Anxiety disorders on the rise

Posted on 17 August 2017

In a world where it’s almost impossible to switch off from the incessant demands of our personal and professional lives, it’s unsurprising that our anxiety levels are often very high. But when everyday anxiety gives way to more serious symptoms, it’s time to consider seeking professional assistance.

One in three South Africans suffers from a mental health disorder, according to the South African Stress and Health Study published in the South African Medical Journal.

‘Anxiety disorders are becoming more prevalent, particularly with our fast-paced lifestyles placing more demands and stress on our work and family life,’ says Nicky Abdinor, a clinical psychologist at Mediclinic Milnerton. ‘Anxiety and depression are often dual diagnoses, and any personal or family history of mental illness can make a person more vulnerable to developing an anxiety disorder down the line.’

Diagnosis can be complicated

It’s not uncommon for those suffering from anxiety disorders to initially be misdiagnosed. ‘Many people suffering from anxiety disorders present first with physical problems before recognising or understanding that they have anxiety,’ says Nicky. These symptoms often include irritable bowel syndrome, heart palpitations and breathing difficulties.

‘Some people experiencing a panic attack go to casualty thinking they’re having a heart attack or stroke because the symptoms can be so severe,’ Nicky adds. ‘Usually after multiple visits to various doctors, it might be discovered that anxiety is either causing or perpetuating the symptoms.’

Compounding the issues that sometimes complicate diagnosis, anxiety disorders often co-exist with other disorders including mood disorders, substance disorders and personality disorders.

‘It’s important to get an accurate diagnosis and to rule out any physical problems before starting a treatment plan of medication and/or therapy,’ says Nicky. ‘A psychologist or psychiatrist uses the DSM-5 [Diagnostic and Statistical Manual of Mental Disorders*] to diagnose an anxiety disorder,’ she explains. The defining symptoms for each mental illness are detailed in the manual. Common anxiety disorders include a generalised anxiety disorder, panic disorder or a phobia.

When to get help

Normal anxiety is a common reaction to stress that motivates us to take action and generally helps us cope with everyday life. It’s used as an appropriate response to a threatening situation ­– for example, getting out of the path of an approaching vehicle.

‘The important distinction to make,’ says Nicky, ‘is when anxiety is “normal” and when it is “abnormal” or in excess, as in the following indicators:

  • An inappropriate response to a situation – there’s no reasonable justification for the high level of anxiety experienced.
  • The intensity and duration of anxiety is so high that the person feels they can’t control it.
  • Anxiety has a significantly negative impact on your general functioning and quality of life.’


Treatment for anxiety disorders can be complex, as the patient generally needs to confront the very situation that makes them anxious.

‘One of the most common coping skills for people who experience high levels of anxiety is avoidance,’ Nicky explains. ‘For example, someone with social anxiety will turn down social invitations. Avoidance only reinforces the anxiety. When it comes to the treatment of anxiety using therapy, many people struggle with compliance as it requires facing the anxiety and working through situations that are usually avoided.

‘The therapist will focus on reducing your avoidance and helping you work on changing the thought patterns that are triggering or worsening the anxiety. This is called cognitive restructuring. For example, instead of thinking “I’m losing control” in a particular situation, you’ll work on changing your thought patterns to “I’m not losing control” or “It’s just anxiety”.

‘The best form of treatment is cognitive-behavioural therapy (CBT), which may be combined with medication depending on the severity of symptoms. Antidepressants are the most effective psychiatric medication, and a person will need to be on them for between 6-12 months or at times longer depending on the psychiatrist’s findings and recommendations,’ Nicky concludes.

Visit for more information and support.

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*Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, published by the American Psychiatric Association in 2013.


Published in Healthy Life

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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