It begins quietly.
A racing heart.
A tight chest.
A stomach that won’t settle.
Medical tests come back normal — yet the discomfort remains.
For millions of South Africans, anxiety is no longer confined to the mind. It is showing up in the body, loudly and persistently, through what experts describe as psychosomatic symptoms — real, measurable physical reactions driven by emotional strain.
And it’s becoming one of the country’s most overlooked health crises.
WHEN THE BODY SPEAKS WHAT THE MIND CAN’T
According to Abdurahmaan Kenny of Pharma Dynamics, anxiety doesn’t simply stay psychological.
“What starts as emotional strain can quietly become a broader health problem,” he explains.
When stress becomes chronic, the body’s fight-or-flight response — designed to protect us in short bursts — remains permanently switched on. Over time, this state of high alert begins to wear the body down.
The result?
A cascade of physical symptoms that can disrupt daily life, productivity, and overall wellbeing.
A GROWING PUBLIC HEALTH CONCERN
Globally, anxiety disorders affect an estimated 4.4% of people, making them among the most common mental health conditions.
In South Africa, the reality is even more striking:
📊 Approximately 15.8% of adults experience anxiety disorders during their lifetime
This prevalence is shaped by complex social factors — including poverty, unemployment, trauma, violence, and the long shadow of historical inequality. Women are also more likely to experience anxiety, reflecting global trends.
One of the most common forms is Generalised Anxiety Disorder (GAD) — marked by persistent, excessive worry lasting at least six months, often accompanied by physical symptoms like muscle tension, sleep disturbances, and irritability.
THE PHYSICAL FACE OF ANXIETY
These symptoms are not imagined.
They are the body’s biological response to prolonged stress.
Common psychosomatic effects include:
- Muscle tension, trembling, jaw clenching
- Headaches and migraines
- Digestive issues (nausea, diarrhoea, constipation)
- Chronic fatigue and restlessness
- Sleep disturbances
- Sweating, rapid heartbeat, shortness of breath
“These reactions are short-term protective mechanisms,” Kenny explains, “but when anxiety persists, they become dysfunctional.”
TREATMENT: BALANCING SCIENCE AND PATIENCE
Managing anxiety effectively often requires a multi-layered approach.
In clinical settings, first-line treatments typically include antidepressants such as SSRIs and SNRIs — widely recommended due to their strong evidence base and favourable benefit-risk profile.
These medications work by regulating neurotransmitters linked to mood and stress.
However, there’s a challenge:
⏳ Relief can take 2 to 6 weeks
For many patients, this waiting period can be difficult — especially when physical symptoms remain intense.
To bridge the gap, healthcare providers may introduce short-term treatments. Some fast-acting options can cause drowsiness or slowed reactions, while newer non-benzodiazepine alternatives aim to regulate stress without the same risks of sedation or dependency.
The key, Kenny emphasises, is individualised care — tailored to each patient’s symptoms, health profile, and level of functional impact.
EVERYDAY STRATEGIES THAT MAKE A DIFFERENCE
While professional guidance is essential, there are practical, evidence-based steps individuals can take to manage anxiety and its physical effects:
✔ Regular exercise to reduce stress hormones and improve mood
✔ Mindfulness and breathing techniques to calm the nervous system
✔ Limiting caffeine and nicotine to reduce symptom intensity
✔ Prioritising sleep to stabilise emotional and physical health
✔ Maintaining social connections and routines for resilience
✔ Psychotherapy, particularly cognitive behavioural therapy, for long-term management
These small, consistent actions can significantly reduce the intensity of both emotional and physical symptoms.
BREAKING THE SILENCE
Despite its prevalence, anxiety remains widely under-treated.
According to the World Health Organization, only one in four people with an anxiety disorder receives any form of treatment globally.
The reasons are clear:
Stigma.
Lack of awareness.
Misunderstanding the condition.
“Understanding that anxiety has both emotional and physical components is the first step,” says Kenny.
Because when people recognise that their symptoms are real — and treatable — they are far more likely to seek help.
FINAL WORD
Anxiety doesn’t always look like panic.
Sometimes, it looks like exhaustion.
Like pain with no diagnosis.
Like a body carrying what the mind cannot release.
But it is not invisible.
And it is not untreatable.
In acknowledging anxiety — both its emotional weight and physical impact — South Africa takes a critical step toward healing.
Because the more we talk about it…
the less power it has in silence.
