Anxiety is increasingly emerging as a major public health concern in South Africa, not only for its psychological impact but also for the way it manifests physically in millions of people.
For many, the experience is deeply unsettling. A racing heart, persistent headaches, digestive problems and overwhelming fatigue often send individuals from one medical consultation to another, searching for answers. Yet, in many cases, no clear physical illness is found.
Chronic stress
These symptoms are not imagined. They are psychosomatic, real, measurable physical responses driven by anxiety.
“What starts as emotional strain can quietly evolve into a broader health problem,” explains Abdurahmaan Kenny, product manager: Branded Generics at Pharma Dynamics.
“When stress becomes chronic, the nervous system stays in a constant state of high alert, and over time, that sustained ‘fight-or-flight’ response begins to wear the body down.”
Prevalence of anxiety disorder
Globally, anxiety disorders affect an estimated 4.4% of the population, making them among the most common mental health conditions. In South Africa, however, the burden is significantly higher.
Research shows that approximately 15.8% of South African adults will experience an anxiety disorder in their lifetime, the highest prevalence among mental health conditions in the country.
This rise is driven by a complex mix of socio-economic and historical factors, including high unemployment, poverty, the ongoing impact of HIV/AIDS, and widespread exposure to trauma, violence and social instability. Women are also more likely to be affected, reflecting global patterns.
Generalised Anxiety Disorder
One of the most common forms is Generalised Anxiety Disorder (GAD), characterised by persistent and excessive worry lasting for at least six months, often accompanied by physical symptoms such as muscle tension, irritability and sleep disturbances.
The public health risk lies not only in how widespread anxiety is but also in how it presents.
Psychosomatic symptoms, the physical expression of psychological distress, can significantly impair daily functioning and quality of life. These include:
- Chronic muscle tension and body pain
- Frequent headaches or migraines
- Digestive disturbances, including nausea and bowel irregularities
- Persistent fatigue and sleep disruption
- Rapid heart rate, sweating and shortness of breath
“These symptoms are part of the body’s natural stress response,” Kenny explains. “They are protective in the short term, but when anxiety becomes chronic, they become harmful and disruptive.”
Left unmanaged, these physical effects can increase healthcare utilisation, reduce productivity and place additional strain on an already burdened healthcare system, reinforcing anxiety’s status as a growing public health issue.
Managing anxiety effectively requires a comprehensive and individualised approach, often combining psychotherapy with medication.
First-line treatments typically include SSRIs and SNRIs, which regulate neurotransmitters involved in mood and stress. However, these medications can take between two to six weeks to provide noticeable relief.
“That delay can be incredibly difficult for patients, especially when physical symptoms are severe,” says Kenny. “People are often looking for immediate relief from distressing symptoms like palpitations or gastrointestinal discomfort.”
During this period, healthcare providers may prescribe short-term treatments to help manage symptoms. While some fast-acting options can cause drowsiness and slowed reactions, newer non-benzodiazepine alternatives aim to ease symptoms with a lower risk of sedation or dependency.
As anxiety continues to rise, experts stress the importance of recognising it as both a mental and physical health condition, one that requires early intervention and holistic care.
“It’s essential that treatment is tailored to the individual. Healthcare professionals consider symptom severity, functional impact and overall health when determining the best approach.”
Everyday tips to help manage anxiety
While clinical treatment should always be guided by a healthcare professional, individuals can adopt evidence‑based strategies that help reduce anxiety and its psychosomatic impact:
- Regular physical activity: Exercise reduces the physiological stress response and releases endorphins, which can improve mood and decrease muscle tension.
- Mindfulness and breathing techniques: Practising mindful breathing can calm the nervous system and reduce physical symptoms of anxiety.
- Limiting stimulants: Reducing caffeine and nicotine intake may help lower symptom severity.
- Adequate sleep: Poor sleep can heighten anxiety.
- Social support and routine: Maintaining social connections and predictable daily routines can build psychological resilience against stress.
- Professional guidance: Psychotherapy, particularly cognitive behavioural therapy, is proven effective and can be used alone or in combination with medication.
