Quietly suffering: Anxiety in the workplace

FARGO -- Amy Lemley calls Microsoft Excel her "sworn enemy."

When she found herself working with a spreadsheet composed of 140 columns and 56 rows at her job, it became "a nightmare."

"I had no training in Excel. I felt inferior because I didn't know how to use it, unlike most of the other editors in my department," she said.

Lemley was hesitant to ask for help, especially on the same issue multiple times. She worried about the perception - that people would think she was "stupid." She worried about getting the project done on time and looking like a "dinosaur" amid younger co-workers. And there was another project that was adding to the stress. Severe anxiety set in.

"Eventually, I started getting a knot in my stomach and feeling tightness in my chest as I was driving to work in the morning," said Lemley, who co-wrote the book "Work Makes Me Nervous: Overcome Anxiety and Build the Confidence to Succeed." "I felt kind of skittish" at the office and like she wanted to hide.

That was uncharacteristic for Lemley, who says, "In general, I'm outgoing, energetic, joyful."

Life is much different today. Lemley she says she's "doing really well." But the experience at the time was horrible.

Lemley's story of stress and anxiety in the workplace isn't an isolated one. According to the American Psychological Association's "Stress in America 2009," 69 percent of employees report that work is a significant source of stress. More than half of employees reported they considered or made a decision about their career based on workplace stress, according to a 2007 article by the APA.

Work-related anxiety is common, said Deb Fetting, a licensed professional clinical counselor and employee assistance program counselor with Fargo-based Village Family Service Center.

"Anxiety is one of the most common reasons people seek counseling, and work-related issues are frequently part of the mix that causes distress," Fetting said in an email interview.

A physical experience

The triggers for workplace anxiety can vary widely among individuals.

Adjusting to new responsibilities, worrying about getting along with co-workers, working under new management and fearing a job doesn't match one's skills and career goals can all be sources of anxiety.

But anxiety isn't strictly a mental dynamic. It works in both the body and mind.

"The mind and body work together so well that an individual may not recognize that anxiety is taking hold," Fetting said. "The nervous system sends signals to the brain, and in turn the brain sends signals regulating the body in an attempt, essentially, to avoid what feels like a threatening situation. Usually negative thoughts feed the worry, and the anxiety increases."

Responses to anxiety can include sweating, trembling, increased heart and breathing rates, feelings of apprehension, headaches, stomach aches and a sense of impending danger, panic or doom.

Workers struggling with anxiety may worry they're not meeting standards even when they are, feel restless or on edge, become fatigued from tasks that aren't typically tiring, have difficulty concentrating and experience sleep loss.

And symptoms can become quite acute.

"You may feel like you're having a heart attack," said Brian Martin, a therapist and licensed independent clinical social worker at Lakeland Mental Health Center's Moorhead office. "I have had a number of clients who have ended up going to an emergency room thinking they were having some sort of a heart attack" when it was actually anxiety-related.

Identifying the problem

Stress and anxiety aren't just issues for employees. They hurt employers as well. A 2001 article in the "Health and Stress" journal estimated that job stress costs U.S. industry more than $300 billion a year in absenteeism, turnover, diminished productivity and medical, legal and insurance costs.

For the anxiety sufferer, their situation can be made more difficult by embarrassment.

"The numbers (of people affected) are hard to discern because it's natural that people who experience anxiety, particularly anxiety at work, hold it as a deep, dark secret," Lemley said. "They're really embarrassed that they suffer."

Of course, some degree of stress and anxiety are part of being human.

"I would say that everybody probably deals with some form of anxiety at work whether it be about performance or if there's something that comes up. But that's situational and that's short-term. It lasts maybe 10 minutes before your meeting with your boss or, you know, before you have to give a presentation," said Martin, LMHC outpatient services supervisor. "It's the normal butterflies sort of thing."

But acute anxiety can disrupt life.

"I would say that when the anxiety starts interfering with normal functioning in some way, then that's when we start being able to actually diagnose an anxiety disorder," he said

Tips for dealing

There are steps anxiety sufferers can take to deal with the issue on the job and in their lives.

- Self-care: Martin said healthy eating, rest and engaging in relaxing activities are important for those struggling with anxiety.

- Prevent the stress buildup: It's important to deal with small issues as they arise, Martin said. "A lot of times if things are allowed to pile up, it becomes a lot more stressful," Martin said.

Those suffering from anxiety can tend to avoid the task causing the anxiety, in some cases, eventually completely detaching from it and pushing it out of their consciousness.

"Then you're starting to really cost yourself," Lemley said. "You're costing yourself esteem at your job. You could cost yourself your job, you know, the job itself if you don't somehow interrupt that cycle."

- Breathing exercises: "It's interesting when you just sit and focus on your breath and the breath going in and the breath going out, you can feel your chest just kind of relax," Martin said. "And then the attempt is, after you take those breaths, you focus on, 'OK, what's real right now.'"

- Think about what you're thinking about: Exaggerated or irrational fears and thoughts can wreak havoc. The thoughts can be crippling, but they can also be combatted.

"One of the things that we do in therapy and that people can do on their own is, if there are particular thoughts that are negative thoughts, challenging them rationally," Martin said.

Lemley advocates for anxiety sufferers to "dial up" more helpful voices, "and then naturally those other critical voices come down."

- Be imperfect: The desire to be perfect is "typical of an anxiety sufferer," Lemley said. "The pressure of perfectionism can be crippling."

- Make a list and be in the moment: A project can be overwhelming, but it's really just a series of tasks. Making a list of those tasks and focusing on only one at a time helps keep a worker move forward, avoid procrastination and stay focused.

- Recognize: Identify anxiety as a physiological process, and try to use the adrenaline rush as fuel.

- Professional help: "If the anxiety reaches a point where it's interfering with daily living, I'd encourage them to seek therapy ... There are also medical interventions," Martin said.

He couldn't say which is better for each person, "but I know oftentimes, a combination of the two even is pretty effective."

- Play outside: "Just being outdoors is relaxing for many people," Fetting said.

- Take breaks: "Busy people often eat at their desks and skip breaks; however, you can be more effective if you give your brain a timeout by taking breaks and having lunch away from your work area," Fetting said.