A lot of people have a little anxiety about coronavirus. But how do you aid those who are very anxious?

Two months ago I felt that people worried about coronavirus seriously affecting Australia were overly anxious. Two weeks ago I thought people stockpiling in preparation for quarantine were panicking. I no longer think either of those things.

The line between reasonable and unreasonable anxiety is subjective even in normal times, and we are in weird times. While working on this article, coronavirus was labelled a pandemic by the World Health Organisation (WHO), my office found out a colleague’s partner’s office was shutting down and doing a ‘deep clean’ due to a confirmed case, and Tom Hanks was diagnosed.

Most Australians are experiencing a small level of fear, and a few of us are experiencing a lot. It’s really not for us to say if that is reasonable. But it is on us to help each other, if we can.

HRM spoke with two psychologists about how you can help a colleague or employee who is feeling highly anxious about coronavirus. This article is broken down into six sections.

1. Detecting anxiety in yourself and others
2. Helping others with anxiety
3. Helping with a panic attack
4. The risk of using facts
5. Thinking about longer-term anxiety issues
6. How to stop anxiety spreading

1. Detecting anxiety in yourself and others

You want people in your workplace to feel safe. If they’re feeling anxious, you want them to come forward. The best detection method is encouraging people to be self-aware, says Amberley Meredith, consultant at The Being Well Process and a registered Australian psychologist.

“It makes getting help 100 times easier,” says Meredith. She offers the following questions that people can ask themselves.

• Am I feeling a bit overwhelmed?
• Am I constantly checking the headlines and looking for updates?
• Am I ruminating so much on coronavirus that I’m not focusing at work?
• Am I able to hear objective facts or am I focusing on fears and potential scenarios?

“It’s amazing how the mind can make those leaps and people stop hearing facts,” says Meredith. “You know someone is escalating when they can’t settle and hear those facts.”

She also says to be conscious of unnecessarily avoidant behaviour. If people are washing their hands and wiping down surfaces, that could be appropriate given the circumstances. But doing things that go beyond the advice of any respected authority might be a sign the anxiety is becoming too much and you should reach out.

Dr. Jodie Lowinger, founder of Sydney Anxiety Clinic and high-performance coaching firm Mindstrength, offers a broad sense of what unhealthy, or even clinical anxiety, looks like.

“Typically it’s when anxiety is getting in the way of us living our life. When it’s causing fear, suffering and avoidance,” says Lowinger. “So if the person seems to have difficulty doing their work or interacting with other people.”

That’s detecting anxiety in yourself. How do you tell if someone is unhealthily anxious but isn’t talking to anybody about it?

The behaviours described above are clues. But Meredith offers another warning sign.

“Often when people are anxious and they’re not expressing it, whether that’s something to do with fears or their personal life, they will have strong reactions to other things that make them angry, frustrated or annoyed that seem somewhat disproportionate,” she says.

“Because a channel has opened up for that other emotion to come out. So when people are reactive above and beyond what you would ordinarily expect, that’s a sign that they’re not coping.”

2. Helping others with anxiety

If you believe someone is anxious, Meredith says there is a six-step process that can help guide how you approach and talk to them. It applies to individuals, but could also be used as the framework for wider organisational messaging.

i. Recognition

Let the person know that you’ve noticed they seem to be behaving in a certain way and clarify this is okay. Recognise the wider coronavirus concerns and nationwide stress. Lowinger agrees that validating the person’s emotions is a key step. Even if you can’t comprehend why someone else would be so worried, take their feelings at face value.

ii. Understanding

If someone confirms they’re feeling anxious, show them understanding. People have different experiences – for example, someone who cares for an ageing parent is likely feeling more concerned about the virus – so show them you see where they’re coming from.

iii. Compassion

“This runs through both those first two steps,” says Meredith. “It’s showing that human kindness of, ‘I actually do care, I can see that you’re suffering, we want to be able to help with that.’”

iv. Offering support

This is when you begin to become more action-minded. Let them know they can talk to people and that the organisation wants to be there for them. If your company provides specific resources, such as an independent counsellor from an employee assistance program (EAP), let staff know how to access them. Also ask the person if they have ideas for what might help them feel better.

v. Suggestions

It’s worthwhile going beyond support and offering other suggestions that people can “hang onto, that are grounded and tangible” says Meredith. A suggestion can be encouraging people to check-in with themselves for the signs listed above, pointing them to worthwhile online resources, or to reach out to their families, independent professionals and so on.

vi. When to ask for help?

This is offering future advice and something of an ongoing framework. The anxious person perhaps now has a plan based on your suggestions, but here is where you tell them what to look for in themselves going forward. Let them know it’s okay to ask for support and that you will check back in with them.

It’s also good to prepare your company by identifying support people. They might be a practised HR professional, in-company counsellors or nurses, someone from an EAP, or just capable managers. This way if some employees don’t feel like they could approach an anxious person and follow these steps they know who to turn to.

Want to know what HR professionals can do to support staff during the coronavirus crisis? AHRI Assist has regular helpful updates. Exclusive to AHRI members.

3. Helping with a panic attack

Sometimes anxiety escalates into a panic attack. This is serious. Lowinger describes a panic attack as “your headspace being hijacked by your amygdala”.

She says it’s important to remember that panic attacks aren’t always caused by dire situations. They can be instigated by fears of coronavirus, but can also be caused by something as small as a negative judgement from a superior.

“It doesn’t matter what the content of the worry is, the brain is responding to it as if it were a tiger – something they need to fight or run away from.”

Meredith agrees that it triggers the flight or fight response. She says you can distinguish between a severe spike in anxiety and a panic attack because the latter is essentially the fear that you’re going to die. It’s noticeable.

If you were to ask someone if they were having a panic attack, she says, they may not be able to answer you. Their response is likely to be a startled, stress-ridden “what!?”

It should be remembered that people who have not had a panic attack, but who are spiralling, can be approached in the same way.

A good first question, says Meredith, might be something like, “Would it be helpful if I try and redirect your mind?” She says they will probably be able to nod at that.

From here, your goal is to de-escalate their mind from a state of primal fear – fight or flight – and back into a more measured way of thinking. You want to engage other parts of the brain so their body stops pumping itself with adrenaline.

Meredith offers a few practical techniques:

• Give them out-of-order number sequences such as 7, 8, 11, 15, 21, 2, 7, 10 and ask them to repeat them.
• Play the alphabet game. Pick a topic such as ‘animals’ and take it in turns to name a different thing in that topic with each letter of the alphabet – so “antelope”, “bear”, “cow” and so on.
• Try sensory redirection. Give the panicking person a drink, give them a stress toy or object and say “feel that, focus on what the texture feels like”.

Unfortunately, what doesn’t tend to work is telling people to breathe normally or calm down. They want to breathe normally, they want to calm down, but they can’t.

Of course, if things keep escalating and the above techniques don’t work, call in someone else. Don’t crowd the person, as that might exacerbate the problem, but find someone with more authority, ability or training to help. Consider contacting a useful helpline. In dire circumstances, you should call an ambulance.

4. The risk of using facts

Some people might believe the trick to calming someone who is experiencing anxiety about coronavirus is to use facts. The problem here is that anxiety often leads to vigilance and hyper-vigilance. An anxious person is likely to know more about coronavirus than you do – they’ve been feeding their growing fear on a diet of live blogs and catastrophic headlines.

You might tell them what the official WHO recommendations are, and they would respond with a detailed accounting of what WHO representatives found on their recent China trip. Your inability to speak to that will diminish your ability to help, in their eyes.

“If people have gone and gotten all this information, and it’s skewed information, then that’s going to play into their fears,” says Meredith.

She says that you shouldn’t engage on a fact-based level unless you are very confident in the facts: “Focus on the emotions and encourage them to seek out very authentic sources.”

5. Long-term anxiety issues?

For some, coronavirus will be the root cause of their anxiety. Their troubles are reactive. But others are living with longer-term anxiety issues. Lowinger says that now is the time to reach out for help.

“If a person has been more predisposed to experiencing anxiety, and it just so happens that the current context we’re experiencing is proving hard, take comfort and hope in the knowledge that anxiety can be turned around quickly with the right evidence-based strategies.”

She says this isn’t just about giving people reassurance, because that alone isn’t going to solve anxiety.

“I would really encourage people to seek out the help they need and engage with a clinical psychologist who is equipped with the toolkits to help individuals deal with clinical psychology. Because there is no need to suffer in silence.”

6. How to stop anxiety spreading

An anxious person doesn’t always keep their anxiety to themselves. Often they feel the need to express it and the act of this can make other people anxious. This can involve simple office chats, where someone regales a colleague with all the worst coronavirus stories from around the world.

But a lot of organisations have formal and informal ways for employees to connect digitally. The company messaging app (think Slack) or social media platform can become a forum for an anxious person to make others anxious, which can be accomplished with something as simple as a news link and the message “we need to all quarantine now”.

The best way to contain this is to get ahead of it. Encourage workers to share their worries with leadership first, says Meredith. If they see a news link they think is relevant to others, get them to hand it to their manager who can vet the article for appropriateness.

Be explicit that you are creating a channel for people to air their concerns as a responsible step you are taking to avoid unnecessary anxiety.

If the cat is already out of the bag and someone has already begun deluging your digital channels, you should confront them respectfully. Meredith offers the following approach:

• Let them know you’ve seen the posts, and that they seem highly anxious.
• Say you want to make sure they are feeling safe.
• Say that you want people to share information, but you don’t want undue panic.
• Ask them if there’s anything the organisation can do to better support them.

“The more you make it about them, the more receptive they are going to be,” says Meredith. “If they feel they are being supported and encouraged, not criticised and controlled, they are going to respond more cooperatively.”

We are possibly headed into a scenario not a single Australian has ever experienced before. But that is precisely why we should feel hope. Whatever happens, we will be doing it together. Be safe, be brave and be kind.

Beyond Blue has an index of national helplines and websites you can call upon if you need assistance.