Anxiety in Eswatini

Effects of high anxiety/stress on health and personal life

• Physical health: Chronic anxiety can cause headaches, muscle tension, chest tightness, upset stomach, fatigue, and a weakened immune response.

• Mental health: Ongoing worry can lead to irritability, trouble concentrating, racing thoughts, sleep problems, and a higher risk of depression or panic symptoms.

• Sleep and energy: Difficulty falling asleep or staying asleep, resulting in daytime tiredness and reduced motivation.

• Relationships and social life: Increased irritability or withdrawal, conflicts with partners, family, and friends, and reduced emotional closeness.

• Work and daily functioning: Impaired focus and decision-making, more mistakes, procrastination, lower productivity, and higher absenteeism or presenteeism.

• Urgent help signs: If you have chest pain, shortness of breath, fainting, severe panic, or thoughts of harming yourself, seek urgent help.

Workplace tip: If anxiety is affecting you at work, talk with a supervisor or HR about supports, and consider digital resources. October offers group sessions, assessments, and content that can help you learn coping skills and track progress. In Eswatini, these kinds of workplace mental health supports can be especially helpful when access to in-person care is limited.

Economic consequences of high anxiety and stress

• Productivity losses: Increased absenteeism and presenteeism reduce output and work quality; anxiety can impair focus and decision-making.
• Higher health and social costs: Greater demand for mental health services, medications, and disability support; higher insurance premiums and public health spending.
• Labor market disruptions: Higher turnover, recruitment and training costs, and skill erosion due to burnout; reduced willingness to take on high-stress roles.
• Demand and investment effects: Cautious consumer spending and lower demand for durable goods; uncertain business outlook dampens investment and slow innovation.
• Macro growth and inequality (Eswatini context): Slower GDP growth and rising inequality; greater impact on informal and low-income workers; burden on public health budgets and social protection; long-term human capital risk if access to care is limited; mitigation through workplace mental health initiatives (e.g., digital group sessions) can help reduce absenteeism and turnover.

Actions Eswatini can take to lower anxiety and stress

• Integrate mental health into primary health care

  • Routine anxiety screening, essential meds in clinics, and training for nurses/community health workers (task-shifting). Use siSwati and English.

• Public awareness and destigmatization

  • Nationwide campaigns with credible messengers (traditional leaders, faith groups, media) in local languages to normalize help-seeking and reduce stigma.

• Strengthen social protection and economic stability

  • Expand cash transfers, housing support, and food security to reduce financial stress and its impact on anxiety.

• School and workplace mental health programs

  • Implement policies and programs for stress management, supervisor training, flexible schedules, and peer support networks.

• Scale up digital psychosocial support

  • Partner with October for group sessions, assessments, and content; deliver via mobile networks, ensure privacy and local language content; pilot and evaluate in both urban and rural areas.

• Policy and leadership commitment (Eswatini-friendly): Create a written mental health policy with clear leadership endorsement, confidentiality protections, and bilingual resources (English and siSwati).

• Confidential mental health support: provide access to confidential services (EAP or equivalent) and digital options like October (digital group sessions, assessments, and content) for employees.

• Workload management and role clarity: conduct regular workload reviews, set realistic deadlines, prevent excessive after-hours work, and ensure clear job expectations.

• Flexible work arrangements and breaks: offer flexible hours or remote options where feasible, encourage regular breaks, and allow mental health days without stigma.

• Manager training and peer support: train managers to recognize anxiety, carry out supportive check-ins, and adjust tasks; establish lightweight peer support or buddy systems.

• Wellness programs and work environment: provide mindfulness/relaxation sessions, promote physical activity, share sleep hygiene resources, and create quiet, private spaces to reduce noise and support recovery.