Stress, Burnout, Anxiety and Panic Attacks

Negative or Positive Stress and Anxiety ?

Life in Johannesburg is fast paced and stressful.   Some reaction to this is normal and even healthy, in that it can be motivating and create energy, excitement and focus.   It is when it starts to increase and at some point becomes unmanageable, that you need to pay more attention and learn to identify what is happening.

Stress and anxiety in excess can lead to exhaustion, irritability, feelings of overwhelm, even illness when not managed.  Your reactions will then negatively impact your relationships, family life, work, creativity and social life.

 The effects of Optimal Stress and Damaging Stress

STRESS is part of daily life and without it you would flat-line… in other words, you would not be alive!  There is something called your “Optimum Level of Stress”. This is the level at which you are functioning at your best; you feel alive and challenged,  in control, motivated, effective and creative.  Problems become challenges, not difficulties or insurmountable obstacles.  There is healthy motivation for growth and achievement.

Normal worries could form a part of this – when you can manage your worrying, still function well on a daily basis and do not experience significant stress.  You are able to “sit” with the worries, or find realistic solutions to them. They don’t last for long and are limited to a specific, small number of realistic concerns.

However, if you function at this level too long without a break, or the pressure mounts  (“life happens”), your stress levels can start to “cost” you.   You start to pay the price.   You lose mental energy and clarity, wear the body out, get insomnia, become over emotional or over sensitive, irritable, tired, reactive and more miserable.

IN THERAPY, we can explore this together to find out where stress is affecting you, and where it is helpful or harmful to you.   We will try to get a realistic perspective of what is happening for you and then look at how to manage this.  There are also some simple coping techniques that can be learnt to manage basic stress.


When stress starts to increase, and becomes uncomfortable, you can start to experience different forms of anxiety.

Anxiety is a feeling of worry, nervousness, or unease about something with an uncertain outcome.  You may feel sick in your stomach, feel uneasy, have butterflies in your stomach, feel a bit nauseous, shaky, lose confidence and become fearful of different things.  Get tummy aches, headaches or backaches.   A major part of this is feeling out of control.

At this point, your anxiety can significantly disrupt your relationships, work, general activities, or family/social life.

It becomes uncontrollable from time to time, you feel extremely upset and stressed, and you worry about all sorts of things, and expect the worst outcome.

There are very simply two types of anxiety: The one is anxiety that you can associate with a “trigger” or situation or event.   The second may feel like free-floating anxiety – just there all the time (or off and on), and you are not able to connect it with anything specific.

IN THERAPY, we can look at identifying and understanding the anxiety. Anxiety is one of the most unpleasant and scary things to have to live with, whether mild or excessive anxiety.  This will be explored with you, and then once there is some understanding, we can look at how to manage it and/or release it.  In longer term situations where there is no simple solution, therapy can assist you to “hold” and “contain” this anxiety for a period of time, until things change or you are stronger to deal with what is happening.

Panic and Panic Attacks

With severely increasing anxiety, or a major life crisis, or a trauma, anxiety and stress can escalate to feelings of panic.  Panic can feel like the following:

You start to sweat, you feel a bit dizzy or unsteady, your body trembles and you can feel faint. It gets harder to breathe and you feel short of breath, even smothered or like you are starting to choke.

Your heart is racing (heart palpitations) and this can increase, to the point that you fear losing control.  To add to these horrible feelings in the body, you can feel pains or tightness in the chest.   In severe cases, it feels like you may be having a heart attack, or that you may die, or “go crazy”.   During or after the panic attack, you could feel ‘unreal’ or disconnected emotionally, bodily and psychologically.

Once you start to experience “Panic Attacks”,  you can feel really out of control and the whole situation can be really frightening.   At some point, you may get panics attacks –  for fear of having another panic attack.  This is when it is getting very serious.

IN THERAPY, you will learn to identify a panic attack, learn where the triggers come from and then how to manage it. Panic attacks are at the other end of the continuum of anxiety and are frightening and overwhelming. If not treated/ managed, panic attacks can escalate until they get out of control.  A vicious cycle that we can assist to break.


Burnout was once described as the “high cost of achievement”.   I would also add to this “the cost of high and unrealistic expectations and of needing to be and do things perfectly – all the time.”       This is a really common experience for many people, including business men and women, Professionals, parents and even students who are studying really hard and have “too full”‘ lives.

While burnout is not recognized as a formal clinical psychiatric or psychological disorder, there are some similar features between burnout and diagnosable conditions such as depression, anxiety disorders or mood disorders.

Some Burnout Symptoms

  • Depleted Physical Energy:  Getting out of bed to face another day of the same gets more difficult, and you feel tired  most of the time.  Everything starts to take huge effort.
  • Emotional Exhaustion: You feel impatient, moody, inexplicably sad, or just get frustrated more easily than you normally would. You feel like you cannot deal with life as easily as before.
  • Lowered Immunity to Illness: When stress levels are high for a prolonged amount of time, your immune system suffers. This can result in increased susceptibility to colds, flu and other minor illnesses (and sometimes some not so minor ones).
  • Less Investment in Interpersonal Relationships: You may feel like you have less to give, or have less interest in having fun, or just have less patience with people.
  • Increasingly Pessimistic Outlook: It is harder to get excited about life, harder to expect the best, harder to let things roll off your back, and harder to ‘look on the bright side’ in general.
  • Increased Absenteeism and Inefficiency at Work.  This is often the point that you start to make mistakes, and can end  up in a disciplinary process.
  • Burnout can roll over into depression, anxiety and mood disorders, and in fact they can co-exist in extreme situations and over a long period of time.
  • Excessive and chronic burnout can be a pre-curser to more severe illness, such as heart attacks, strokes, high blood pressure, migraines, diabetes.

Some high costs for living a driven and stressful life, of striving for high achievement and perfectionism.

Contact me to see if you are suffering from harmful levels of stress, anxiety, panic attacks and burnout, and to find ways to cope with this – both short and long term.