the impairment of your life and if it's getting in the way. So if you said to me, listen, the GI stuff is so bad that I'm not taking speaking events

anymore. I can't do it. Then I would say that's a disorder. That's a problem. Now you're avoiding it to help you manage it. That's a challenge. And just briefly, why is it important to understand the difference? So you understand what to do. And just briefly, why is it important to understand the difference?

So you understand what to do. And listen, I'm going to argue to the end of the day that people get help sooner rather than later. Right. And so if you're starting to have stress and you're like, I'm not sure is this a disorder or not, the fact that you're even asking the question, talk to someone, get some help, engage in some strategies and tools to help manage and mitigate some of that

before it becomes a full-blown disorder. And now all of a sudden, you're in treatment, potentially you need an intensive outpatient treatment program, potentially you need inpatient, and it's just, or to take a leave of absence from work. And I think that's one of the challenges we see with women is they ignore some of those early signs. And so I think the more we empower folks to be educated,

and then when we talk about managers too, how do we help managers see kind of those warning signs or those potential warning signs so that we can enact and engage sooner so we're not dealing with crises later? We have a clip from Cody, one of our listeners, who was remembering for us when her anxiety really intensified. I started to feel a lot of fear

when taking care of my patients. I see all the trauma and how they suffer. Is this what I might have to go through one day? Or my stomach hurts. Do I have some cancer? You know, something like that that I'm treating. And just a lot of fear. And I remember we had one patient come in and it was a busy day and it was a stroke patient.

And I just started to feel lightheaded and I started to feel like I had to flee. Symptoms of a panic attack. And I couldn't take care of the patient, and I had to go, and another nurse pulled me to the side, put me on the heart monitor, my heart was racing. So just a lot of those physical manifestations in addition to just being fearful of what I was seeing and what I was taking care of.

Michelle, what would you say to women who are unsure whether their anxiety is a natural response to work stress or a sign of a disorder that needs attention? I would say if you're even asking the question, it would be really helpful if you talk to someone else who's in the field who can understand what might be normative or typical. Like, so she's a nurse, so I would talk to another nurse and say, hey, I'm wondering if I get your advice on

what I've been experiencing lately. I've been having nightmares or haven't been sleeping. And I'm taking home some of the patients that have coded or the patients that we've lost or my mind is just replaying through them. I'm wondering if that has happened to you or what do you think is typical? Now, that person might say to her, oh yeah, that's actually really normal when you start the job and it gets better and here's how I managed to get it better. Or someone might say, you know what, it sounds like you're really struggling.

Why don't we get you to the employee assistance program or have someone to talk to or more professional in the mental health field to really help you assess and figure this out going forward. So I don't always think, listen, I'm a psychologist, but I don't always think you need a psychologist or professional to talk to. I think often starting with peers and connecting, but we're not always willing to out ourselves

for how we're feeling. We tend to think we could like solve our own problems when we really need to connect with other people. I love the idea of talking to someone in your field because like you said, they can sort of help set the bar for what's normal, like what's a normal reaction for an ER nurse that's going to be very different for the editor of a magazine, for example, right? The level of stress in your job, the reaction. So I love that idea of starting by talking to someone you work with.

I have a question specifically about gender, which could apply really in any field, which is that we know that statistically women are more likely to experience anxiety and depression, or at least be diagnosed with anxiety and depression than men are. And I'm curious if you have a sense of how much gender inequities, things like, you know, pay inequity, caregiving, gender-based violence, can exacerbate or even influence how anxiety disorders show up in the workplace. Is that something you see happen? Absolutely. Because I think women, there's so much going on and there's so many different roles we hold. I think women sometimes feel like, where do we turn? How do we manage?

Who do we talk to about this? And then sometimes we have a conversation and it feels like it gets turned back on us. And then there's almost like this gaslighting that feels like it happens or victim blaming. It certainly has happened to me in my career where, you know, you'll have conversations about, well, how do I get promoted? Or why didn't I get promoted? And it's like, well, because you haven't asked enough or you're not good enough or, well, what about all this other stuff I'm doing? Well, that actually doesn't count towards promotion. And so there's a lot of this, you know, unpaid labor that women wind up doing as well. And we're not really great always about advocating for ourselves because we're not socialized to do that. And so I think it gets pretty complicated. And so some of those factors disempower us or marginalize us in ways I just don't think workforces, not all of them, because I don't want to be universal, because there are certainly some that are amazing, but I don't think they're set up to really support women in a flexible way to empower them. Yeah, we have another listener named Mary.

And Mary, I like the way she articulated how this bias and discrimination that we're talking about plays into her own anxiety. Let's hear from her. I do think that part of my anxiety comes from being a woman in a corporate environment and feeling that there's something I have to prove. I tend to do a lot of overthinking about it or a lot of additional

worry about how I handled something or how I might handle myself or how this might go in a future setting. Like knowing that I'm speaking to leadership about something and it's mostly men or I'm in a group with mostly men and I know I have a really specific point I want to make sure is clear and so I do a lot to actually prepare for meetings to write down what is that key point or that key thing I want to come across if someone pushes back, think about that as well. Maybe write down a couple of key points that I would say. And it's not because I don't know those things, I do, but because my anxiety is so strong

and I'm worried about how I'm coming across or how others might perceive me, I might not be able to think of those things as quickly as I would like in the moment. It makes me anxious even listening to her, right? Yeah. Like her mind is worrying about the past. What did I do? It's worrying about the future, but it's not actually like hanging out in the moment

and enjoying the fruits of her labor. And I think this is why we see women really prone to burnout, is they're overcompensating in ways that they think they need to, to just show up and feel like they're overcompensating in ways that they think they need to, to just show up and feel like they're equals to the other folks on their team. Just hearing how much worrying and thinking through and catastrophizing all of the possible scenarios, it's just exhausting. Harvard Business School executive education develops leaders who make a difference in

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Hey, listeners. If you want to hear from more leaders to help you answer questions like, should I talk about my anxiety at work? Or how do I claim my leadership power? Then you should listen to TED Business, hosted by Columbia Business School Professor Madhupe Akhnola. The show features TED Talks about everything from setting smart goals to the latest on DEI in business, followed up with a mini lesson from Madhupe

on how to apply these lessons in your own life. Listen to TED Business wherever you get your podcasts. All right, let's get into some practical advice, Michelle. Amy, you wanted to ask a question. Yeah, as we turn to this practical advice, I would just want to clarify, Michelle, because some people listening will have a diagnosable anxiety disorder

and others will experience anxiety that's not reached that level. And I would just wonder if the advice you give is true, regardless of whether you have a diagnosis or not. Is it applicable to anyone? Yes. Actually, if that's the one thing people walk away from listening to this is that any of these skills or tools are helpful regardless of what you're experiencing. And so if we had more people leveraging these tools and skills more often, we probably would have

less anxiety disorders and just more people are having stressful times or moments. Excellent. Okay. So making a mistake will cause anyone to experience anxiety. But for people with an anxiety disorder, it can really cause them to spiral. And if you've made a mistake, how do you not spiral? What do you tell people who are more apt to spiral after a mistake? So first of all, not everyone's bothered when they make a mistake. Who are those people?

What? Oh, there's plenty of people who are just like, oh, oops, you know, I made a mistake and they move on and they just don't have anxiety or stress about it. I think women tend to be a lot harder on ourselves. And then you're right, if you have an anxiety of sort of, you're heightened. So one of the things I often talk about with people I work with is we're like a pot of water

on a stove, right? And there's always heat on us. And the goal is to keep the heat as low as possible and to notice when it's getting high so that when you do something like make a mistake or get some criticism or something happens, you don't boil over. So you have to first be aware though

of where's your temperature at managing yourself and thinking about all of those tools and strategies that you can use to help keep yourself a little bit more level with the heat down, not all the way off, right? There's always stress in our life, always, always, always stress, but keeping it a little bit lower. So if I were working with someone for whom mistakes

was a particular trigger, we would have a lot of conversations about this, but one of those would be to reframe what is the mistake and what are you taking away from it. And so reframing it as a learning opportunity, potentially first and foremost, and then potentially doing a root cause analysis of, well, how did you get there?

How did the mistake happen? How do we prevent those going forward? And so it's both this psychological flexibility approach of managing that mistakes do happen and how do you navigate them, but then also thinking about preventing them going forward, which, you know, a manager or a leader would particularly want to do with someone and normalizing mistakes happen, right?

Everybody makes them. Yeah. I'm thinking it makes me think about our failure episode. We did an episode last season about mistakes we've made and specifically what we learned from them. How do we sort of reframe? And part of the fun of that episode was getting to hear someone, you know, as accomplished as Amy B or our former co-host Sarah Green-Carmichael talk about, oh yeah, they messed up too, right?

That's part of the supportive nature of our relationships to be able to help us normalize those things. You know, you just made me think about something, Amy, which is that we both know people. We work with people who do not spiral when they've made a mistake. And in fact, I don't even think they talk about it. And it makes me wonder, Michelle, whether sometimes talking about the mistake

will actually prompt the spiral. Meaning it doesn't discharge the energy that actually feeds the energy. It amps it up. I have felt that. I mean, one of the things I think about is, you know, a major league baseball pitcher pitches a ball that turns into a grand slam home run. And what really good pitchers do is they shake it off and they throw the next pitch to strike out the next batter.

It just feels like something we should all be able to do and many of us can't. What you're describing is being in the moment, right? That present moment awareness and almost practicing a beginner's mind to each opportunity as opposed to taking all of that history with you. But I think we just carry stuff with us, chewing on it in our head over and over again, thinking that that's actually going to help us. But I think, Amy, this is where you were getting at, right? It doesn't always help us to chew on it and ruminate it and talk about it unless you're doing it in a way that's effective to help

you drive forward. In fact, if your therapist is only sitting there and letting you bitch at them for an hour, they are not doing a good job. Because data actually show that sitting and just talking about stuff without having tools or strategies to manage some of that affect is not getting it off your chest is not an effective intervention. Mm-hmm.

Right. So we've talked about the mindset shift. What do you actually have to do? So like you're at work, you mess up, is not an effective intervention. So we've talked about the mindset shift. What do you actually have to do? So like you're at work, you mess up. What do you actually wanna do? The first thing you wanna do is take a breath, find your feet, which is really just code

for being in the moment. So stabilize yourself a little bit and then think about, actually this is a dialectical behavior therapy, DBT strategy of something called wise mind. And it's the intersection of rational reasonable mind. So asking yourself what was the mistake? What were the consequences?

Like just the facts, right? Just the facts. Was it a real big mistake? You know, is it going to cost the organization billions of dollars or is it like a typo or you miss sent an email by accident? It's really not that big of a deal. And then you look at emotion mind how you're feeling about it. And then you find wise minded, which is that intersection of both the emotions and the rational. So I feel this and I know this. And this is what I'm going to do. And then you figure out what

path forward makes most sense wise mindedly. But it starts with stopping. Because sometimes we panic. And when you're panicking, you're not rational and thoughtful. And you're not actually going to be able to have an effective conversation. So stop, breathe, and find your feet. And that's really an important thing for women who want to lead, to keep in mind. Mary, our listener, has some really good advice for not letting anxiety stop her in her tracks. I can think about times in my career where I have accepted some different roles

where looking back, wow, my anxiety really could have stopped me from taking those other roles or responsibilities. I'm so thankful that it didn't, and I took a chance and took that risk because I learned so much, and I look back on how much that change I made helped me to build up resilience over time.

Even going through what I experienced 10 years ago, a feeling so low, that I've taken so much from over the years and I can see how far I've come and how the anxiety is not just going to go away at some point it will always be here but looking back and reflecting on difficult things that I've done or difficult moments that I've been through that gives me confidence in it it's part of my toolkit. Michelle what did you hear in that. it. It's part of my toolkit. Michelle, what did you hear in that? So I think there's two things going on in what she's saying. One is this radical acceptance or this willingness

that anxiety or stress is always going to be on there. Right. So it's, it's kind of like that pot of water that we're on the stove. There's always going to be some heat on it and we are not shooting for no heat on it. So there's never any stress in our life, no anxiety. You know what that means? We're dead, right? And so there's always, so that stress and anxiety is like, is mobilizing and engaging and that motive, it's actually motivating for us.

And so it's flipping anxiety and stress on its head in a little bit. The other piece that she's talking about, which is a really important tool or strategy is something we call perspective taking. Going back and kind of tapping that version of yourself on the shoulder and saying, all right, what do you know? What did you learn?

How did you get through that? The other piece of perspective taking, and this is actually one of my favorite things, is I generally zoom forward to when I'm like 85 years old sitting on my porch on a rocking chair and I say, hey, old lady Michelle, I'm pretty stressed out about this like HBR interview that I'm doing. What do you think I should do? How should I manage this?

And she just cracks up in my face and she's like, oh, that is like nothing. And that is, I can't believe you're stressed out. You are so adorable and just go do your best and you'll be fine. And I often consult with her because I know that sometimes in the moment I have my head down and the stress is just flaring. But if I pick my head up and I look just like we heard from the listener, then it's not so bad.

Right? And so that perspective taking exercise just really enables that psychological flexibility to manage, to just kind of ride the waves, right, and manage more effectively. I do a version of that with myself, which is I imagine a friend or a family member coming to me with the thing I'm experiencing and how it would sound to me if I were listening as an empathetic friend. The other thing I like to do is if I'm gonna engage in catastrophic thinking, which sometimes I am going to, I remind myself I have to also think in euphoric thinking. So if I'm really,

really nervous about this talk I'm about to give and I think I'm gonna lose my place in the middle, no one's gonna be engaged, people are gonna walk out in the middle. I also have to tell myself, well, think about what if you knock it out of the park? What if I get a standing ovation? And somehow that sort of helps to balance the worry for me because it makes me also realize how absurd both of those are. It's probably something in the middle,

which is really what's going to happen. Well, you know, what's interesting is my reaction to that is women aren't often socialized to think about our success in that way. We have this much stronger internal critic and so it's much easier for us to go to the worst case scenario than it is to imagine the best case scenario. It all starts with the awareness in the moment of where our head is at and what we're feeling in our bodies as well, like the heart racing's a little bit of sweating. And so it's really just connecting with your own body and mind to know when you

are experiencing that so that then you can, well, oh, I have this toolbox and we pull out those tools and leverage them more effectively. Yeah. There's a stat from Deloitte, we'll include the link in the show notes, that says two thirds of women don't feel comfortable discussing mental health at work. And Cody, the ER nurse who we heard from earlier, has felt this, let's hear from her again. I've been an ER nurse for 11 years.

And ER nursing, you come across as tough. You're looked at as being a hero, and disclosing initially felt like a weakness to me. And I know that now that that's not true, but that was my hesitancy, like, will you see me and attach that stigma to me that, oh, she has a weakness, even though she appears to have it all together. So given that we're telling women to talk with people

in their field, to talk with others, how can women with anxiety disorders advocate for themselves without worrying about that stigma or even having job-related consequences? This is a tough one, because I don't think we're there yet, where universally you can out yourself for what's going on.

It makes me really sad to say that. I wish that weren't the case. You do have to be careful and judicious. I feel like this is like the old school advice of find the helpers. Figure out who is a safe person at your organization. Talk to employee assistance programs. And here's the other thing, and I've worked with multiple patients who we've had to sign out of, take leaves of absence because of their anxiety.

And so one that I worked with during the pandemic, she was really struggling and would not disclose. In fact, she was ready to quit before she'd be willing to disclose what was going on. And actually, she doesn't need to disclose because it's a medical condition, right? And so you don't need to disclose if you have a medical condition. Why should you have to disclose if you have a psychological condition? But we were able to take her out for a medical leave of absence, get her the treatment that she needed, both me and a psychiatrist working collaboratively to help her and then get her back in. Her

organization, it was a large bank, had the resources and tools where they had kind of an intermediary who knew what was going on. I wrote in some accommodations for her. And so all her manager really needed to know was what accommodations she needed. And then she couldn't be discriminated against in her performance. And you know what? She's been promoted since then because she was able to get the treatment she needed in a safe space and then to reintegrate into her role in a way that was helpful. And I can't say that all stories have happy endings like that, right? Because we live in a world where there's just challenging and problematic people who just don't understand mental health

and how to manage it in a workplace. Let's talk a little bit more about that. Say you wake up in the morning and you just really can't face going to work. You're that anxious. How do you recommend handling that? In Reddit, we saw some people will say they have a stomach bug or a migraine or something, and that's the excuse they'll give. What do you advise people to do? Do they come out to their bosses? You say in some places that doesn't work, but...

Yeah, I think you need to know your setting and your boss. And I mean, I think we could talk about what managers could do to make it a more open and supportive environment. But if you don't know, I mean, I generally would just say, hey, I'm not feeling well or I'm feeling off today. I'm going to take a day off. You don't need to specify whether, I mean, it's kind of like people don't like to say, oh, I have diarrhea. So you don't have to say that you're having an anxious day.

And I hope for a world where we could say, I'm having a really rough day. My anxiety is just really peaked. I'm gonna take some time to see how I can manage it and I'll check back in with you later if that's okay. And then a manager might write back and say, thank you for sharing. Let me know how I could be helpful or how I could support you.

If you're feeling better or if there's things I could do and that there's a collaboration around that as opposed to people hiding in the corner and ashamed of how they're feeling. Yeah, the team I work most closely with at HPR, we will say, I'm taking a wellness day, but that's been very normalized by the leader of that team defining what a wellness day is, that it's okay to take it, right? Like it's been set up as the norm. It's not someone doing that on their own. Well, and I think that's one of the things managers and leaders can do best

is by modeling all of that, right? So I often will say in my organization, I'm taking a recovery day. Like I have a lot going on, I'm taking a day to just kind of recover and spend some time with my family. And just talking about when you are stressed, as opposed

to being super Pollyanna-ish about it and saying everything's great or, oh yes, I know we're in the middle of a merger and acquisition and you're not really sure if you're going to have a job in six months. But isn't change amazing? Change is amazing, right? And I think that toxic positivity leads to an environment where people don't feel safe talking about what's going on with them and then we can't help them and we can't help them manage through. And as leaders and managers, we're not their psychologists or therapists, and yet we have a responsibility to help them thrive in a way that makes the most sense for them.

And I think that's, I think more managers and leaders are becoming more empowered and wise about how to do that. And we still have's, I think more managers and leaders are becoming more empowered and wise about how to do that. And we still have so, so far to go. Yeah. Harvard Business School executive education develops leaders who make a difference in the world. They bring together executives with varied backgrounds from influential organizations around the globe.

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So if I as a manager see that someone on my team might really benefit from taking a day, she's clearly off. I don't know if it's anxiety or what, but I want to be there for her. How do I handle that? So first of all, good for you if you notice that, right, that someone's off. And then I would ask permission or pull them aside in a, you know, one-on-one type private area and then ask permission to say, hey, can I share with you, you know, what I'm noticing or thinking? And then use I statements of like, I'm concerned, I'm wondering if it might be helpful for you to take some time off. Because I think if you go in and you just say, hey, you're having a rough day, go home.

No, that sounds great. That sounds great, but wouldn't it feel also punishing and shameful in some ways of like, well, what about when I come back, right? Or what am I coming back to? Or accusatory, right? Like, yeah, definitely. Yeah, and so I'm a big fan of open questions.

What's going on? How are you doing? How can I be helpful and being curious and open and realizing that there could be something going on. It could be a bad, literally a bad day and someone's gonna shake it off or they really will appreciate being seen and the support. And you can offer them options. You can say, listen, if it's helpful, you can take the rest of the day off.

If it's helpful, you can work in this quiet space. What else might be most helpful? Yeah. Something that some people with an anxiety disorder do is compulsively seek reassurance. If you manage someone who does that, how can you respond compassionately and then also in a way that helps them check the compulsion so it's not becoming a burden on you? So first I would let them know that I'm noticing that. And I get it, you want to check. Or maybe you're nervous because it's a new job.

How would we find out a good cadence for us to do that checking? And so you would schedule a meeting or a time in a way that works and functions, and then you could titrate them off, right? Now, that's what we would do in therapy with someone who we're trying to manage obsessive compulsive behavior like that. But you could do it behaviorally with someone who were trying to manage obsessive compulsive behavior like that.

But you could do it behaviorally with someone that you oversee, but I would do it very transparently. I would normalize, hey, it makes sense on some level that you want to check in, and this level of checking in is not empowering for you, and it gets in the way of what I'm doing. So let's figure out a different path to get you off of that. Yeah. Amy B, could you imagine doing that? You know, I'm actually sort of taking notes because I do have people who need a lot of, you know, some people do need a lot more hand holding. Yeah. And it does get in the way. It's time consuming and I know something else is going on there and something I can't fix.

So this is very helpful language to think about. So what if you're the boss and someone comes to you and says, I'm having trouble with so-and-so on our team, and you know that so-and-so struggles with anxiety and that the behavior, like let's take Cody for example. Cody's irritable with a colleague, that colleague comes to her boss and says, I can't deal with her irritability, it's impacting our work together. How do you handle that? That's when it sucks to be a manager because you can't talk about someone else's anxiety, that's not appropriate. And so all you can validate is how hard and tough that might be.

And then you could ask about possible solutions, what might need to happen going forward, what might be a reasonable solve. The other thing you can do, I've been in this position where you cannot obviously, as Michelle said, you cannot talk about someone else's medical conditions. But you can say to the person raising the complaint, can you imagine why Cody would have reacted that way? And basically urge empathy. Put yourself in Cody's shoes. Because you know what? Cody may have had a perfectly good reason to get a little bit sharp. So you know, when someone complains about someone else, I'm always hyper aware that I'm hearing one side of the story.

Yes. Well, and I think having written a book about difficult behaviors, right, I can tell you I wouldn't even venture a percentage, but a huge majority of that behavior is driven by anxiety or stress. Yes. Michelle, when a colleague's anxiety is starting to wear on the team or to affect performance in some way affect the organization, how much should the boss accommodate in the face of broader impact from an individual's struggle with anxiety? Yeah. There's not an easy answer to this question, because you really need to think about the individual

in the context and the circumstances. Like, are they going through something that's particularly unique? And what the value is of that individual, do they have a long-standing relationship or is it someone who just dropped in and they started and they already have challenging behaviors that are interfering with some of their performance? You know, at the end of the day, and I've heard you say this on your podcast, right? Like we're there to work. We have to work and we have to perform at some level.

And so it's really figuring out where the anxiety is going from. Is it short-term? Can we do stuff to accommodate them that's gonna help them get through? Or is this a longer term problem and then we need a longer term solution, which could mean a different role in the organization.

It could mean a leave of absence or is this something that we just need to call it, right? That this isn't a good fit for them and we figure out a different solve or a different role that might be a better fit for them. Yeah, that's actually what Cody told us that she was a supervisor on the night shift and it was just too stressful for her. And so she shifted off. Well, and I usually encourage people not to make a choice about their career or job when

they're in a crisis mode. So if they're in an acute anxiety state or an acute depressive state, this is why I often encourage a leave of absence. That you just take some time to get yourself better and you may ultimately decide to leave the job, but at least then you're leaving the job with a wise mind as opposed to just an emotion mind. You know, I've had multiple patients who really needed that time to step back. So some of them came back with those accommodations, some of them came back being able to talk to their manager. So part of what they learned is how do they manage and talk about and out themselves when they're having anxiety and then get some accommodations. But in that moment, you don't want to just quit because that's an avoidance

strategy and it might work and works in the moment because now I'm no longer working, but it's not a good long-term strategy. Yeah. So I want to ask you about a feeling that I bet a lot of us get. It's Sunday and you feel, you just feel your anxiety rising and rising. And so Mary had a question about how to keep what she calls the Sunday Scaries at bay. I don't have my anxiety totally figured out and my anxiety about work can really take over my time outside of work. And I have therapy and I have physical activity and I have meditation. But sometimes

I feel like I need a little bit more to maybe get out of a rut. Are there any other tips for things you can do to get yourself unstuck if you're really in that spiral? So props to Mary for having a toolbox. There's also this strategy that we use typically with people who have generalized anxiety disorder, which means they worry often and their anxiety is diffused. They're just anxious about something all the time. And so we use a strategy with them called scheduled worry time, where you actually like block off time to worry, which I know sounds counterintuitive.

But the reality is if I have stuff coming through my mind and I'm worrying all the time and I'm having a hard time getting unstuck from it, then I might want to schedule time where I say, all right, not now, mind. And I actually might talk back to my mind, not now, we'll think about that later. So I'm really worried about that meeting, not now, I'll come back to it and think about it at 730 at night. Or even write yourself a sticky note to think about. And so you're compartmentalizing and doing it really intentionally.

I'm going to let myself worry about it, but I'm going to do it later so that the worry isn't permeating your entire day. And that's one tool or strategy that often works for people who have really this diffuse anxiety and have a hard time turning it off. Yeah. I can see doing that at noon on Sunday. Right? Like, I'm just going to get this out of the way now and then I'm gonna enjoy the rest of my Sunday.

Michelle, this has been great and I took a note or two. So thank you from the bottom of my heart. You're welcome. I'll send you the bill. That's right. She does have an hourly rate. Yeah, you can direct that to Amanda, our producer. But thank you so much. Thank you for having me. That's our show. I'm Amy Gallo.

I'm Amy Bernstein. HBR regularly publishes articles about mental health that will help you take care of yourself and be a compassionate colleague and boss. Articles like managing anxiety whenxiety When There's No Room for Error and When Your Employee Discloses a Mental Health Condition. These pieces, along with many more, are available on hbr.org. Women at Work's editorial and production team is Amanda Kersey, Maureen Hoke, Tina

Toby Mack, Rob Eckhart, Erica Truxler, Ian Fox, and Hannah Bates. Robin Moore composed this theme music. Get in touch with us by emailing womenatwork at hbr.org.