What are the personal costs of anxiety?

Anxiety disorders can have a profound impact on a person’s quality of life, influencing their capacity to work, placing strain on intimate relationships and sometimes causing people to withdraw from social interactions altogether.

What are the economic costs of anxiety?

A 1996 US study found that, while anxiety related costs to the economy were substantial ($46.6 billion in 1990) less than one-quarter of these costs were for direct medical treatment; over three-quarters were attributable to lost or reduced productivity, perhaps because so few anxiety sufferers sought appropriate treatment.

There have been no comparable Australian studies, however in 1998 a national survey of mental health and wellbeing found that people with anxiety disorders reported being unable to carry out their usual roles or tasks one day out of every twelve, suggesting that Australia is also paying for anxiety in lost or reduced productivity. Only 28% of Australian anxiety sufferers sought treatment for their difficulties, the vast majority of these from GPs.

Although there is as yet no data to prove or disprove this theory, it is possible that the Better Access to Mental Health Care initiative, by which Medicare subsidises psychological treatment for mental health problems including anxiety, may have increased the number of Australians seeking appropriate treatment for anxiety disorders.

How might anxiety affect work and return to work?

Anxiety may lead to sleeplessness or disturbed sleep, difficulties concentrating, muscular tension and social withdrawal. In addition to the emotional difficulties associated with excessive worrying, these symptoms may impact a person’s rehabilitation and return to work.

Anxiety may sometimes be the main reason behind work absence.

Specifically, anxiety disorders may impact:

• Attendance. In the short term, one way of dealing with anxiety is to avoid situations that provoke it. If work is stressful, or if a person finds workplace interactions difficult, they may deal with these difficulties by taking the day off when they are feeling particularly anxious. However, in the long term, avoiding situations that provoke anxiety feeds anxiety. Methods for working with anxiety are discussed in the third and final part of this series.
• Performance. Since anxiety can make concentration difficult, work performance may suffer. According to Andrews and Hunt, “Just as moderate levels of anxiety facilitate coping, high levels reduce the capacity to plan, to make accurate judgements or to carry out skilled tasks, or even to comprehend useful information.” A person with social anxiety may also be less likely to speak up in meetings and may struggle to communicate effectively with co-workers.
• Injury. A person who is distracted by persistent worries may be more likely to make mistakes that lead to injury. Since anxiety also has physical symptoms such as tense muscles, anxious workers may also be more prone to overuse injuries.
• Return to work. Anxiety may impact on the speed and durability with which someone returns to work in a number of ways:
  • If work has been a source of anxiety, they may wish to avoid it. Similarly, if the person’s injury or illness is a source of anxiety, they may avoid doing things that remind them of it – for example, attending medical appointments –  even if these things will be helpful in the long run.
  • As mentioned above, high levels of anxiety make it difficult to process information. A person who is feeling very anxious may find it harder to take on board the facts about:
    • Their illness / injury;
    • The importance of activity and return to work for recovery; and
    • The difference between pain and re-injury.
  • Anxiety may lead to pessimism about recovery (sometimes called ‘catastrophising’), and this can have a negative impact on motivation to exercise or do whatever it is they need to do in order to promote rehabilitation.
  • Because it feels overwhelming, anxiety can lead people to believe that they don’t have the power to cope with rehabilitation and return to work. A person’s belief in their ability to cope (sometimes called ‘self-efficacy’) has a big impact on return to work outcomes.