Overcoming workplace anxiety

Have you ever sat staring at that urgent email or test result, or are in a meeting with peers or people more senior than you with your heart racing and your mouth dry? You know you need to make a decision, or put forward an opinion but fear holds you back.

If this is familiar then you're not alone in experiencing workplace anxiety.

For clinicians and healthcare professionals, anxiety can manifest as procrastination, avoiding challenging conversations with patients or colleagues, avoiding meetings or hesitating to pursue leadership roles or additional training. It’s a self-fulfilling cycle; each time you avoid something it reinforces the anxiety, making the next challenge seem even more difficult.

The ramifications go beyond delayed decisions or missed career opportunities. It erodes our self-confidence, damages professional relationships, and can lead to career stagnation.

More importantly, living in frequent ‘fight or flight’ mode takes a toll on both mental and physical health, creating a vicious cycle that can build up over time.

So, how can you move out of the state of fear toward flow?

Let's start with understanding the brain.

The brain transmits information via neurotransmitters. The repeated exchange of information builds up pathways and networks, which is how we build habits. Our brains develop in response to lived experiences which means that the brain can be changed by what we give our attention to, this is known as neuroplasticity.

As the neuropsychologist Donald Hebb said:

‘Neurons that fire together, wire together’

In essence, this means that we can intentionally ‘reprogramme’ our neural pathways to unlearn and relearn habits.

We can think of the brain in three parts that evolved separately and coexist:

The reptilian brain – the brainstem and cerebellum, this is responsible for basic functions like breathing and heart rate, it is the autopilot part of the brain that allows us to do essential routine tasks without thinking.

The Limbic system – located between the brainstem and cerebral cortex, this is responsible for emotional responses especially those related to survival such as feeding, reproduction and fight or flight responses.

It tends to act automatically to stimuli but it is not able to distinguish between real threats to your life (a car coming at you) or a minor threat (an urgent deadline). Think of it as a smoke alarm that can go off whether it’s burnt toast or a raging inferno, it doesn’t differentiate, it just reacts.

This then activates the amygdala, overriding logical thinking and stimulating the sympathetic nervous system causing blood and energy to rush to the muscles, and the stress hormone cortisol to be released. When there is no real threat to life it is sometimes known as the ‘amygdala hijack’.

The neocortex or rational brain – this is the most sophisticated area of the brain and only found in primates. It is responsible for planning, logic, imagination and abstract thought. In order to take control of our emotions we need to recognise when we are having an amygdala hijack and activate this part of our brain as soon as possible because doing this can break the stress cycle.

By having an awareness and recognising which brain is taking charge in any given moment we can manage our responses more effectively. One way to do this is to learn to pay attention to our responses by bringing ourselves into the present and simply noticing what is really going on. Increasing awareness of our emotional triggers and observing anxious thoughts allows us not to get tangled up in them and can break unhelpful patterns of behaviour.

Allowing space between the trigger or stimulus and the automatic reaction to it gives us time to consider options and solutions rationally.  Our emotions may still ‘kick in’ automatically but it is possible to more quickly reduce or limit the damaging effect it has on our mood and behaviour by responding rather than reacting.

It is important to know that anxiety is not a reflection of your capabilities and competence. It's a response to the environment you work in and the beliefs you hold, consciously or unconsciously.

Anxiety is:

“Over-estimating the outcome of an event causing the worst case scenario, multiplied by under-estimating  your ability to cope with the outcome”

James Elliot.

So what can you do to reduce the effects of workplace anxiety?

Practice mindfulness – and before you roll your eyes or dismiss this as psychobabble there is a growing body of evidence of the effectiveness of mindfulness [1]. Through regular practice it is possible to cultivate an awareness and attention to the present without judgement.

This means that in stressful situations you are better able to take a step back and observe what is happening without making any immediate interpretations. You begin to notice patterns in your behaviour and can be curious about them, asking “why am I reacting like this?” and “how does it serve me?” Creating space between stimuli and reaction enables the rational brain to take control and respond in a more measured way.

Tackling workplace anxiety is a journey, be patient and kind to yourself. Change doesn't happen overnight, but with consistent effort, you can rewire your response to anxiety-inducing situations.

References

[1] Mariana Toniolo-Barrios, Lieke L. ten Brummelhuis (2023) How does mindfulness reduce stress at work? A two-study examination using a stress appraisal perspective, Personality and Individual Differences, Volume 215.