AMY BERNSTEIN: You’re listening to Women at Work from Harvard Business Review. I’m Amy Bernstein.
AMY GALLO: 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.
AMY BERNSTEIN: Then there’s everything going on in our personal lives. For me, it’s the upcoming holidays and ongoing work pressures.
AMY GALLO: 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.
AMY BERNSTEIN: Worrying is a fact of life. It comes and goes, usually. Because another fact from the U.S. 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.
MARY: I would wake up and cry and just count the minutes until I had to start work.
AMY BERNSTEIN: That’s Mary, one of our listeners, whose mornings went on like that for a couple of months before she saw a therapist.
MARY: 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 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.
AMY BERNSTEIN: 10 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 is careful to get enough sleep. When something disrupts those preventative measures like insomnia or too many meetings…
MARY: 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. Also in meetings, another way anxiety can show up is I might freeze and not say the thing I really wanted to say.
AMY BERNSTEIN: Anxiety, likewise, messes with Kodee, another listener of ours who hasa 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.
KODEE: I had trembling nausea, chest pain, headaches, all of that.
AMY BERNSTEIN: 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.
KODEE: But sometimes if I become overwhelmed with a lot of asks 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 understanding. And so I might say, “Per my last email…”
AMY BERNSTEIN: But now Kodee knows to let her irritation settle before pressing send, because therapy.
KODEE: 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.
AMY GALLO: 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.
AMY BERNSTEIN: 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.
AMY GALLO: 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.
AMY BERNSTEIN: Michelle, help us understand the difference between run-of-the-mill anxiety and anxiety disorders.
MICHELLE DRAPKIN: 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 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.
AMY BERNSTEIN: So, is there a time box around that at all? I mean, I’ve had moments before giving a big speech or something where I definitely had intestinal disorders. Does that push me into the anxiety disorders category?
MICHELLE DRAPKIN: 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.”
AMY BERNSTEIN: And just briefly, why is it important to understand the difference?
MICHELLE DRAPKIN: 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. 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 those warning signs or those potential warning signs so that we can enact and engage sooner so we’re not dealing with crises later.
AMY BERNSTEIN: We have a clip from Kodee, one of our listeners who was remembering for us when her anxiety really intensified.
KODEE: 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? 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, and my heart was racing. And 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.
AMY BERNSTEIN: 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?
MICHELLE DRAPKIN: 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. 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 manage 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 solve our own problems when we really need to connect with other people.
AMY GALLO: 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 a normal reaction for an ER nurse – that’s going to be very different for the editor of a magazine, for example, 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 pay inequity, caregiving, gender-based violence can exacerbate or even influence how the anxiety disorders show up in the workplace. Is that something you see happen?
MICHELLE DRAPKIN: Absolutely. 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 the 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’ll have conversations about, well, how do I get promoted or why didn’t I get promoted? And it’s like, well, 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 unpaid labor that women wind up doing as well. And we’re not really great always about advocating for ourselves because 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, because I don’t want to be universal, 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.
AMY GALLO: 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.
MARY: 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.
MICHELLE DRAPKIN: It makes me anxious, even listening to her, right?
AMY GALLO: Yeah.
MICHELLE DRAPKIN: Her mind is worrying about the past. What did I do? It’s worrying about the future, but it’s not actually 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 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 exhausting.
AMY BERNSTEIN: All right, let’s get into some practical advice, Michelle. Amy, you wanted to ask a question.
AMY GALLO: 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?
MICHELLE DRAPKIN: 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.
AMY BERNSTEIN: Excellent. 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?
MICHELLE DRAPKIN: So, first of all, not everyone’s bothered when they make a mistake.
AMY BERNSTEIN: Who aren’t those people?
MICHELLE DRAPKIN: Oh, there’s plenty of people who are just like, Oh, oops, 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 disorder, 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, 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 a manager or leader would particularly want to do with someone. And normalizing mistakes happen, right? Everybody makes them.
AMY BERNSTEIN: Yeah.
AMY GALLO: It makes me think, Ame, about our failure episode. We did an episode last season about mistakes we had 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 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.
AMY BERNSTEIN: 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.
AMY GALLO: Meaning it doesn’t discharge the energy-
AMY BERNSTEIN: It amps it up.
AMY GALLO: It actually feeds the-
AMY BERNSTEIN: It amps it up. I have felt that, I mean, one of the things I think about is 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.
MICHELLE DRAPKIN: What you’re describing is being in the moment. 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. 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.
AMY GALLO: So, we’ve talked about the mindset shift. What do you actually have to do? So, you’re at work, you mess up, what do you actually want to do?
MICHELLE DRAPKIN: The first thing you want to 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? Just the facts. Just the facts. Was it a real big mistake? Is it going to cost the organization billions of dollars or is it like a typo or you miss send an email by accident and 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.
AMY BERNSTEIN: 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.
MARY: 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 of 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 and it’s part of my toolkit.
AMY BERNSTEIN: Michelle, what did you hear in that?
MICHELLE DRAPKIN: 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. So, it’s 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. And so there’s so that stress and anxiety is mobilizing and engaging and 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, hat 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 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 nothing. And 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, whew, flaring. But if I pick my head up and I look, just like we heard from the listener, then it’s not so bad. And so that perspective taking exercise just really enables that psychological flexibility to manage to just ride the waves and manage more effectively.
AMY BERNSTEIN: 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.
MICHELLE DRAPKIN: Yep.
AMY GALLO: The other thing I’d like to do is if I’m going to 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 going to lose my place in the middle, no one’s going to be engaged. People are going to 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 helps to balance the worry for me. 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.
MICHELLE DRAPKIN: Well, it’s interesting if my reaction to that is women aren’t often socialized to think about our success in that way. We had this much stronger internal critic, and so it’s much easier for us to go to the wors- 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, 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 let me pull out those tools and leverage them more effectively.
AMY GALLO: 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 Kodee, the ER nurse who we heard from earlier, has felt this. Let’s hear from her again.
KODEE: 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. 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?
AMY GALLO: 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?
MICHELLE DRAPKIN: 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. And it makes me really sad to say that. I wish that weren’t the case. And so you do have to be careful and judicious. And so I feel like this is 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. 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 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 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.
AMY BERNSTEIN: So, 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.
MICHELLE DRAPKIN: 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 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.” And you don’t need to specify. I mean, 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 going to 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.
AMY GALLO: Yeah. The team I work most closely with at HBR, 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. It’s been set up as the norm. It’s not someone just sort of saying or doing that on their own.
MICHELLE DRAPKIN: Well, and I think that’s one of the things managers and leaders can do best is by modeling all of that. So, I often will say in my organization, “I’m taking a recovery day. 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 Pollyannaish about it and saying, “Everything’s great.” Or “Oh, yes, I know we’re in the middle of a merger, an 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.” 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 more managers and leaders are becoming more empowered and wise about how to do that. And we still have so, so far to go.
AMY BERNSTEIN: 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?
MICHELLE DRAPKIN: So, first of all, good for you if you notice that, that someone’s off. And then I would ask permission or pull them aside in a one-on-one-type private area, and then ask permission to say, “Hey, can I share with you what I’m noticing or thinking?” And then use I statements of, “I’m concerned. I’m wondering if it might be helpful for you to take some time off.” I think if you go in and you just say, “Hey, you’re having a rough day, go home.”
AMY BERNSTEIN: No.
MICHELLE DRAPKIN: 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? Or what am I coming back to?
AMY GALLO: Or accusatory, right?
AMY BERNSTEIN: Yeah, definitely.
MICHELLE DRAPKIN: 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 literally a bad day, and someone’s going to shake it off, or they really will appreciate being seen and the support. And you could 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?”
AMY GALLO: 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?
MICHELLE DRAPKIN: 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 about we find out a good cadence for us to do that checking?” And so kind of scheduled worry time, you would schedule, kind of, a meeting or a time in a way that works and functions, and then you could titrate them off. So, make the intervals between each of those. 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 that you oversee. But I would do it very transparently of, 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.”
AMY GALLO: Yeah, Amy B., could you imagine doing that?
AMY BERNSTEIN: I am actually taking notes because I do have people who need a lot of… some people do need a lot more hand-holding. And it does get in the way. It’s time-consuming, and I know something else is going on there and it’s something I can’t fix. So, this is very helpful language to think about.
AMY GALLO: 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… Let’s take Kodee, for example. Kodee’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?
MICHELLE DRAPKIN: 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.
AMY BERNSTEIN: But 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—
AMY GALLO: Mental health issue.
AMY BERNSTEIN: … medical conditions. But you can say to the person raising the complaint, “Can you imagine why Kodee would’ve reacted that way?” And basically urge empathy. Put yourself in Kodee’s shoes. Because you know what? Kodee may have had a perfectly good reason to get a little bit sharp. So, when someone complains about someone else, I’m always hyper aware that I’m hearing one side of the story.
MICHELLE DRAPKIN: Yes.
AMY GALLO: Yes. Well, and I, having written a book about difficult behaviors, I can tell you… I wouldn’t even venture a percentage, but a huge majority of that behavior is driven by anxiety or stress.
MICHELLE DRAPKIN: Yes.
AMY BERNSTEIN: 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?
MICHELLE DRAPKIN: 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? At the end of the day—and I’ve heard you say this on your podcast—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 going to 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, 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?
AMY GALLO: Yeah, that’s actually what Kodee told us, that she was a supervisor on the night shift, and it was just too stressful for her. And so she shifted off.
MICHELLE DRAPKIN: 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. So 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. I’ve had multiple patients who really needed that time to step back and take it. And 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
AMY BERNSTEIN: Yeah. So, I want to ask you about a feeling that I bet a lot of us get. It’s Sunday and 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.
MARY: 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?
MICHELLE DRAPKIN: 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 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 7:30 at night.” Or even write yourself a sticky note to think about. And so you’re compartmentalizing and doing it really intentionally. I am 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.
AMY GALLO: Yeah, I can see doing that at noon on Sunday: I am just going to get this out of the way now, and then I’m going to enjoy the rest of my Sunday.
AMY BERNSTEIN: Michelle, this has been great, and I took a note or two, so thank you from the bottom of my heart.
MICHELLE DRAPKIN: You’re welcome. I’ll send you the bill.
AMY GALLO: That’s right. She does have an hourly rate.
AMY BERNSTEIN: Yeah, you can direct that to Amanda, our producer. But thank you so much.
MICHELLE DRAPKIN: Thank you for having me.
AMY GALLO: That’s our show. I’m Amy Gallo.
AMY BERNSTEIN: I’m Amy Bernstein. HBR regularly publishes articles about mental health that’ll help you take care of yourself and be a compassionate colleague and boss. Articles like “Managing Anxiety 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.
AMY GALLO: Women at Work’s editorial and production team is Amanda Kersey, Maureen Hoch, Tina Tobey Mack, Rob Eckhart, Erica Truxler, Ian Fox, and Hannah Bates. Robin Moore composed this theme music.
AMY BERNSTEIN: Get in touch with us by emailing womenatwork@hbr.org.
