How to manage and reduce stress

Are you feeling overwhelmed by stress? You don't have to be. Although times are hard, understanding stress and learning how to manage it can help you reduce your stress levels and regain control of your life.

Wednesday, November 7 2018

Stress may be affecting your health, even though you don’t realise it. Stress is a physiological or psychological reaction to an external stimulus which helps us to act in threatening situations. But when stress is prolonged, it can have a negative impact on both our physical and mental health, leading to burnout, depression, panic and even illness.1

Signs and symptoms of stress

Psychoneuroimmunology (PNI) research suggests that chronic stress plays a role in worsening certain mood disorders. These include depression, anxiety, bipolar mood disorder, cognitive problems and personality disorders.2

Signs and symptoms of stress include the following:

  • Sleeping problems and fatigue
  • Appetite changes
  • Feelings of worthlessness, helplessness, hopelessness
  • Inability to make decisions or concentrate
  • Withdrawal from activities that usually bring pleasure
  • Agitation, restlessness and irritability
  • Being short-tempered
  • Intense feelings of anxiety
  • Excessive defensiveness and anger

The causes of stress
“Stress is a normal part of life,” says Fathima Khatib, clinical psychologist and member of the multi-disciplinary team at the Centre of Psychotherapy Excellence (COPE), Akeso Umhlanga. “A healthy amount of stress can motivate you to achieve certain goals. But when stress becomes uncontrollable, it can interfere in your life and have harmful effects. It’s important to be aware of some of the causes of stress to successfully regulate it.”

People have different stress triggers, she adds. “For many, work problems, relationship difficulties, financial difficulties, illness and death or loss of a loved one can cause significant stress. Men and women also have different stress triggers. For example, women tend to feel more stressed over hate crimes and war than their male counterparts. Technological advances have also led to people spending less time interacting with family members and friends, and more time working from home. This may lead to an increase in stress levels.”

Competitive, ambitious, impatient and aggressive personalities are more prone to stress and stress-related illnesses.3 People who have affective traits such as low resilience to distressing situations, low self-esteem, low self-efficacy and high levels of isolating themselves from others are also more likely to feel stressed.4
External resources such as community or family support, financial and social support, and internal resources such as experience, courage and wisdom also play a role in whether some are more prone to stress than others. 

Stress in South Africa
Zinhle Mkhize, occupational therapist at COPE, Akeso Umhlanga, says traumatic events such as domestic violence, theft, hijacking, rape and murder – experienced personally and via the media – are the biggest causes of stress in South Africa.5 Work-related problems, unemployment and family-related issues also feature as notable causes of stress.6 

An international study indicated chronic stress to be associated with the socioeconomic status of a country’s population. Lower socioeconomic status is associated with important social and environmental conditions that contribute to chronic stress, including increased population (crowding), noise pollution, crime and discrimination.7

Although there is a dearth of research on the relationship between social contexts and mental health in South Africa, our population demonstrates rates of mental illness at or above levels elsewhere in the developing world.8
A local study, ‘Top Ten Things South Africans Stress About’, indicated that just 33% of South Africans believe the nation is on the right track. This study, based on more than 21 000 surveys conducted amongst persons aged 18 to 64, indicated financial and political corruption as a global concern, with 35% listing it as a major concern. Other concerns included unemployment (57%) and crime and violence (58%).9 

Stress becomes a health risk when it is chronic and leads to a withdrawal from everyday life. Often, physical symptoms should be an indicator to seek help.10 Chronic stress can actually lead to structural changes in the brain, which can increase a person’s vulnerability to mental illnesses.11,12 The development of diseases such as cardiovascular dysfunction, diabetes, cancer and autoimmune syndromes have been linked to chronic stress. Stress can also have an impact on mental health, leading to depression and anxiety.13

Ways to manage stress14

  • Take a break from the stressor. It may seem difficult to get away from work, personal and financial responsibilities. Give yourself permission to step away, do something else which can help you develop a new point of view. Have lunch away from your work desk. It’s important not to ignore your stress triggers (those bills have to be paid sometime), but even just 20-minutes to take care of yourself is helpful.
  • Exercise. Research has continuously highlighted how exercise benefits your mind as much as your body. We keep hearing about the long-term benefits of a regular exercise routine. But even a 20-minute walk, run, swim or dance session in the midst of a stressful time can have an immediate impact.
  • Laugh a little. Neuroscience has investigated how our brains are interconnected with emotions and facial expressions. Therefore, when we experience stress, our face would hold a lot of the stress. The reverse can also be true; laughs can help relieve some of that tension and improve the situation.
  • Get social support. Connect with those who are close to you. Sharing your thoughts with others relieves the burden. Ensure that it is someone who you trust and feel validated by.
  • Take meditating moments. Being present in the moment, the here-and-now, reduces stress. Prayer or meditation for example assists the mind and body to achieve a relaxed state. Mindfulness can help people open their mind to other perspectives, develop self-compassion, forgiveness and gratitude.

When and how to seek help and treatment
“We advise seeking help for stress when it starts to affect your ability to function in everyday life,” says Jonelle du Plessis, clinical psychologist and Head of COPE at Akeso Umhlanga. “If your appetite or ability to sleep is affected, if you are experiencing anxiety and a generalised feeling of being out of control, talk with your healthcare professional. They can offer support and give you some practical lifestyle tips on how to manage stress without letting it take over your life. There is no need to suffer alone.”


  • Schönfeld, P., Brailovskaia, J., Bieda, A., Zhang, X. and Margraf, J. (2016). The effects of daily stress on positive and negative mental health: Mediation through self-efficacy. International Journal of Clinical and Health Psychology, [online] 16(1), pp.1-10. Available from:,day17/02/2016
  • Mills, H., Reiss, N. and Dombeck, M. (2018). Mental and Emotional Impact Of Stress. [online] Available from:
  • McLeod, S. A. (2017). Type A personality. Available from:
  • Lecic-Tosevski, D., Vukovic, O., & Stepanovic, J. (2011). Stress and personality. Psychiatriki, 22(4), 290-297.
  • Kaminer, D., & Eagle. G. (2001).  Traumatic Stress in South Africa.  Wits University Press: Johannesburg.
  • IOL. (2017). Work is the biggest cause of stress. Retrieved from
  • Baum, A., Garofalo, J. P., & Yali, A. M. (1999). Socioeconomic status and chronic stress: does stress account for SES effects on health? Annals of the New York Academy of Sciences, 896(1), 131-144.
  • Hamad, R., Fernald, L. C. H., Karlan, D. S., & Zinman, J. (2008). Social and economic correlates of depressive symptoms and perceived stress in South African adults. Journal of Epidemiology & Community Health, 62(6), 538-544.
  • Central, C., (2018). Top 10 things that South Africans stress about. Alberton Record. Available from on 22 October 2018.
  • Hendal, A. 2009. When Does Stress Become a Dangerous Health Concern. Available from: Accessed 22/10/2018.
  • Lucassen, P. J., Pruessner, J., Sousa, N., Almeida, O. F., Van Dam, A. M., Rajkowska, G., ... & Czéh, B. (2014). Neuropathology of stress. Acta neuropathologica, 127(1), 109-135.
  • Blix, E., Perski, A., Berglund, H., & Savic, I. (2013). Long-term occupational stress is associated with regional reductions in brain tissue volumes. PLoS One, 8(6), e64065.
  • Mariotti, A. (2015). The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future science OA, 1(3).
  • American Psychological Association. Five tips to help manage stress. Available from:

About the Akeso Group
Akeso is a group of private in-patient psychiatric hospitals, and is part of the Netcare Group. Akeso provides individual, integrated and family-oriented treatment in specialised in-patient treatment facilities, for a range of psychiatric, psychological and addictive conditions.
Please visit, email, or contact us on 011 301 0369 for further information. In the event of a psychological crisis, please call 0861 435 787 for assistance.