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HR Handled Right

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Between 2007 and 2012, the number of complaints filed with the EEOC increased by more than 50%, with the second most common disability claim under the ADA involving a psychiatric illness. In fact, mental impairments account for 11.7% of the ADA claims and include depression, anxiety, post-traumatic stress disorder and bipolar disorder.

Anxiety disorders, in particular, are exceedingly common. Although most people who develop an anxiety disorder feel alone, frightened and – all too often – “crazy,” the reality is that anxiety disorders are the most commonly experienced mental illness. Forty million people in the United States – 18% of the adult population – experience an anxiety disorder at some point in their lives.

Symptoms can range from a chronic sense of worry and tension to unwanted and intrusive obsessions and compulsions to spontaneous bursts of severe anxiety with accompanying physical sensations such as a racing heart or shortness of breath. Some sufferers can pinpoint the source of their anxiety; for others, it remains a mystery.

Bringing Anxiety to Work

One of the most frustrating aspects of many anxiety disorders is the unpredictability of their symptoms. For sufferers, this can feel like perpetually waiting for the other shoe to drop. For the employer, whose business depends on predictable and consistent performance and attendance, it can be disruptive and frustrating as well.

However, most anxiety sufferers perform well at work. Many do not need accommodations at all, having learned ways to cope with their anxiety symptoms through trial and error, treatment, or a combination of both. Others require minimal assistance, i.e., a short-term flexible schedule to adjust to a new medication or an organized supervision style with regular meetings, clear assignments, and advance notice of unexpected changes. In fact, given the prevalence of anxiety disorders, it is highly likely that you have a coworker who successfully manages symptoms that no one s/he works with is aware of.

Just Give Me More (and More) Time

Much less frequent is the employee who uses his or her diagnosis to create more favorable (or convenient) work conditions. This is the employee, for example, whose use of intermittent leave routinely happens on a Friday or around a holiday, or who routinely requests a change of supervisor because his current one makes him nervous (While a change in supervision style can be a reasonable, and often effective accommodation, a change in supervisor may not be).

The best way to eliminate these situations is to a) have a clear absenteeism policy with call-in guidelines; b) track absenteeism patterns and, during medical certification, include any unusual pattern with the employee’s job description and ask the physician whether the employee’s diagnosis would create this pattern, and c) make sure job descriptions clearly outline interpersonal expectations (such as getting along with peers and managers) as essential job functions.

Don’t Worry; I’m (Trying to Be) Happy

Then there’s the flip side; the employee who keeps insisting she’s fine when she’s not. This is the employee who keeps coming to work even though she repeatedly falls apart, seeks out several coworkers to help her, and has to be taken by ambulance to the emergency room. Whether it’s because she’s fearful of losing her job if she takes time off, or in denial about the seriousness of her symptoms, she just doesn’t seem to grasp the limitations that she currently has.

In this situation, a first step is to encourage her to get the help she needs. Consider open questions that will encourage an employee to request support or accommodation. At the same time, remember that your job is not to probe into an employee’s personal life, to diagnose a problem, or to act as their counselor (It’s possible to have a conversation about this without ever mentioning the word “anxiety” or “mental illness,” i.e., by focusing on her behavior at work and the impact it is having on the people she works with.)

Make available whatever company resources you have to assist her. If she decides to pursue FMLA, make sure you provide the doctor with a copy of the job description and the employee’s attendance record; as many as one out of every three anxiety disorder sufferers also have a substance abuse problem and a Friday/Monday pattern of absences may be an indicator. You might also want to ask for a very specific return-to-work note.

The Bottom Line

Invisible disabilities like anxiety can’t be seen but they are surely felt – by the sufferer as well as those around him/her. Fortunately, they are also highly treatable; in fact, all of us work with individuals who have successfully dealt with anxiety or depression. With a little flexibility and adequate resources, employers can help anxious employees return to a more productive and happy state by focusing on whether and how they can accommodate them rather than whether or not a certain medical condition is a disability.

Companies also better take a second look at their job descriptions and address, where appropriate, the emotional stamina requirements of a job. This is important because, under the law, employers do not have to eliminate essential requirements, only how they are performed. If a job requires the ability to work long hours or with little supervision, make it clear. Not only will this provide some legal protection, it can help applicants who aren’t able to meet these demands to opt out before they fail.

It’s been a long week. Your mom, who’s been successfully battling breast cancer, was hospitalized with a chemo-related infection. Your fiscal quarter ends at the end of the month and you’re two deals away from making quota. And could those rumors of more layoffs be true? You’re barely keeping your head above water as it is.

Suddenly, in the middle of an important sales presentation, you can’t breathe. Sweat starts to roll down your back and your heart races. Everybody is staring. What in the hell is wrong with me? You suddenly flash on your Uncle Bob; didn’t he have a heart attack in his mid-forties? Oh, God, am I dying?

Signs and Symptoms of Panic

No. You’ve just had a panic attack, an episode of intense fear that is often accompanied by physical symptoms such as a racing heartbeat, chest pains, difficulty breathing, and dizziness/lightheadedness. It’s far more intense than feeling “stressed out” or “worried.” In fact, for many panic attack sufferers, the sensations are so severe that the sufferer worries that s/he will either die or go crazy.

If you’ve ever been in a life-threatening situation, and can recall the terror you felt, you know what a panic attack feels like. These attacks, though, occur without warning and for no apparent reason.

Fear by Association

Even though they often initially have nothing to do with the situation the person is in, they can easily becomeassociated with whatever the person is doing or where the person is at the time they have the panic attack. In a way, it’s just like getting sick to your stomach after you’ve eaten something; it doesn’t matter whether or not the food had anything to do with your nausea. Odds are, for weeks, months or even years afterward, just the thought of that food can make you feel queasy. (A friend of mine off a car and got a nausea-inducing concussion after eating Kentucky Fried Chicken; thirty years later, she still can’t stand the smell of fried chicken).

So someone who has her first panic attack while driving starts to worry that she’ll have another one the next time she gets behind the wheel. This worry, of course, creates more stress, making it more likely that she will have another panic attack. Pretty soon, if this cycle continues, she can’t drive at all.

But – wait – now she unexpectedly has a panic attack in the grocery store. The cycle repeats itself and, if left untreated, can result in increased isolation and decreased functioning.

Stress, Panic and Work

According to legal secretary Nancy Topolski’s lawsuit, by 2009 she was providing full time support to four attorneys at the law firm Davis Wright Tremaine. The fourth, which had been added after a series of layoffs in early 2009, allegedly had a pattern of waiting until the last minute to give her projects, putting her under tremendous pressure and forcing her to rush to get the tasks completed. After requesting a lighter workload several times and informing her supervisor that her job responsibilities were causing her significant stress, she suffered a panic attack at work. After a second panic attack, she was terminated.

Remember that any stressful situation – work-related or not- can trigger a panic attack at the office. Most commonly, it’s a build up of lots of stressors over time that initially gets the panic attack ball rolling. Once it starts, though, it can take on a life of its own, adversely affecting the employee’s productivity as well as his or her morale.

What You Can Do

If panic attacks are left untreated it can affect the body, emotional aspect as well as the behavior of the sufferer. This can also lead to more serious problems like depression, substance abuse (drugs and alcohol) or physical ailments like ulcers or heart conditions.

  1. Don’t play doctor. If an employee’s symptoms last more than a few minutes, call 9-1-1 (especially if s/he complains of chest pains or has asthma). Better safe than sorry.
  2. If you know the employee has a diagnosis of panic disorder, reassure him or her that it will pass. Allow the person to go somewhere where s/he feels comfortable doing deep breathing or relaxation exercises.
  3. Understand where s/he is coming from. Most panic attack sufferers work really hard to keep their disorder secret because they’re afraid of what others might think. Remember; the person experiencing the panic attacks can’t will them away.
  4. Provide the employee with referrals or encourage him or her to make doctor’s appointments as needed.

The Bottom Line

John Kenneth Galbraith once said, “All of the great leaders have had one characteristic in common . . . the willingness to confront unequivocally the major anxiety of their people in their time. “ As HR professionals, we have the opportunity to lead one person at a time – and encourage our employees to confront – and conquer – the anxiety that holds them back from their peak performance.


I wouldn’t say I loved to fly before I was pregnant with my first child, but it certainly wasn’t a white-knuckle event. Then, during a business trip when I was six months along, we flew into a storm. On the meteorologist’s scale, it was not even close to the perfect storm; I’d been through worse turbulence during my business travels.

However, I was suddenly gripped with a terror I can still recall but not adequately describe. The fear that something bad might happen to my baby quickly erased any rational thoughts from my head – and left me gripping the arm of the poor man sitting next to me and promising myself that if I ever got off that plane I would never, ever fly again.

Employees Lose Out on More than Frequent Flyer Miles

Of course I did. But it took years before I could board a plane without feeling a tightening in my gut and a shortening of my breath. Apparently, I’m not alone.

The fear of flying–or aviaphobia–is more of a problem than you might realize. Twenty-seven percent of USA Todaysurvey respondents said they were at least “somewhat fearful” of flying. Nine 9 percent are terrified of it.

A survey by the American Management Association found that 13 percent of employers reported that a fear of flying had adversely impacted their business. Employees pass up promotions that involve air travel and miss-out-of town meetings, while employers miss out on advancing otherwise stellar employees who could greatly contribute to the bottom line.

What are You So Afraid of?

While the fear of flying may be distinct phobia in itself, it is often a mish mash of different phobias. For example, it may be an indirect manifestation of one or more other phobias, such as claustrophobia (a fear of enclosed spaces) or acrophobia (a fear of heights). It may have other causes as well – a fear of terrorism, of not being in control, of turbulence, of crashing, etc.

It is a symptom rather than a disease, and different causes may bring it about in different individuals. A fear of flying is a level of anxiety so great that it prevents a person from traveling by air, or causes great distress to a person when he or she is compelled to travel by air. The most extreme manifestations can include panic attacks or vomiting at the mere sight or mention of an aircraft or air travel.

Oh, Those Pregnancy Hormones

Fear of flying often begins during pregnancy. We might think it is because of the responsibility for another life – and that’s part of it. However, shortly before delivery, the brain of an expectant mother is flooded with hormones that cause her to become obsessed with safety.

Everything that even remotely looks like a risk has to be controlled or avoided. The hormones go away after delivery, but, unfortunately, the patterns of behavior established by the hormones may continue.

Fear of Flying and the Law

Always consult with your attorney before making any decisions about policies and practices related to mental or physical illnesses. If a company does not make reasonable accommodations for an employee who is truly traumatized by the thought of flying or affected to the point of having a medical issue-such as panic disorder-or to the point where he cannot perform job functions, serious legal issues and obligations under the Family and Medical Leave Act, Americans with Disabilities Act, and/or National Labor Relations Act may apply.

From a practical (and humane) standpoint, seriously consider an employee’s reasonable request for accommodation, such as telecommuting or participating in meetings via teleconference. If such an arrangement does not cause significant disruption to the smooth operation of your business, providing such an option, at least on a temporary basis, may assist employees in getting past a period of anxiety, especially give the fact that some of the typical flight anxiety relievers (Xanax, a few vodkas) aren’t recommended for pregnant women.

If the problem continues after childbirth, you can deal with it then; no one has to accommodate an employee by removing an essential function of her job. But the flexibility you show in the short run is the kind of strategy that costs little – and earns big bucks in terms of employee loyalty.