Anxiety is a very normal part of being human, and we all experience it on some level from time to time. It’s our inbuilt early warning system that has been designed by evolution to warn us when there might be trouble, and ready us to deal with it. Sometimes though, the early warning system works a little too hard, switching on too often when there’s just no need. 
Anxiety can be thought of as the workings of a strong healthy brain that’s being a little overprotective. It’s not crazy and it’s not troubled. It’s overprotective. Like anything overprotective, anxiety can be intrusive, confusing and exhausting. For some people, there may be no outward clues that they are anxious at all. Their symptoms will be managed beautifully and will have minimal, if any, intrusion into their lives. For others, anxiety can be debilitating.  
The stats on anxiety are staggering. Anxiety is so common, that if you aren’t experiencing it yourself, it’s very likely that someone you care about is. Bupa has created an infographic that illustrates some of the statistics. Find it in the Blue Room here: ‘Feeling Anxious? You’re Not Alone’. 
Anxiety is just another part of being human. We all have our ‘stuff’, and anxiety is just one that many of us will struggle with from time to time. If someone close to you is experiencing anxiety, there may be signs. Sometimes they may be obvious. Sometimes, they may make their way into the shared space between you in more subtle ways. As with anything that’s happening the lives of the people we love, it is when anxiety is misunderstood or ignored that it can do the most damage. 
Here are some subtle signs to watch out for. If you see them happening, don’t make a big deal of things. For the person you’re with, they would have been likely living with it for a while. Just be there and know that you don’t need to fix anything. 
None of these behaviours necessarily mean anxiety is causing trouble for someone you care about, but they might. Being open to the signs and the different ways anxiety looks when it lands will help you to be a strong, steady, soothing presence (rather than a confused one) for the person you care about. And we all need that from time to time. 
The Subtle Signs of Anxiety. 

1. The details. All of them. ASAP.If you are someone who is more a go-with-the-flow type of person, an excessive need for details might seem confusing for you. For someone with anxiety, having as many details as soon as possible can be the greatest defence against anxiety sashaying in when it’s not welcome. And it’s never welcome. The details may help to cut down the ‘what-ifs’ that feed anxiety before they’ve had the chance to breathe. The need to clarify plans, or fill in or change some of the details isn’t about needing to control anything, but about trying to stop anxiety controlling them. 
2. Decisions. Ugh.People with anxiety often have wonderfully strong and vibrant minds and when there’s a decision to be made, they’ll tend to think of all the different angles. On the plus side, they may be the ones to think of things that nobody else saw coming. On the other hand, anxiety can make decision-making more difficult. The outward signs of this may be trouble deciding, planning, weighing up consequences and organising thoughts in a logical, rational way to get to a good decision. The capacity to make a good decision is there, but anxiety can send it offline. 
3. Avoiding new people, too many people, places, situations, the unfamiliar.It’s normal to want to avoid things sometimes, but if someone close to you regularly pulls out of things, looks for an out, says ‘no’ to invites, or changes plans, anxiety might be in the driver’s seat. This isn’t about avoiding situations, people or places (even though it looks that way), but about avoiding the awful feelings that rocket in with anxiety. 
4. Flight. The need to leave – a place, a relationship, a situation, a crowd.Anxiety drives people to make things safe. The two ways this can happen are fight or flight. ‘Flight’ can look like leaving, ignoring, not picking up the phone, wanting out of relationships, or wanting to leave a gathering early. This isn’t done to hurt anyone and it isn’t an avoidance of you, the people they care about, places or situations. It’s an avoidance of the anxiety that might come bundled with those things in certain situations. 
5. Or fight. Anger, aggression, tantrums, irritability.Anxiety isn’t always about avoidance or escape. During anxiety, the alternative to ‘flight’ is ‘fight’. This can look like aggression or anger, but underlying it might be anxiety and the need to feel safe.
6. Tears. Unexpected ones.When people are anxious, they might burst into tears, not because of sadness, but because of anxiety. The part of the brain that is involved in anxiety, the amygdala, is also involved in emotion. During anxiety it can be on high volume, so emotions can be too. 
7. They might seem a little aloof, disinterested or indifferent. Except they’re not.People with anxiety can appear aloof to outsiders, but they’re often the warmest people in the room. What looks like aloofness, is actually the process of standing back and taking things in until they feel comfortable and safe enough. There’s nothing wrong with it and it isn’t something that needs to be changed. Not everyone feels the need to open up straight away, and that’s okay. It makes it all the more wonderful when the wall goes down.
8. There’s a tendency to overgeneralisePeople who are living with anxiety have a unique wiring that causes them to interpret things as harmful, even if they’re not harmful at all. This is called ‘overgeneralisation’. In an evolutionary sense, this is a great thing – it’s the reason people with anxiety are often alive to potential trouble long before it hits. The problem is that it can also cause too many false alarms. Rather than assessing the potential harm of things in the environment with fresh eyes every time, the anxious brain tends to tag everything as a potential threat.
9. Tummy trouble.Where there is anxiety, there is often tummy trouble – constipation, diarrhoea, or irritable bowel. There’s a good reason for this. In the gut are hundreds of millions of neurons. This is affectionately known as ‘the brain in our gut’ or our ‘second brain’. They send information from the belly to the brain and they are a key player in mental health and emotional well-being. When the environment in the gut is out of balance, the messages sent back to the brain via the vagus nerve (the very long nerve that runs from the belly to the brain, touching the heart along the way) can stir anxiety. As well as neurons, the 100 trillion bacteria that call your gut home also play a major role in mental health. According to professor of physiology, psychiatry and behavioural sciences at UCLA, Emeran Mayer, gut bacteria contain extraordinary amounts of wisdom that get sent to the brain, influencing our behaviour and emotional well-being every minute of the day.
10. A need for reassurance.Nothing can cast a healthy, vibrant mind into the future like anxiety can. Once the ‘what-ifs’ launch into action, it can make the need for reassurance a hungry one. The reassurance can be about anything – how you feel, how other people feel, whether the plans make sense, whether you’ll get there on time. An anxious brain is geared towards noticing threat before it happens. Understand that even though your reassurance might be needed more than once, you’re helping to soothe their anxiety back to small enough. We all need that sometimes.
11. Oh but it’s not quite perfectly perfect. The need for things to be exactly right can often be a well-built disguise for a fear of being criticised or judged if there is a mistake, fall or fail. To protect from failure, people with anxiety might place ridiculously high standards on themselves. They might redo things over and over and worry endlessly about getting the detail completely perfect. Sometimes it will be easier to never finish anything, or to have the excuse of falling short of time (because it was done over and over and over and ov…) than to claim full effort and for the result to not be good enough. On the plus side, when something makes it to completion, it’s likely to be exceptional.
12. Worrying thoughts settle in.When thoughts become persistent and unrelenting, there’s a good chance they might be driven by anxiety. Often, there is an edge of irrationality or excessiveness to the thought. It’s normal to worry sometimes, but when it influences behaviour (such as compulsive behaviours [checking, washing], constantly asking for reassurance), anxiety might be the pushy little beast behind it all. Worries can also take the shape of ‘what ifs’ and for someone with anxiety, those worries can start to feel like predictions. What if I make a mistake? What if I say something stupid? What if everybody has a dreadful time? What if this headache is a tumour? What if something bad happens to someone I love? … You get the idea. Just keep in mind that the thoughts might feel irrational to you, but for your loved on, they can feel very real. Telling them to ‘stop worrying’ will work as well as telling someone to ‘stop breathing’. Instead, acknowledge the worry and suggest putting a limit on whatever the safety behaviours are, whether it’s checking, asking, washing. This is a way to show that you’re on their team, and to help bring a sense of calm back to their world.
13. Rocketing to the worst case scenario.An anxious mind tends to always on guard for possible danger. This can drive a tendency to leap to the worst case scenario in a single, almighty, bound. When this happens, people can come across as negative, but it’s more about being careful and wanting to avoid trouble down the track. 
14. Difficulty sleeping.Anxiety loves showing up when there’s nothing else to compete with it for air time. The early hours of the morning are prime time. We all shift between sleep cycles, but when sleep works as it should, we quickly put ourselves back to sleep again. If anxious thoughts find their way in, that gentle stirring can become a wide-eyed awakening that can persist for hours, breathing life into worrying thoughts along the way. A lack of sleep can make even the nicest of humans tense, irritable or cranky. Sometimes a bad sleep is just a bad sleep. And sometimes it’s the work of an anxious mind.
15. Physical pain.Anxiety can be physically painful. Even though anxiety does some of its best work in the head, it’s a physiological response that can create painful symptoms. When the brain senses a threat (real or imagined – it doesn’t care) it activates the fight or flight response by surging the body with a chemical cocktail made up of hormones and adrenaline. This is a very normal, healthy response that happens in all of us from time to time. It’s designed to ready the body to deal with the possible threat by making it faster, stronger, more powerful and more alert. When there is no need to run or fight, there is nothing to burn these chemicals that are surging through the body, so they build up. This creates the physical symptoms of anxiety, some of which can be painful. These can include a tightening around the chest, a racy heart, headaches, nausea, muscle tension, tummy aches, a dry mouth. 
16. They seem forgetful, scattered, inattentive, distracted.If someone seems forgetful, scattered, or inattentive, anxiety might be the culprit. We can all be a bit like this sometimes, but the clue lies in the regularity or intensity of the distractedness. Anxiety has a way of dominating head space with all sorts of thoughts and worries. This can skittle someone’s focus and steer attention away from the present. Someone who is feeling anxious, might have trouble focusing on you or the conversation, despite the most heartfelt desire to be fully present with you.
17. Habits that seem unusual, or usual things done in an unusual way.People sometimes develop habits as a way of self-soothing during times of anxiety. These habits might not always make sense when you’re looking from the outside in, but they don’t need to. The main thing to understand is that for whatever reason, they make anxiety feel smaller for a while. Anxiety-driven habits might include compulsive behaviours such as washing hands, checking locks, having to do things a certain number of times or in a particular order. They can also be physical, such as nail biting, pulling out hair (trichotillomania) and skin picking (dermatillomania). These symptoms will often escalate with the intensity of the anxiety.

And finally …
Anxiety can also come with an abundance of strengths. Anyone who experiences anxiety would always choose not to have it, but it can also work to shape the person someone is in many ways for the better. People with anxiety will be some of the strongest, most emotionally generous, intelligent, creative, funny, warm and wise people you could meet.
Above all else, know that anxiety isn’t a failure, a disease, a weakness or a deficiency. It’s just another part of being human, and the sometimes beautiful, sometimes messy, sometimes ridiculous art that it is.  We all have things that we struggle with. Ultimately, they are the things that will make us braver, wiser, stronger, more compassionate humans. It’s just the way it seems to work. 
There is nothing to be scared of with anxiety. Nothing at all. Understanding when anxiety might be driving behaviour will help to stop anxiety feeling intrusive, confusing or isolating. One of the greatest feelings in the world is being close to someone who gets us, or who tries to. The truth is, we’re all complex beings with plenty of mystery to our edges. There are few things that feel as wonderfully strengthening and enriching than when someone makes an effort to understand us through our own eyes, from wherever we happen to be.
* This post has been sponsored by Bupa, but the views are the author’s own.
About the Author – Karen Young.Karen has worked as a psychologist in private practice and in educational and organisationalsettings. She has lectured and has extensive experience in the facilitation of personal growth groups. She has an Honours degree in Psychology and Masters in Gestalt Therapy. Karen founded the popular website, Hey Sigmund, after realising the power of solid information. The website attracts millions of readers each year worldwide. Her articles have been translated into a number of languages and her work has been published on various international sites including The Good Men Project, The Huffington Post, The Mighty, and Yahoo Health.

Protect yourself from Burnout by taking time to notice when you’ve done a good job 

It’s hard to like people who boast a lot. But deep down, underneath it all, you and I know something about why they do it. It’s because they feel insecure. 
As I’ve got older, I’ve noticed that people who are good at what they do don’t waste time talking about it.  They just get on with it. They work hard, they invest their lives in helping other people. And, they tend to ask for very little in return. They are, in my view, the salt of the earth. But, while extending kindness to others is key to helping people thrive, it can also lead to compassion-fatigue where you find yourself with nothing left to give.
The good and bad of being productiveBeing productive has many benefits. You get lots done, you’re more organised and you can deliver a better service to your patients and your students. Productivity is active. It’s doing. Its moving your feet or your hands. And when you contribute in these ways, people notice it. They notice, because it impacts them. If you do it well, then it makes their lives better.
But productivity can have a dark-side. When you’re ambitious and you work in public service, there is always something to do. There is always someone else who needs your help and there is often a better way of doing things that hasn’t yet been discovered. When you value productivity, you risk being over-active to the point where you are likely to burnout.
What braggers and non-braggers have in commonYou might think that people who brag a lot and those that never brag are completely different people. And, I think you’d be right in some ways. What they do and how they appear to other people is very different. But, what if, under the surface, the same insecurities that cause some people to show-off are the same insecurities that drive excessive modesty?
Fears of failure are common in my experience. So too are beliefs that “I’m useless” and “I’m inadequate.” And these beliefs can be painful, because you feel ashamed, sad or anxious a lot of the time. And the way people cope with these feelings can be different.  Here are several examples:

• Keep busy running around 
• Take on too many responsibilities 
• Blame self entirely for poor outcomes 
• Downplay professional successes 
• Ignore the value of your efforts 
• Worry and ruminate 
• Avoid jobs 

And, of course, the one I’ve left off the list is….boasting!  Yes, just like the hard-working, modest and focused professional, the person who spends all their time boasting can have the same difficult thoughts and feelings. They are just coping with it differently.
These two groups of people have something to learn from each other. Those that boast a lot would benefit by taking a leaf out of the book of the modest co-worker. If they could learn to tone-down what they say and how often they say it, everyone would appreciate it.
And I believe, that the productive carer and teacher who is always thinking about what else needs to be done, could learn something in return. And that something is to celebrate your professional successes.
What does actual success look like?So, what does a professional success look like? This will vary on your circumstances e.g. job role, environment and level of responsibility. Your job description might provide some clues, but it would make a lot of sense to identify this in your own words.  What does you doing a good job look like? How do you know when you’ve done it?
A professional success is what you set out to do every day when you arrive at work. And, to bring this alive even more and to make it easier, think back to a time in the past when you have felt really energised. Let your mind settle on that sweet-spot, which is a time when you felt like you were doing your job and being deeply fulfilled from it.
It may have been a time when you felt deep pride or joy.  And, it may have been a time when you felt angry or scared, but you did something important and meaningful that made a real difference. The feeling isn’t so important. Its more about finding a memory that you are glad to have. A memory that you wouldn’t want to forget.
When you have chosen something, write it down. And then write down what you think it says about what is most important to you. You are looking for a value, which is a verb or an adverb like caring, supportive, lovingly or courageously. These words represent what you truly value and tell you the kind of person you want to be.
Once you have identified your values, you can use these as a guide to define professional successes. A professional success is when you do something that is consistent with what you value.
Is it still a success when you don’t make any difference to someone’s life?This question goes straight to the heart of the traps professionals often fall into when they evaluate success. Successes are shaped by outcomes e.g. does a patient get better or does a student pass an exam?  These are the successes by which your employer measures things. They are connected to targets they receive from government. And, whilst reducing mortality rates and academic achievement are important goals, a problem occurs when you equate those targets directly with your own professional successes.  They aren’t entirely dependent on your individual actions.
When you care for someone, you can’t control how well they take care of their health. When you teach someone, you can’t control what they learn. Outcomes are dependent on what others do as well. Therefore, it works to measure your own professional success by what YOU do.
How to reasonably measure successWhen it comes to measuring your own successes, there are two things to factor out or ignore. They are what your patient or student does and what your peers think about you. The reason is that you have limited control over these actions. So, why would you judge your own success by what other people do?  It just wouldn’t make sense. And, it wouldn’t be fair.
The two areas that make much more sense are:

1. What you know and understand 
2. Your level of skill 

What you know and understand is created. You create it by investing in study, education and vocational training. You reflect on what you do, how well it works and what might work better. It’s the process of becoming competent and moving into reflective practitioner status.
Your level of skills is determined by how much you’ve practiced and adapted. Knowledge and skill are related. This is sometimes called your declarative knowledge and your procedural knowledge. And, how effective you are being is influenced by the combination of these dimensions.
Allocate some time to noticing your successesThe hope is that when you focus on what you understand and how you can get better, then it will have a stronger influence on people. People will find it helpful and say good things about you. But it is not guaranteed. Sometimes, it won’t work. And it does not help to focus on those as failures.
What works much better is to allocate some time to noticing your professional successes. It doesn’t have to be a long exercise and it doesn’t have to involve telling everyone. But, it is important that you at least notice your successes yourself.
When you are training, it helps to get a balance between ‘not knowing enough’ and noticing when you’ve done a good job. When you neglect to identify examples of when you’ve done something well, not only do you deny yourself the chance to feel pride, you also deny yourself the chance to get better at what you are doing.
When you’ve been in the job a while, your standards get higher. It’s easy to regard what you do every day as ‘nothing special’. You might think “that is what I am supposed to do.” And, so you downplay the success of it. But, if that action is what you are supposed to be doing and it is what you care about, then why not tell yourself ‘well done!’. What have you got to lose?
When you invest in your professional development throughout your career, it protects you against burnout. When you stop learning and developing, you can become stagnant. And when you stop moving forwards, you start going backwards. There is no such thing as standing still.
In this article, you have explored getting a balance. You have explored getting a balance between ‘doing’ and ‘slowing down’. Doing is what makes you better and helps you to make professional successes. Slowing down is what helps you to notice your successes, so you can build on them and revitalise your spirit. When you notice your successes, it shows you that you are on the right path. Try not to dismiss them. It won’t protect you from burnout, but noticing them can save you. Noticing them can help you thrive, which consequently, will helps others to thrive as well.
Thanks for reading this article, which is the 3rd in a series about protecting yourself against burnout. You can read the first article here and the 2nd article here.  I’m taking some time off over the next couple of weeks to re-charge and have some fun. I’ll be back with the next article in this series in early September.
If you’ve enjoyed this article, please leave a comment and share it around.
About Jim Lucas
Jim is the Founder and Managing Director of Openforwards. He is a BABCP Accredited CBT Therapist / Supervisor & a Teaching Fellow at University of Birmingham School of Psychology. 
He writes articles, records podcasts and creates online courses to give you the opportunity to get the knowledge, skills and support to help you feel and cope better.