What to do if an employee has anxiety: a practical guide for HR and managers

What to do if an employee has anxiety: the short answer

If an employee tells you they have anxiety, the first thing the company should do is listen without judging, thank them for their trust and not ask for a diagnosis. The second is to agree with that person on one or two specific, temporary adjustments to their work (workload, hours, interruptions) and review them in two weeks. The third is to offer a fast, confidential route to professional help, such as the psychologist of an Employee Assistance Programme (EAP) or the occupational health service, rather than expecting the manager to act as a therapist.

That is the whole sequence. The rest of this article explains how to carry it out well: legal limits, the first conversation, adjustments that work and when the problem stops being an individual one.

The scale of the issue is not small. The World Health Organization estimates that anxiety and depression cost the global economy around one trillion US dollars a year in lost productivity, and in Spain anxiety disorders are the most common mental health problem among adults according to the National Health Survey. In any workforce of a certain size there are people with anxiety right now, whether they say so or not. When one of them does say so, it is good news: there is trust, and there is still time to act.

What the company can and cannot do: the limits worth knowing

Four limits every HR lead and every manager should be clear about:

The company cannot demand a diagnosis. Health data is a special category protected by the General Data Protection Regulation (Article 9). The employee may share it voluntarily but is not obliged to, and sick notes do not include the diagnosis. What the company can and should ask is what the person needs in order to work well.
Health surveillance is voluntary and confidential. Under Article 22 of Spain’s Law 31/1995 on the Prevention of Occupational Risks, medical examinations are voluntary except for a few defined cases, and the company only receives the fitness-for-work conclusion, never the clinical content.
The company does have a duty of protection. Article 14 of the same law requires it to guarantee the health and safety of its workforce, and Article 25 requires it to protect workers who are especially sensitive to certain risks. A person with anxiety may fall into that category and need an adaptation of their role.
No reprisals and no labels. Deciding on a transfer, removing responsibilities or holding back a promotion “for their own good” without discussing it with the person is both a human error and a source of labour conflict. Any change must be agreed, temporary and reviewable.

In short: the company does not manage the illness, it manages the job. That distinction simplifies every decision that follows.

How to have the first conversation: guidelines for the manager

How the news is received shapes everything that comes afterwards. These guidelines apply whether the employee raises it spontaneously or the manager, having spotted signs of strain in the team, opens the conversation.

Choose the time and place. A private space, no rush, no screens. If they raise it in a meeting or by message, thank them and suggest talking calmly that day or the next.
Listen more than you talk. Useful questions: “What is proving hardest right now?”, “Is there anything about work that makes it worse?”, “What would help you over the next few weeks?“. Questions that do not help: “Since when?”, “Are you on medication?”, “Is it something at home?“.
Do not minimise or compare. “We are all stressed” or “I went through that too” close the conversation down. Validating is not diagnosing: “I understand you are having a hard time, thank you for telling me” is enough.
Do not promise what you do not control. Not sick leave, not a change of team, not absolute silence if there is a safety risk. What you can promise is discretion, support and a second conversation with a date.
Ask about confidentiality. “Do you want HR to know? Do you want anyone on the team to be aware?“. The decision is theirs, except in situations of risk.
Close with a concrete step. An adjustment, a referral or an appointment in two weeks. The worst thing that can happen after a conversation like this is that nothing happens.

And one idea we repeat to middle managers: the manager is not the therapist. Their job is to create the conditions for the person to work and to access help, not to treat the anxiety.

Which reasonable adjustments work (and which do not)

Anxiety gets worse with uncertainty, sustained overload and constant interruptions. That is why the most effective adjustments are small, specific and predictable:

Clear workload and priorities. Review with the person what is essential this week and what can wait. Often the relief comes from knowing what does not need doing.
Hours and breaks. Flexible start times, short scheduled breaks and respect for the right to disconnect outside working hours.
Partial remote work or a quieter space, not as isolation but as less stimulation for a period.
Exposure. If presenting in public or dealing with difficult clients triggers symptoms, redistribute it temporarily without removing responsibility or status.
Time off for medical appointments or therapy, with no interrogation.

What does not work: offering “a few days off” as the only response, moving the person to another project without consulting them, or quietly reducing their workload without telling them (they will notice and read it as distrust). Every adjustment comes with a review date: after two weeks and then monthly.

Employee with a worried expression in front of a laptop in an open-plan office, an image of the workplace anxiety that HR and managers need to know how to address

When to refer to a professional, and to whom

There is a point where the manager’s support is not enough, and recognising it in time prevents long absences. Refer when:

Symptoms have gone on for more than two or three weeks without improving despite the adjustments.
Repeated short absences, out-of-character errors or sleep problems appear.
There are crises (palpitations, breathlessness, freezing) at the workplace.
The person expresses hopelessness or thoughts of harming themselves. Do not wait: in Spain the Ministry of Health’s 024 line handles suicidal behaviour 24 hours a day, and 112 handles emergencies.

To whom? To the primary care doctor as the gateway to the public system; to the occupational health service if a work-related origin is suspected, because it can assess the role and propose adaptations; and to an accessible, confidential psychologist, which is what an EAP provides. The EAP’s advantage is time: waiting lists in public mental health care are measured in weeks or months, and the longer the first help takes, the more likely the case ends in long-term sick leave.

If there are several cases in the same team, the problem is organisational

One case of anxiety is individual. Three cases in the same department in six months are not. When they repeat, look at the environment: demands, lack of control over the work, leadership, role clarity, conflict. These are the factors measured by the mandatory psychosocial risk assessment; if the last one was done years ago or never led to an action plan, this is the moment to update it.

An aggregated, anonymous wellbeing diagnosis, like those included in beLASAI, gives HR that reading by department without exposing anyone: it makes it possible to tell whether the distress belongs to one person or to a whole unit.

The role of the EAP when an employee has anxiety

An EAP fits this situation at the three key moments:

At the first step, because the employee can speak to a registered psychologist in under 48 hours without the company knowing who consulted or why. That confidentiality is the reason people use it.
In crises, with a 24/7 support line for the moments when distress does not wait for office hours.
In prevention, with wellbeing diagnoses and an aggregated dashboard for HR that shows how the team is evolving without individual data, plus nutrition and exercise advice, which weigh more than you might think on sleep and on regulating anxiety.

For the manager, the EAP also answers the most uncomfortable question of that first conversation: “so what do I offer them now?“. Having a concrete, fast answer changes the tone of the whole exchange.

Frequently asked questions about what to do if an employee has anxiety

Can the company ask an employee whether they have anxiety?

It can ask how they are and what they need in order to work well, but it cannot demand a diagnosis or clinical information: health data is specially protected under the GDPR, and health surveillance is voluntary and confidential (Article 22 of the Law on the Prevention of Occupational Risks).

What should a manager do if an employee tells them they have anxiety?

Listen without judging, thank them for their trust, ask what would help, agree one or two temporary adjustments, offer a confidential route to professional support and set a date for a second conversation. They should not try to treat the anxiety or decide anything about the person without discussing it with them.

What adjustments to the role can the company make for anxiety?

Review workload and priorities, make hours and breaks more flexible, temporarily reduce exposure to whatever triggers the symptoms (presentations, difficult clients), allow partial remote work and time off for therapy. Always agreed, temporary and with a review date.

Is an employee’s anxiety the company’s responsibility?

The company is not responsible for each person’s mental health, but it does have a legal duty to protect its workforce from work-related risks (Articles 14 and 25 of Law 31/1995). If the anxiety is linked to workload, leadership or how work is organised, it must assess those psychosocial risks and act on them.

When should an employee with anxiety be referred to a professional?

When symptoms last more than two or three weeks despite the adjustments, when there are crises at work or repeated absences, and immediately if they express hopelessness or thoughts of harming themselves (024 line and 112). The usual routes are the primary care doctor, the occupational health service and the psychologist of an Employee Assistance Programme.

How does an EAP help an employee with anxiety?

It gives them confidential access to a registered psychologist in under 48 hours and to a 24/7 line, without the company knowing who consults. It shortens the time between the first symptom and the first help, which is decisive for a case to resolve in weeks rather than end in long-term leave, and gives HR aggregated data to act on the causes.

The next step: do not let the next conversation catch you without an answer

An employee saying they have anxiety is an opportunity to get it right, and getting it right is a matter of preparation: clear limits, a well-handled conversation, concrete adjustments and a route to help that does not depend on the manager’s diary. If you want to know how your team is doing today, start with beLASAI’s free workplace health test.

And if you want every person on your payroll to have an Employee Assistance Programme (EAP) with a psychologist within 48 hours, a 24/7 line and an aggregated dashboard for HR, discover all of beLASAI’s services, book a 30-minute demo with our team or write to us. We will show you how it would fit your company.