Your heart is pounding. Your stomach is in knots. Your shoulders feel locked in tension, and exhaustion hangs over you, yet medical tests show nothing physically wrong. For millions of South Africans, anxiety doesn’t stay confined to the mind; it shows up powerfully in the body as psychosomatic symptoms, with very real physical sensations that can include chest discomfort, headaches, digestive upset, and chronic fatigue.
These mind‑body interactions are more than discomforting left unmanaged; anxiety can significantly impair daily functioning, reduce productivity at work, and erode overall quality of life, while increasing the risk of additional health complications.
“What starts as emotional strain can quietly become a broader health problem,” says Abdurahmaan Kenny, Product Manager: Branded Generics for Pharma Dynamics. “When stress becomes chronic, the nervous system remains on high alert. Over time, that constant ‘fight-or-flight’ response starts to wear the body down.”
Anxiety is a growing public health concern
Globally, an estimated 4.4 % of people currently live with an anxiety disorder, ranking among the most common mental health conditions worldwide. In South Africa, anxiety disorders are similarly prevalent. A national survey found that anxiety disorders were the most common class of lifetime mental health conditions, affecting around 15.8 % of adults.
This is brought on by several factors, including poverty, unemployment, HIV/AIDS, a history of political and social upheaval, and trauma from exposure to violence and abuse. Women are also more likely than men to experience these conditions, consistent with global patterns.
One of the most common clinical forms is Generalised Anxiety Disorder (GAD), a condition characterised by excessive, persistent worry occurring more days than not for at least six months, often accompanied by physical symptoms, such as muscle tension, sleep disturbance, and irritability.
How anxiety shows up in the body
Psychosomatic symptoms are physical signs of anxiety that are real and measurable.
They can include:
- Muscle tension, trembling, and jaw clenching
- Headaches or migraines
- Upset stomach, nausea, diarrhoea, or constipation
- Fatigue, restlessness, and sleep difficulty
- Sweating, rapid heart rate, or shortness of breath
These physical reactions aren’t imagined; they’re the body’s stress response, short‑term protective mechanisms that become dysfunctional when anxiety is persistent. While understanding these physiological responses is important, managing anxiety effectively often requires a comprehensive approach. This may include psychotherapy and medical treatment options tailored to the individual’s needs.
Medical treatment options
In clinical practice, first-line antidepressant therapies for anxiety, including SSRIs and SNRIs, are widely recommended because of their strong evidence base and favourable benefit–risk profile. These medications work by regulating key neurotransmitters involved in mood and stress responses.
However, their effects are not immediate. Relief typically takes two to four weeks, and sometimes up to six, to become fully apparent, leaving some patients struggling with ongoing symptoms that affect daily functioning. That waiting period can be particularly challenging for patients. When physical symptoms, like palpitations or gastrointestinal distress, are severe, patients naturally want faster relief.
During this time, healthcare providers may prescribe short-term adjunctive treatments to bridge the gap. Some fast-acting agents, while effective, can cause central nervous system depression, including drowsiness, dizziness, and slowed reactions.
Other non-benzodiazepine options work differently, helping regulate the stress response without the same level of sedation or dependency risk. Treatment decisions must be individualised, and a healthcare professional will consider symptom severity, functional impairment, and overall health profile before recommending the most appropriate 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: Practicing 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.
Breaking the silence around anxiety
Despite its high prevalence, anxiety remains under‑treated globally. Stigma and lack of awareness are major barriers, but understanding that anxiety has both emotional and physical components is the first step toward seeking help. The more we normalise conversations about anxiety, the more likely people are to seek appropriate support.
