This is Dr. Ken Richmond, Board Certified Psychiatrist, organizational consultant, and Telepsychiatrist.

Do you realize we spend a significant amount of time in the workplace?  One of the things that that came to mind was just identifying at least some of the mental health conditions that are affecting individuals in the workplace as well as in their lives. This a realization rang true for me today because I had to write some return to work documents allowing patients (and some organization’s employee) to be out of work for a period of weeks to months.  More importantly, was having to determine when those individuals can return to work. And it had me thinking a little bit more about some of the mental health conditions that employers also have to manage.

I wanted to do this talk in a three-part series. The first one I’m going to talk about which is anxiety, but then give mention to the subsequent two that I will be reviewing which is depression and substance abuse disorders. Stay tuned for those posts.

For anyone who has ever struggled or experienced anxiety, having to experience that level of this emotional distress oftentimes makes it difficult for that individual to articulate their symptoms. It is a downright scary experience when anxiety happens.  Worse yet, anxiety can be provoked (i.e. you know what triggered it) or unprovoked (i.e. you have no idea what may be going on with you).  What I’d like to do is begin with mentioning some of the common symptoms, briefly mention some of the treatment options that one may ask about when meeting [mental] healthcare provider, and to acknowledge that anxiety not only impacts the individual, anxiety affects our workforce and society in general.

ANXIETY AND YOU
How many of us have ever experienced anxiety in some form? How many of us knew it was anxiety when we first experienced it? For individuals experiencing anxiety they can have the following symptoms: increased heart rate, that’s where you feel like your heart is attempting to beat outside of your chest; there’s an intense thunder and pounding sensation, which is uncomfortable when that starts to happen; there’s usually chest tightness, which can make individuals feel as though they are unable to take a deep breath. Usually our recommendation is to do deep breathing, but it’s difficult to do that when that individual feels like their chest is so tight that it’s hard to breathe to begin with. They may also experience things like what we called paresthesias or numbness, prickly sensations that can occur in the fingertips. You can also become hot and sweaty (also known as diaphoretic).

In addition, the five (5) senses can also be affected. That means that their ability to hear may “go in and out,” their vision can get blurry. The term “tunnel vision” is often used to describe the sudden change in one’s ability to see.  There are also instances where the mouth becomes very.  A patient can also have a condition called globus hystericus or aphonia, basically where there’s a sensation of a lump in that individual’s throat. It makes it difficult to speak.  Headaches are another neurological symptoms that may or may not happen during bouts of anxiety. Psychic symptoms, or internal symptoms, can also be things like racing thoughts. An intense need to escape from their immediate environment. A sense of impending doom, catastrophic thinking, which means that they just fear the worst, that you know something bad is going to happen. And that’s usually how they perceive that experience.
MAKING A CASE
Take a second to imagine working with or managing someone whose primary responsibility is to answer the phone.  For more clarity, let’s imagine the individual works at a Call Center or an employee at your favorite credit card company.  What do you imagine could happen during a call if a customer begins to yell and scream when he or she does not feel their request is able to be met?  Of course some people may be able to handle the customer service issue with proficiency and skill.  The employee may recall all the trainings they received regarding validating the customer, restating their concerns, quoting their policy, and so on. But, what about that employee who is struggling with anxiety?  What about that employee who has their first panic attack in the workplace?  Imagine if that employee has such severe anxiety, experiences aphonia and is unable to speak.  What training skillset would be referenced in that moment?  I have to admit, we frequently ask: Do you want some water?  Well, it’s at least a step to show concern for someone we recognize is in distress.  In the above example, I trust you can see how uncontrolled anxiety can significantly impact one’s ability to function in the workplace or even their daily life.

TO CONTROL OR TO BE CONTROLLED
When these symptoms happen in a very short period of time, and they can be unpredictable, they can be provoked, unprovoked. Let’s say it happens when that individual is driving a car, they can pull over. If they’re at home they can be inconsolable. If they’re at work they would obviously want to leave work. Sometimes unexplained absences can happen as a result of them having such intense symptoms, and that’s what’s called a panic attack. They may also feel like they’re having a heart attack and they want to go to an emergency room to be assessed only to be told, “This is just anxiety.” I’m sure we’ve had patients or even loved ones, friends who’ve had an experience like that where they went thinking that it was something ominous and, hopefully, were relieved to know that it was a mental health condition called anxiety.

POSSIBLE TREATMENTS
I suspect we are clearer that anxiety can be a pretty dreadful and distressing.  More importantly, I want you to know there is hope.  Treatment options would consist of medications antidepressants (i.e. serotonin reuptake inhibitors or SRI). Although the class of medications are called antidepressants, they treat both–depression and anxiety. Beta blockers are sometimes used off-label to address the physical symptoms of anxiety.  Caveat: we do our best to avoid using beta blockers in individuals with asthma or other respiratory issues to avoid precipitating acute breathing issues. Lastly, benzodiazepines typically are used with extreme caution to minimize the risk of patients becoming addicted to them.

This was an overview of one mental health condition that affects individuals, the workplace, and society.  Look forward to others posts on depression, substance abuse conditions, and many others in the near future.  We cannot escape the reality that untreated mental health conditions impact one’s ability to function personally, occupationally, even if they were in school, secondary to them being untreated.

I am Dr. Ken Richmond. I help corporate leaders pinpoint leadership issues so they can develop thriving workplaces with less turnover, improved workplace morale, and increased organizational performance.  You can follow me on all social media platforms @DrKenRichmond.

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