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For MSPs Dealing With Anxiety, Help Is Available

By Teddy Durgin

When this author — Generation Xer — was a kid in the 1970s and ‘80s, if you ran across someone with anxiety, they might be referred to as a “Nervous Nelly” or a “worrywart.” On the radio, we bopped to such catchy tunes as Billy Joel’s “Pressure” and the Queen-David Bowie team-up, “Under Pressure.” And at the movies, characters like Alan Ruck’s jittery teen Cameron in “Ferris Bueller’s Day Off” or Ally Sheedy’s self-professed “basket case” Allison in “The Breakfast Club” were sources of comedy even as they were striking a chord with certain audience members dealing with deep fears of worry and concern.

Thankfully, society and pop culture have come a long way since those days in recognizing the risks and dangers of anxiety and the effects the disorder can have on one’s life. In the post-pandemic era, more and more people are also recognizing how much anxiety can impact medical services professionals (MSPs).

Hannah Neal, a National Board Certified Health and Wellness Coach, says, “Anxiety levels are high in medical professionals due to a variety of reasons: long hours, fast-paced environment, exposure to suffering, and working conditions, among other factors. Unfortunately, COVID exacerbated these issues, and the rates of fatigue, burnout, and mental illnesses have increased, according to the Center for Disease Control and Prevention.”

Dr. Gregory Corey Claxton, DNP, APRN-PMHNP-BC, is in full agreement with Neal. He says, “Anecdotally, I have seen many colleagues and students show high levels of anxiety. The pressure of being the person whom others rely on each shift can become physically and emotionally taxing.”

Some of the common reasons he hears MSPs give are staffing issues, patient-to-provider ratios, and the nature of working around ill and dying patients. Claxton, currently an assistant professor in the School of Nursing at Georgia College and State University, adds, “Several of my colleagues have told me they started therapy and/or psychotropic medication due to the stress of their jobs.”

But not everyone in the profession seeks help. Why is that? “There is still a stigma that exists around mental illnesses or admitting that you’re struggling,” Neal, who has an extensive background in suicide prevention and providing self-compassion training to professionals, says. “Shame is a common emotion that keeps people from reaching out for help — there may be learned beliefs that mental illness isn’t something that exists, that seeking help is a sign of weakness, or even that there will be consequences if spoken about.”

Claxton says the reasons why MSPs often don’t seek help for their anxiety vary from person to person. Among the most common are fear of judgment, feeling as if they are mentally weak, and fear of embarrassment. He further notes, “Others come from families and backgrounds where mental health concerns are not discussed or are dismissed, and they might not even realize that they are experiencing an unhealthy level of anxiety.”

The dangers of not confronting the problem are many. Untreated anxiety disorders can lead to substance abuse and/or mental health conditions such as depressive disorders. Claxton says, “MSPs struggling with untreated anxiety might experience burnout, poorer work performance, and a more negative outlook on their professions.”

Neal adds, “Anxiety is uncomfortable to experience — and if it’s interfering with your ability to cope with day-to-day life, it’s important to reach out for help. Untreated anxiety can lead to challenges with sleep, focus, mood regulation, and other functions. It is important to take these symptoms seriously.”

Taking the symptoms seriously ultimately means therapy. There are many different non-pharmaceutical methods that can be used to manage anxiety. “Therapy is a good option, as it gives you the space to examine and process your emotions with a licensed professional,” Neal says. “Likewise, mental health coaching is another option to work on goals related to building healthy coping skills for anxiety. For someone who might not want professional help, mindfulness is a practice that is commonly used to help relieve anxiety.”

There are also numerous resources and exercises available online or through phone apps. They include Headspace and Insight Timer, just to name a couple.

For some, though, prescription medication from a medical doctor is ultimately the best course of action. In addition to his scholarly duties, Claxton works part-time as a psychiatric-mental health nurse practitioner (or PMHNP) seeing patients who live throughout the state of Georgia via telehealth. He says, “For moderate to severe anxiety, cognitive behavioral therapy is almost always recommended in addition to psychopharmacological treatments if the patient consents. Our first-line treatments are selective serotonin reuptake inhibitors (SSRIs). Common SSRIs are fluoxetine (Prozac®), escitalopram (Lexapro®), and paroxetine (Paxil®). Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®) and venlafaxine (Effexor®) also show efficacy in anxiety disorders.”

Claxton adds, “It is important for MSPs to seek professional guidance to decide on a treatment plan that is most appropriate for them as individuals. I have treated patients from early childhood through late adulthood who struggle with anxiety. It is important to remember that everyone is different. Some MSPs might develop an unhealthy level of anxiety the first day of the job, others might experience it many years in, and others might retire without difficulty. Even if two MSPs worked together each day and experienced the same set of circumstances, one might develop a pathological level of anxiety while the other does not. We all have different genetics, different childhoods, different perceptions, and different lives outside of our professions.”

Hopefully, for most MSPs, the benefits soon become clear, and living with anxiety will eventually become more manageable. Things can get better! Neal concludes, “The skills learned in therapy or coaching can vastly improve your physical and mental wellness, not only with how you manage anxiety. You can expect your resiliency to grow and to be able to better manage difficult situations and emotions as they arise in the future.”