Anxiety is the most common mental health disorder in Australia, which means it's in our workplaces too.
Sometimes people's anxiety has nothing to do with their work but it affects their ability to do their job.
Other times, work causes anxiety.
The cost of all this poor mental health is billions of dollars in lost productivity, absenteeism and income support payments.
So what can you do if you or your staff have anxiety?
Focus on what's important to you
Emmanuel Georgoudis has lived with anxiety for years.
"I have had anxiety several times in my life and I think the thing that I've realised is that it's OK to not be OK."
Mr Georgoudis is a customer support centre manager for machinery hire company Coates, in Sydney.
Last year's lockdown brought up a lot of his anxiety as he tried to manage his team working from home.
"There'll be times where you've got no motivation, you don't want to really talk to anybody, you've got this overwhelming feeling in your stomach and it just doesn't go away," he told ABC News.
When those feelings take over, Mr Georgoudis calms himself with his breathing.
"Over the years of having it, I've kind of picked up a few techniques to just try to help me deal with it.
Then he focuses on his family.
"After that box breathing technique, it might be a phone call, a chat to my wife or a text, or even just looking at a photo of my beautiful son.
"I just try to go to a happy place, reset and just breathe it out."
He says he's then able to get back to work.
Know your non-negotiables
Sunny Bahuguna also connects with his family when his anxiety becomes overwhelming.
As the oldest son in a family raised by a single mother, he says he takes on a lot of feelings of responsibility.
"There are a lot of pressures, I think, internally, that get created, just your sense of responsibility in the house, your responsibility to provide as well.
"Having that in general, I think, especially being a man in a South Asian household, that needs to sort of provide and protect for your family."
Mr Bahuguna started his job as a financial services consultant at global accounting firm EY as the pandemic hit.
He found adjusting to a new job, while working in isolation, exacerbated his anxiety.
"There were a lot of different things happening at one time.
"Firstly, you're kind of by yourself for a lot of the time working from home, secondly, you don't get the chance to interact or have that sense of community that you would at a workplace, and thirdly, I think just that sense of connection.
"Connection is one of my biggest values and I think having that omitted from the last few years has been a big part of that anxiety and that feeling of sort of unease."
But Mr Bahuguna has been managing his anxiety for years and has figured out how to keep it at bay.
"The biggest lesson I've got, and I think it's kind of come through with trial and error, is knowing what the non-negotiables are in your life.
"Taking that time away from the tools to have time with family, have dinner, is a big component of that and I see it in the smiles of my younger brother or mum, just being able to spend time at home and have dinner with them, is a big part of what I value."
Mental health in your inbox
Get a selection of the best mental health content from across the ABC by subscribing to our monthly newsletter
What's the cost?
The Productivity Commission estimates all mental illness, not just anxiety, costs the economy between $200 billion and $220 billion a year.
"That's almost 10 per cent of our national GDP," explained economist and director of the Centre for Future Work, Jim Stanford.
Dr Stanford's research shows workplaces cause between $15.8 and $17.4 billion dollars of that cost.
"Anxiety is only a part of that, but a significant part, so we know absolutely, we're looking at a cost of tens of billions of dollars from people who are inhibited by anxiety from joining the labour market, finding and keeping work, attending work, and doing the job to the best of their abilities."
Dr Stanford has analysed the Productivity Commission numbers, as well as his own studies, and estimates absenteeism costs the economy $9.6 billion a year, while presenteeism costs $7 billion.
"Presenteeism means you showed up at work but you really weren't capable of doing your job — you're not able to produce the output and quantity or quality that you would normally be expected to do because you're paralysed by anxiety or stress or other mental health issues."
He estimates poor mental health also limits people from working as much as they could if they were otherwise mentally fit and that lower participation costs the economy $12.2 to $22.5 billion dollars a year on lost productivity that would otherwise be generated.
He also estimates about $11 billion is paid in income support payments to people who can't work because of poor mental health.
The Australian Mental Health Index, a monitor of the mental wellbeing of Australians by Lifeworks, an employee support consultancy firm, shows our mental wellbeing is falling.
Anything below zero indicates a decline in mental health. In January this year, it was -11.9.
The figure for just anxiety is worse, at -12.8 points.
At -12.9, managers have a poorer reading of mental health than people who are not managers, which was -11.3.
It may come as little surprise that household incomes also play a big part in a person's mental wellbeing.
Households on less than $30,000 a year recorded a reading of -22.6, while those with more than $150,000 coming in were -5.6 points.
What can businesses do?
Mr Georgoudis's employer, Coates, implemented check-in chats with all of its employers when it saw the impact COVID was having on its workforce.
It wants to keep those talks going so has recently started working with the not-for-profit group TIACS (This is a Conversation Starter) to help facilitate ongoing chats.
"Which has done a fantastic job in really starting to break down some of the barriers, in particular in blue-collar workforces, around dealing with mental health and anxiety issues," said Coates' Executive General Manager of People & Safety, Elise Manns.
"We're really pleased that we can partner with them and continue to encourage their work at Coates and in other parts of heavy industry."
Ms Manns said ensuring a happy workforce also makes good business sense.
"There's enormous benefits for us — it can reduce absenteeism, it helps us connect with our people, I'm sure it helps us retain them as well, and it helps in their day-to-day productivity at work.
Her advice to other business owners: it takes time.
"It's not something that you can just put a few emails out and a few posters on the wall and think it's going to happen.
"You have to keep talking about it. You have to keep making it safe for people to talk about things."
COVID also helped EY cement the importance of keeping its workforce mentally well.
"Our people's wellbeing and brains are central to our business, so we need to pay attention regardless of where that stress and pressure is coming from," said EY Oceania People, Place & Culture Leader, Kate Hillman.
"We have over 100 trained mental health first aiders but, you know, that's for when we get to a point where it's really necessary.
The company has introduced another 10 sick days specifically for COVID, adding to the 10 that workers were already entitled to.
Last year, it also introduced four company-wide days off a year.
"Our unplugged days are a recognition that everybody's worked extremely hard over the last couple of years without much of an opportunity for a break," explained Ms Hillman.
"They're a day where everybody takes the day off and we're all offline. That means we can all take a genuine break and you're not worried about the phone ringing for something urgent or looking forward to coming back to a large amount of unread emails."
The way we employ people
Of course, not everyone works for a big business that can afford counselling services and additional days off.
"We do live in an economy where the old idea of having a permanent full-time job with normal entitlements like an annual vacation and sick leave — that seems to be very rare these days," said Dr Stanford.
Cafe workers, retail staff, cleaners and food delivery drivers are just some of the roles where people are less likely to be afforded the same care and consideration as those who work in an office.
"Maybe half of Australian workers now have a job that doesn't have those characteristics, where they're working from one short term contract to another, or they're working casual hours, or they're working in a gig type setting where they don't know how much they're going to make," added Dr Stanford.
He said employers have an obligation to care for the mental wellbeing of their staff and is calling for all workers to be afforded more job security, personal leave and care.
"The pay-off of helping people get over anxiety would be enormous for them, first and foremost, and their families, but also for employers and for the economy."
