As managers and leaders, you know the workplace can be stressful. If left unchecked for too long, stress can lead to many mental health issues, including anxiety attacks and other similar disorders.
Anxiety comes in many forms and can manifest in many signs and symptoms. But one symptom can be debilitating: anxiety attacks.
Anxiety attacks can happen anywhere. Fortunately, it’s manageable. However, here is a more critical dilemma: do you know how to calm an anxiety attack if it happens to one of your subordinates?
Your work and workplace are possible sources of stress. It is quite normal for employees to experience mild to moderate stress levels. In fact, according to research by the University of Georgia (2022, July 28), low to moderate stress levels help lower the risk of developing mental health disorders and build resiliency. Because contrary to a lot of the common narrative about stress, it is a needed response in the right doses.
However, persistent high stress levels can lead to the development of mental health issues such as anxiety disorders. Anxiety, once developed from stress, can be overwhelming and debilitating.
Anxiety disorders have several types, such as generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, phobia-related disorders, and separation anxiety disorder. Phobia-related disorders are the most common anxiety disorders in adults, while separation anxiety disorder is the least common.
The different types have their specific signs and symptoms, but they all have similar physical manifestations:
People with phobia-related disorders harbor an irrational fear of a specific object or event, such as spiders or being confined in small spaces. People with social anxiety disorder have an extreme, irrational fear of social situations where they can be judged or embarrassed, such as public speaking.
Those with GAD have a constant feeling of fear but with no known reason. People who have panic disorder have the same persistent feeling of fear accompanied by recurrent intense physical, emotional, and psychological reactions known as panic attacks.
These two are often used interchangeably. However, they are different to medical professionals. The medical community doesn’t use the term “anxiety attack.”
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), the primary reference book on brain-related and mental health disorders and conditions, does not mention “anxiety attack.” On the other hand, DSM-5 recognizes panic attacks and are categorized as either expected or unexpected.
According to the Mayo Clinic, a panic attack is a sudden or unexpected episode of an extreme feeling of dread, impending doom, or fear. The feeling is so severe that it often causes physical reactions such as rapid breathing, racing heart, and sweating. People in the middle of a panic attack might feel like they have a heart attack, are losing control, or dying.
Expected panic attacks are episodes that happen with known triggers, such as a person’s phobias. Unexpected panic attacks occur without any apparent cause.
Many people experience one or two panic attacks throughout their lives and come away fine. Most often, these unexpected panic attacks happen when the person is faced with a stressful or traumatic situation. Once the crisis passes, so does the panic attack.
However, people with panic disorder experience recurring unexpected attacks that can sometimes last for hours.
Imagine if one of your employees has panic disorder and you witness one of their episodes. That could be quite frightening to see, but it might also be nerve-wracking to think you are in charge, and you have no idea how to respond. What must you do in that kind of situation?
First, you must understand that panic attacks are highly personal experiences. Two people who have panic attacks will likely need different methods of support.
Your goal is to ensure your employee or coworker is safe until their attack subsides. When their panic attack stops, and they have calmed down, you need to be there to offer support.
The first thing you must do is stay calm. Stay within your team member’s line of sight, but at a safe distance so as not to crowd them. Oftentimes, when one experiences a panic attack, the overwhelming sense of dread and rapid heart rate might feel like a heart attack. It may be in your best interest to call any onsite medical support to rule this out.
Talk to them in a clear but gentle voice. Reassure them that it is okay, and once it is a confirmed panic attack, reinforce that they are only having a panic attack and that you will be there to ensure they are safe until it subsides.
First, help them to regulate their breathing. When in fight or flight, our heart rate and breathing will become more rapid in order to oxygenate our limbs for battle. Because there’s no battle in sight, working to slow the breath will also help the heart rate to slow. Help them to slow their breathing by counting a 5-second inhale and a 7-second exhale.
As you are focusing on breathing, you can help the person to anchor or ground by helping them to practice mindfulness. Giving them cold water to drink and feel with their hands can help them to practice presence through their senses of touch and taste.
Next, ask them what they need. They may not want anyone nearby, or for anyone to touch them at the time. They might also ask for specific items they find comforting. Comply with their request unless what they are asking for could harm them or others.
Sometimes, people will answer “I don’t know” when asked what they need. This is totally normal, as the limbic or lizard brain is in charge during a panic attack—logic or decision-making is not as accessible. If this happens, assure them that it is okay and practice “holding space.”
Holding space is a simple process of allowing the attack to play out in its natural time while you are there to help them feel safe. It requires very little other than your calming presence. Do not feel the urge to rush them through the experience, past it, or distract them. Instead, maintain slow and steady breaths yourself and they will attune; this is called co-regulation.
Follow through with what your employee agrees on. Calmly ask everyone to leave the room quietly if they want to be alone. Reassure your employee that you will also leave but will be close at hand should they need anything else.
According to a 2022 study (Chalmers et al.), coping with panic attacks depends on what the person having the attack feels comforted by. There is no one-size-fits-all procedure.
Once your employee has calmed down and the panic attack has passed, reassure them that they did nothing wrong. Also, let them know they will not be penalized for having a panic attack at work. The guilt of having a panic attack in public ironically can contribute to the same chronic stress that causes panic attacks. Afterward, consider any light duty activities they might finish their day doing. If it is feasible, let them go home for the day. Suggest and encourage they reach out to their preferred appropriate health care professional.
Seeing one of your employees have a panic attack can be frightening. But you can help that employee and all those around you by having a plan of action and keeping a cool head. Be calm, confident, empathic, and supportive, just as you would in any other crisis situation in the workplace.
If you found this helpful, please share it with others or consider reaching out to me for additional training for your team regarding mental performance!
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