Stress, anxiety and anxiety disorders
- Stress is the body's response to a demand or threat, such as a deadline, money worries or a family crisis.
- Anxiety is a feeling of worry or fear, often about what might happen.
- An anxiety disorder is when anxiety is out of proportion to the situation, persists (often for several months), and affects work, relationships or everyday activities.
How common is it?
According to the World Health Organization, anxiety disorders affected about 470 million people worldwide in 2023. They are more common in women and often begin in childhood or adolescence.
Common symptoms
In the mind:
- excessive worry that's hard to control;
- a sense of dread or that something bad will happen;
- trouble concentrating or making decisions;
- irritability and restlessness.
In the body:
- a racing or pounding heart;
- sweating, trembling or shaking;
- shortness of breath or a tight chest;
- nausea or stomach upset;
- muscle tension;
- trouble sleeping.
People often avoid situations that trigger anxiety, which can make it worse over time.
Types of anxiety disorders
| Type | Main feature |
|---|---|
| Generalised anxiety disorder | Persistent, excessive worry about many everyday things |
| Panic disorder | Repeated panic attacks and fear of having more |
| Social anxiety disorder | Intense fear of embarrassment, judgement or rejection in social situations |
| Agoraphobia | Fear and avoidance of situations where escape might be hard |
| Specific phobias | Intense fear of particular objects or situations |
| Separation anxiety disorder | Excessive fear of separation from people you are close to |
People can have more than one, and anxiety often occurs alongside depression.
Panic attack or heart attack?
Panic attacks can cause chest pain, a racing heart and breathlessness, which can feel frightening. If you have chest pain and aren't sure of the cause, especially for the first time, treat it as an emergency and call 10177 or 112. It's always better to be checked.
What helps?
Self-care steps recommended by the WHO
- Avoid or cut down on alcohol, and avoid recreational drugs; both can worsen anxiety.
- Exercise regularly, even a short walk.
- Keep regular sleeping and eating habits.
- Practise relaxation, such as slow breathing or progressive muscle relaxation.
- Try mindfulness meditation, even a few minutes a day.
- Limit caffeine, which can mimic or worsen anxiety symptoms.
- Stay connected with people you trust.
Professional treatment
- Psychological therapy is the core treatment. CBT, including gradual exposure to feared situations, has the strongest evidence. It can be delivered one-to-one, in groups, online or through guided self-help.
- Medicines can help some adults, particularly certain antidepressants. Your doctor will discuss benefits and side effects with you.
- Sedative medicines that can cause dependence are generally not recommended for long-term use.
Rule out other causes
A doctor may check for physical causes that mimic anxiety, such as an overactive thyroid, heart rhythm problems, side effects of medicines, or too much caffeine or other stimulants.
When to see a doctor
- Worry or fear is affecting your work, relationships, sleep or daily life.
- You're avoiding places or situations because of anxiety.
- You're having panic attacks.
- You're using alcohol or other substances to cope.
- You also feel low or hopeless.
Get help now
If you are thinking about harming yourself or ending your life, or are worried about someone else, contact emergency services on 10177 or 112, go to your nearest emergency unit, or contact a crisis line. Tell someone you trust.
The South African Depression and Anxiety Group (SADAG) Suicide Crisis Helpline is 0800 567 567.
Frequently asked questions
Is anxiety a sign of weakness?
No. It is a common health condition, and seeking help is a sensible, practical step.
Will I need medication forever?
Not necessarily. Many people improve with therapy alone, and medicines are often used for a period and then reviewed.
Can anxiety cause physical symptoms?
Yes. Anxiety commonly causes a racing heart, stomach upset, tension and poor sleep, but new physical symptoms should still be checked.
Can exercise really help?
Yes. Regular physical activity reduces anxiety symptoms for many people and supports sleep and mood.
References
- World Health Organization. Anxiety disorders fact sheet. https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
- NICE. Generalised anxiety disorder and panic disorder in adults: management (CG113).
This article is for general educational purposes only, like a health newsletter. It is not medical advice, diagnosis or treatment, and reading it does not create a doctor and patient relationship. Please speak to your own doctor about your situation. In an emergency, call 10177 or 112, or go to your nearest emergency unit.