Living With Anxiety: What It Actually Feels Like

Introduction

Most people who come to see me about anxiety don’t call it anxiety.

They say they’re stressed. That they’ve always been a worrier. That they’re fine, really, just tired, just a bit much at the moment, just not sleeping well.

The word itself has become slightly devalued through overuse, which is a shame, because the thing it describes is specific and it is horrible. So rather than a symptom checklist, here is what it actually feels like, in the hope that somebody reading recognises themselves in it.

What It Actually Feels Like

It arrives in the body first, usually before you have any idea what it’s about. A tightness that sits somewhere between the throat and the stomach. A heart that has decided, for no reason, to go faster. A restlessness in the legs at ten o’clock at night.

Then the mind catches up and supplies a reason, because a mind cannot tolerate a feeling with no story attached. So it hands you the email you sent on Tuesday, or the mole on your shoulder, or a car accident your daughter has not had.

The reason changes. The feeling doesn’t. That is the single most useful thing to notice, because if you solve the Tuesday email, the anxiety simply moves to something else by Thursday.

And there’s the exhaustion, which people rarely mention because it doesn’t sound serious. Vigilance is expensive. Scanning a room, a face, a tone of voice, all day, for a threat that isn’t there, costs as much as real work.

The Version Nobody Notices

A great deal of anxiety is invisible, and in some cases it looks like competence.

The person who replies to everything within four minutes. Who arrives forty minutes early. Who has read the entire agenda and prepared for the question nobody asks. Who is described at work as reliable, thorough, unflappable.

None of that is anxiety, necessarily. But when it’s driven by the certainty that something will go wrong if you stop, it is, and it gets rewarded rather than treated. People in this position often don’t seek help for years, because everything looks fine from outside and they can’t point to anything wrong.

Being praised for the symptom is a genuine obstacle to doing anything about it.

Why Avoidance Makes It Worse

This is the mechanism, and it’s worth understanding, because it explains why anxiety grows over time rather than settling.

You avoid the thing that frightens you. The dinner, the phone call, the highway, the appointment. The relief is instant and enormous.

And that relief is precisely the problem. Your nervous system learns that avoidance worked, which teaches it the thing was genuinely dangerous, which makes it more frightening next time. So the world quietly contracts. First the highway, then driving after dark, then driving.

Nobody chooses this. It happens one sensible decision at a time.

You Are Very Far From Alone

The South African Stress and Health study, which remains the largest survey of its kind here, found anxiety disorders to be the most common class of mental health condition in the country, affecting roughly one in six people over a lifetime.

A more recent national survey put the proportion of adults reporting anxiety symptoms considerably higher again.

The figure that matters more, though, is this one: an estimated 75% of South Africans with a common mental health condition receive no treatment at all. Not because it doesn’t work. Mostly because of cost, distance, waiting lists, and the belief that other people have real problems.

What Anxiety Does to the People Around You

This is the part people feel most ashamed about, so let me say it plainly. Anxiety is not a private condition.

It leaks out as irritability, as needing to control the plan, as asking for reassurance in a loop that never quite satisfies, as an inability to be spontaneous about anything. It becomes an argument in a kitchen about something that is not remotely the subject of the argument.

Partners often become unpaid managers of it, and then feel guilty for resenting that. Both people usually need somewhere to put it.

When It Is Something Else

Anxiety is frequently the presenting complaint and not the whole story.

If it has been a lifelong pattern rather than a recent one, and it sits alongside difficulty with organisation, overwhelm in noisy places, or exhaustion after ordinary social contact, an undiagnosed neurodivergence is worth considering. Anxiety is often what unsupported ADHD or autism looks like from the outside.

If it’s mostly physical, and mostly at night, and it started after something specific happened, the body learned it somewhere and that is a different piece of work.

And teenagers show it differently again, usually as irritability, stomach aches or school refusal rather than as worry they can describe.

A good first session is largely about working out which of these you’re dealing with, because the answer changes the approach.

What Actually Helps

• Approaching the thing you’ve been avoiding, gradually and deliberately. This is the active ingredient in almost every effective anxiety treatment, and it is the opposite of what your instincts will tell you.
• Learning to let a thought be present without arguing with it. Trying to reason your way out of an anxious thought usually feeds it.
• Slow exhalations, longer than the in-breath. Simple, unglamorous, and it works on the physiology rather than the story.
• Sleep and caffeine, in that order. Both are boring and both are doing more than you think.
• Dropping the reassurance loop, gently. Asking a partner to confirm you’re fine works for about ninety seconds and strengthens the habit.
• Movement, because a body that has been braced all day needs somewhere to put that.

When to Get Help

When it’s shaping your decisions rather than just accompanying them. When you’re declining things you’d like to do. When the physical symptoms have sent you to a doctor more than once and the tests keep coming back clear.

SADAG offers free telephonic counselling nationally on 011 234 4837 or 0800 20 50 26, from 8am to 8pm daily. Your GP is a sensible first stop, both for the physical symptoms and for ruling out the things that mimic anxiety, thyroid problems among them.

How Anxiety Therapy Helps

Anxiety therapy isn’t about becoming a calm person. Some of us are not going to be calm people, and that’s a poor target anyway.

The work is about changing your relationship to the feeling, so that it stops making your decisions. That involves understanding what your particular version is doing and what it’s protecting you from, practising approach rather than avoidance in manageable steps, and looking honestly at whatever the vigilance was originally for. It usually turns out to have been for something, once.

Most people notice the change first in what they’re willing to do, rather than in how they feel.

Conclusion

If you’ve read this far, you probably recognised something.

The thing worth knowing is that anxiety responds well to treatment, and it responds better the earlier you go. Most people wait years, usually because it hasn’t reached the standard of a real problem yet.

That standard doesn’t exist. I work with adults and teenagers in Claremont and across the southern suburbs, and online throughout South Africa.

About Me

I am Paula Marais, a registered specialist wellness counsellor based in Claremont, Cape Town. I hold an Honours in Psychology (Unisa) and a Master’s in Creative Writing (UCT), and I am registered with the Association for Supportive Counsellors and Holistic Practitioners (ASCHP).

I see adults, teenagers and children, in person in Claremont and online across South Africa. Online sessions are equally as effective as in-person sessions.

There is no pressure and no judgment. You can reach me at info@paulamaraistherapy.com or on WhatsApp at 072 633 7661.

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