Anxiety – Normal or Abnormal?

We all know how it feels to experience anxiety. That nagging feeling of apprehension. The butterflies in your stomach. The internal commentary of doubt and need for reassurance.


Anxiety is after all a common reaction to stress. It can motivate us to take action. Normal anxiety helps us to cope with everyday life. It is used as an appropriate response to a threatening situation. For example, it would be a normal and healthy response to be anxious if you were faced with a venomous snake in your path – you would need to flee the situation! It is also normal to be nervous or worry about an upcoming exam – that motivates us to study! The important distinction to make is when anxiety is “normal” and when it is “abnormal” or in excess as shown by the following indicators:

  • When it is an inappropriate response to a situation (there is no justification for the high level of anxiety)
  • The intensity and duration is so high that the person cannot control it
  • When it has a significant negative impact on your general functioning and quality of life


One of the most common coping skills for people who experience high levels of anxiety is avoidance.  For example, someone with social anxiety will turn down social invitations or someone with a phobia of lifts will always take the stairs (even if it means climbing 5 flights of stairs to the office each day). Avoidance only reinforces the anxiety.

In some cases, people self-medicate to limit the physical symptoms of anxiety, mostly using alcohol and prescription medication (such as tranquilizers). These self-medications only mask the symptoms of anxiety and do not treat the anxiety long-term.


Anxiety is future-oriented and most people with anxiety experience intolerance for uncertainty.  They need to know if they will arrive at their destination safely (fear of driving), they need to know if their relationship will continue, or they need to know if they will pass an exam. Excessive anxiety and worry will not make the future more certain, we need to learn to tolerate uncertainty.


The great news is that of all the psychiatric disorders, anxiety has some of the best outcomes for treatment through therapy, medication (anti-depressant or SSRI’s), or a combination of both. Cognitive-Behavioural Therapy (CBT) will help a person learn to control their anxiety rather than let the anxiety control them.

The therapist will focus on reducing your avoidance and helping you work on changing your thought patterns that are triggering or worsening the anxiety. Often we experience normal anxiety (including physical symptoms like increased heart rate or shortness of breath) and our thought patterns become irrational and unhelpful (for example, “I am losing control” or “I am going to die”). Our thoughts only worsen the anxiety. We start to get anxious about being anxious! Cognitive restructuring will help the person change their thought patterns to more rational and helpful thoughts (for example, “I am not losing control” or “It is just anxiety” or “It will go away”).

If you think your anxiety is controlling you, consider consulting your General Practitioner, a Psychiatrist or Psychologist for a thorough assessment and treatment plan. Contact The South African Depression and Anxiety Group (SADAG) for an appropriate referral or more information on their services