Workplace-related stress and anxiety are not new phenomena. Many employees in the U.S. report their jobs as a major source of stress and anxiety which, left unchecked, can easily rise to the level of an anxiety disorder with negative consequences for physical health, mental well-being, workplace productivity and career opportunities. The COVID-19 pandemic exacerbated what was already a widespread and largely unaddressed mental health problem in the workplace. This has markedly increased the prescription of antidepressants and anti-anxiety medications, many of which are associated with significant side effects and safety concerns, including risk of misuse, overuse, addiction and even death. Addressing workplace stress and anxiety during the COVID-19 pandemic and beyond requires novel approaches to mental/emotional health support and a fundamentally different standard of care compared to current medication alternatives for anxiety and depression disorders.
Workplace stress and anxiety prior to COVID-19
Workplace stress and anxiety have long been problems for American workers. Self-reported data suggest that up to 72% of American employees experience daily stress and anxiety that interfere with their day-to-day lives. Additionally, 40% report persistent stress or excessive anxiety linked to their jobs. Further, 28% report experiencing job-related anxiety or panic attacks.
What are the sources of this stress and anxiety in the workplace? Employees report that the most common anxiety-provoking stressors are:
- Deadlines (55%)
- Interpersonal relationships (53%)
- Staff management (50%)
- Conflict resolution (49%)
This stress and anxiety can have a significant impact on the way people operate at and away from work. According to self-reported data, many employees find that stress and anxiety have a negative impact on workplace performance and quality of work, as well as interpersonal relationships both in and out of the workplace.
Despite these startling statistics, only 9% of American workers have been clinically diagnosed with an anxiety disorder. Given that many people living with an anxiety disorder might not seek treatment for up to a decade after first identifying their symptoms, this percentage is almost certainly lower than the reality of actual workplace anxiety. Additionally, reports have indicated that about 40% of employees are hesitant to discuss their stress and anxiety with their employers for fear doing so could negatively impact their career opportunities.
The lack of adequate support and treatment for workplace stress that rises to the level of a persistent anxiety disorder is evident in the coping mechanisms that many workers adopt. The most common include:
- Excessive caffeine consumption (31%)
- Smoking (27%)
- Excessive fitness (25%)
- Over the counter or prescription medication (23%)
- Excessive alcohol consumption (20%)
While the problems of workplace stress and anxiety have long been present in American society, the COVID-19 pandemic created several situations in which stress and anxiety are more prevalent and severe than ever before.
Stress and anxiety related to working during COVID-19
The COVID-19 pandemic has compounded the existing challenges associated with stress and anxiety in the workplace. For some, the realities of working in public during a global pandemic raise significant health and safety concerns. For others, working from home carries challenges of its own. Others still find themselves unemployed and in dire financial straits, which heavily contributes to stress and anxiety as well.
For those working from home, the stress of social isolation and an "always-on" mentality could easily contribute to burnout, a common workplace phenomenon acknowledged by the World Health Organization. For those working in a physical workplace, the demands of adapting to COVID-19 and social distancing measures can interrupt creativity and workflow productivity in meaningful ways. Additionally, many employers might fail to provide adequate personal protective equipment (PPE) or avail employees to much-needed paid time off.
The circumstances created by the spread of COVID-19 and the national response to the pandemic have impacted the vast majority of employees. Nearly 70% of American workers reported that the COVID-19 pandemic has been the most stressful time of their career. Similarly, 88% of employees reported moderate to extreme stress in the early months of the pandemic.
- Concern regarding personal health or the health of family and friends;
- Concern about alerted financial circumstances or worry about loss of a job;
- Changes in sleeping or eating patterns;
- Difficulty sleeping or maintaining focus;
- Worsening of pre-existing chronic health conditions;
- Worsening of mental health conditions;
- Increased consumption of caffeine, nicotine, alcohol, or other substances.
The impact of these conditions has been significant on productivity as well. Among employees reporting increased stress levels during the pandemic, 62% said they lost at least one hour per day in productivity, while 32% reported losing two hours per day. That translated to the loss of nearly $23 billion in the brief window from the start of the pandemic to April 2020. As the COVID-19 pandemic drags on, the lost productivity and the costs to employee health and well-being, continue to mount.
The risks of increased prescriptions of anti-anxiety medications
Subsequently, the pandemic has led to an increase in prescriptions for antidepressant and anti-anxiety medications, many of which carry a host of negative side effects and, in the case of anti-anxiety medications called benzodiazepines, or benzos, sedation, cognitive impairment and a high risk of abuse and physical dependency. At the start of the pandemic, there was a 21% increase in the total number of prescriptions for antidepressant and anti-anxiety medications. At the peak of this increase, 78% of prescriptions filled were for new prescriptions, suggesting more people than ever are turning to medication as a solution for their stress and anxiety.
Unfortunately, some of these medications could end up doing more harm than good. Benzodiazepines, for example, are a class of sedatives often prescribed for the treatment of anxiety disorders. They work by depressing the central nervous system and enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA), which inhibits anxiety responses in the brain. However, benzodiazepines have a long list of potential side effects, including:
- Memory impairment
- Appetite fluctuation
- Weight gain
- Dry mouth
More serious potential side effects of benzodiazepine usage include:
- Respiratory depression
- Suicidal ideation
- Reduced or increased heart rate
- Low blood pressure
Additionally, these medications have a wide potential for abuse and physical dependency due to the rapid development of tolerance by patients taking them. Of the 30.5 million Americans aged 12 and older who have used a benzodiazepine, 5.6 million reported misusing the drugs at least once. As prescriptions for benzodiazepines increase, so too does the likelihood that more people will misuse the drugs or develop a dependency.
Addressing workplace stress and anxiety
To adequately address the growing problem of workplace stress and anxiety both during and after the COVID-19 pandemic – and the physical and mental health consequences associated with it – a multi-pronged approach is needed. This approach should include the provision of additional mental/emotional health support from employers in the form of employee assistance programs (EAPs), as well as novel approaches to psychotherapy and fundamentally different medications by mental health professionals.
An EAP is a program sponsored by employers that avails employees access to counseling services and other resources. Many EAPs also often address challenges in an employee's life that contribute to stress and anxiety, such as child care services, financial assistance, legal counsel, and more. These include phone- and video-based counseling, live web chat, and face-to-face sessions typically at no or reduced cost to employees.
Employers who are operating during the pandemic should consider implementing an EAP or enhancing existing packages. Consulting with employees about the resources that would be most effective to them during this time could help employers craft a more effective EAP that addresses the real challenges employees face both inside and outside of the workplace.
While often effective, comprehensive EAPs are generally not enough to address the needs of patients with diagnosed anxiety disorders. As these diagnoses increase and medication is more commonly prescribed, the need for an alternative is clear.
While the development of a truly novel alternative anti-anxiety medication is likely to take time, late-stage development of at least one fundamentally different medication, one that appears to not cause the side effects and safety concerns related to benzos, is underway, and new hope is now on the horizon. In a time where an already stressed workforce is experiencing more anxiety than ever, new medication alternatives coupled with extensive support and accessible resources provided by employers will play a key role in the mental health and wellness of workers, as well as productivity and reduced employee turnover.