What Are Anxiety Disorders?

Anxiety disorders are a collection of mental health conditions characterized by excessive worry, fear, and/or panic. An anxiety disorder is more than the normal worrying that most people experience from time to time. Rather, people with anxiety disorders have excessive fears, as well as behaviors that disrupt their ability to function in daily life. Specifically, they often avoid feared items, situations, and places to such a degree that it adversely impacts their ability to live a full life. For instance, someone with social anxiety disorder might repeatedly quit her jobs and experience financial strain because of being required to work closely with and interact with others.

Several types of anxiety disorders are recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision. The American Psychiatric Association (APA) classifies anxiety disorders as follows:¹

• Separation anxiety disorder: a disorder of excessive and persistent fear of separation from home or from attached individuals
• Phobias: disorders of intense, irrational fear of specific items, events, or places (e.g., heights, blood, insects)
• Agoraphobia: the fear of being in situations where escape may be difficult or embarrassing, or help might not be available in the event of panic symptoms
• Social anxiety disorder: a disorder of extreme discomfort with social interactions or situations due to fears of being humiliated, embarrassed, or rejected
• Panic disorder and panic attacks: sudden experiences of intense terror that include sweating, dizziness, increased heart rate, and feeling like you are losing control or dying
• Generalized anxiety disorder: a condition of excessive, constant worry about a wide range of items, events, and topics, such as health, money, relationships, and everyday life

Anxiety disorders are the most common mental disorders in the United States, with several surveys showing a prevalence rate of up to 33.7% among adults.² In a recent national survey of U.S. adults, the prevalence of anxiety symptoms was 44%.³ The Centers for Disease Control and Prevention found the prevalence of anxiety symptoms in the U.S. adult population ranges from 25% to 38% from 2020–21.⁴

Symptoms of anxiety disorders vary based on the specific disorder. However, most anxiety disorders involve some degree of the following:¹

• Feelings of excessive worry or fear about a specific situation or object or, in the case of generalized anxiety, about a wide range of everyday situations
• Avoidance of the situation, object, or place that causes anxiety
• Difficulty concentrating
• Increased heart rate
• Shaking or trembling
• Sweating
• Insomnia
• Feeling restless or irritable
• Feeling out of control or thinking that you’re going to die
• Gastrointestinal upset

Anxiety disorder symptoms are persistent and occur for several months or consistently when in the presence of the feared situation or object.²

Individuals with anxiety disorders and their loved ones can learn more by visiting the APA’s anxiety disorders webpage for patients and families. This page includes information about anxiety symptoms, treatment, and how anxiety disorders differ from everyday worrying.

How Anxiety Disorders Affect Employees and Employers

Just because anxiety is common does not mean it is not serious. Anxiety can affect every facet of a person’s life, from their health to their work to their ability to complete everyday tasks. In severe instances, anxiety can lead to long-term disability.⁵

Physical Effects

Anxiety disorders can have a wide range of effects on the physical body. These include:^6,7,8

• Headaches
• Chest pain, heart palpitations, and other cardiac symptoms
• Shortness of breath
• Nausea, gastroesophageal reflux, and other gastrointestinal problems
• Insomnia
• Musculoskeletal pain

Anxiety disorders have also been linked to numerous chronic health conditions, such as chronic pain, diabetes, cardiovascular disease and events (e.g., heart attack, stroke), irritable bowel syndrome, and asthma.⁹ However, the risk of death from anxiety disorders is low.

Psychiatric and Functional Effects

By definition, anxiety disorders result in people feeling excessive and persistent worry, fear, and avoidance.¹⁰ Anxiety disorders are strongly associated with other psychiatric disorders, notably major depressive disorder, bipolar disorder, and substance use disorders.¹¹ People with severe anxiety often experience marked difficulties in school and work functioning, social functioning, and in other areas of life.¹² Anxiety disorders also carry an increased risk of suicide, with as many as 11.5% of all suicides being due to anxiety.¹³

Work-Related Effects

In addition to affecting a person’s health and everyday living, anxiety disorders can also interfere with occupational functioning. Some of the possible work-related outcomes associated with anxiety include:

• Presenteeism — Anxiety disorders lead to an average of 5.5 workdays of reduced productivity per month.¹⁴
• Absenteeism — Employees with anxiety disorders have more than 1.5 times the risk of being absent for at least two weeks than those without anxiety and more than double the risk of having poor work performance.¹⁵ In one study, approximately 15%–21% of workers with anxiety disorders reported being absent from work for two or more weeks per year over the 4-year course of the study.¹⁶
• Work productivity loss — In a sample of nearly 73,000 U.S. adults, workers with mild-to-severe anxiety had significantly greater productivity loss—represented by higher rates of combined absenteeism and presenteeism—than workers with no anxiety.¹⁷
• Cost to employers — In that same study, workers with anxiety had significantly higher annual mean indirect costs than those without ($10,057–$10,339 vs $7,933).¹⁸

Tips for Employers: How You Can Help Employees with Anxiety Disorders

Because anxiety disorders and symptoms are so common, the likelihood of working alongside someone struggling with anxiety is high. Workplace interventions that make it easier for employees to manage their anxiety and optimize their well-being should be welcomed by everyone. A supportive workplace can help build employee loyalty, dedication, and motivation to perform well for the company, which is ultimately to everyone’s benefit.

Tips for employers concerned about anxiety disorders in the workplace include the following:

• Educating employees and managers about mental health conditions, including anxiety disorders. Integrate mental health educational messages in health communication strategies. Include content about anxiety disorders in company newsletters, on the intranet, and on other regular employee communication platforms.
• Promoting the use of an employee assistance program and other related health programs. Encourage employees to seek care when they need it by educating the workforce that mental illnesses are real medical illnesses rather than conditions of weak character or willpower and can be effectively treated. There are many effective treatments available for anxiety disorders, and early intervention is key to helping people get the help they need to live fulfilling, functional lives.
• Giving employees greater control over their work lives. Certain job characteristics are associated with lower worker satisfaction, greater distress, and more absenteeism; these include higher levels of job demand, lower levels of task autonomy, and coworker support. Thus, giving employees more control over their assignments and schedules and ensuring a supportive environment may help individuals with anxiety perform better on the job.¹³
• Being mindful of the need for accommodations. Employees with anxiety disorders may benefit from certain adaptations, such as modified workspaces, flexible schedules and deadlines, or permission to take periodic breaks throughout the workday.
• Offering coaching and mentorship. People with anxiety often struggle with organization, planning, and time management and may benefit from coaching or skill-building in these areas. In return, clearly communicate performance expectations by providing specific instructions and regular, ongoing feedback.
• Assigning tasks that play to employees’ strengths and limit their weaknesses. Discussing project roles and task management with employees can give those with anxiety disorders the opportunity to choose responsibilities and tasks that are unlikely to trigger or exacerbate their anxiety.
• Being flexible in handling work absences. Supervisors should work with employees on an individual basis to handle absences attributed to anxiety. Stay in regular contact with absent employees and work collaboratively to develop accommodations to make the job setting as comfortable and productive as possible.¹⁹
• Reminding all employees of the availability of resources for staying healthy and productive. Ensure that employees know how to access care confidentially and quickly by providing information on how to do so in multiple places regularly throughout the year. Heavily push these messages during times of high stress, such as at the holidays.
• Maintaining an empathic, understanding attitude. Like other mental illnesses, having an anxiety disorder carries with it a certain amount of stigma and misunderstanding from others. By demonstrating an openness and willingness to address anxiety as seriously as any other medical condition, those affected may feel more willing to ask for assistance.

Resources

Managers, supervisors, and other employers can learn more about anxiety disorders in the workplace through the following resources.

• The Equal Employment Opportunity Commission (EEOC): Disability Discrimination provides information about the employment provisions of the Americans with Disabilities Act.
• The Job Accommodations Network offers employers with guidance on employing people with disabilities, including possible job accommodations for employees with anxiety disorders.
• The Anxiety Resource Center is a nonprofit dedicated to helping educate mental health consumers, loved ones, and the public about the challenges of living with anxiety, including employer information about addressing stress and anxiety in the workplace.