The new reality of work: stress without pause

South Africa’s professionals now experience stress as a persistent reality rather than isolated incidents, according to the findings of the Profmed 2025 stress index.

The survey was carried out among 4,000 members of the Profmed Medical Aid for professionals in South Africa. Among the findings was a marked shift in how South African professionals are experiencing stress, from once-manageable, isolated pressures to a persistent, multilayered reality.

The index draws on longitudinal data, tracking how stress has evolved from primarily financial concerns before 2020 to pandemic-driven anxiety and now a complex mix of economic, workplace and lifestyle pressures.

The report reveals “a growing group of professionals who are spending prolonged periods in a heightened state of pressure”, with 44.05% of respondents saying this was having a negative impact on their long-term physical and mental health.

“Financial strain, workplace culture, systemic pressures and lifestyle challenges now intersect, compounding daily stress,” says the study. “Nearly a third of respondents report disrupted sleep and exercise patterns, while 44% said they felt overwhelmed despite using coping strategies.”

Alarmingly, many acknowledged the health impact of stress but delayed seeking support due to cost and time constraints, or unsupportive work environments.

Stress has tangible and long-lasting implications for health, with:

• almost 32% of respondents reporting that increasing pressure has affected their ability to exercise;
• 33% claiming that stress has affected their sleep schedule; and
• just under 30% experiencing disrupted eating patterns; while
• a further 44.05% felt overwhelmed despite coping strategies such as physical exercise, mindfulness practices and therapy.

Work

Professionals in the health care/medical sector report the highest levels of stress at 41.81%. After health-care professionals, those who were most stressed worked in:

• finance and banking at 8.08%;
• legal (7.56%);
• built environment (7.10%);
• education (5.19%);
• information and communications technology (3.38);
• trade and retail (1.54%);
• creative industries (1.4%); and
• transportation and logistics (1.47%); with
• a large group of “other” at 23.48%.

Coping mechanisms

The top coping mechanism surveyed was exercise, at 64.93%. Then came:

• talking to friends and family (55.3%);
• mindfulness or meditation practices (28.98%);
• avoidance, for example by sleeping and procrastination (28.78%);
• social media or digital distractions (26.45%);
• therapy or counselling (13.03%); and
• using alcohol, cannabis, caffeine and/or illicit substances (10.85%).

Almost every system in the body is affected by stress, which causes the creation of a cycle that affects both body and mind,

—  Justine Lacy, Profmed clinical executive

According to the index, among the group who used substances, such as alcohol and cannabis:

• 17.44% said they did not feel the need to reduce the amount they consumed to help manage stress;
• a further 6.51% actively reduced levels but said they struggled; and
• 2.59% said they wanted to.

Seeking outside help

Almost half of respondents expressed concern about the long-term effects of stress on their mental health. Many expressed an openness to therapy or counselling as a source of support but 29% found such professional services to be unaffordable.

When it comes to seeking outside help:

• as many as 43.56% said they did not because they preferred to handle things privately;
• 29.39% said the cost of therapy and mental health care deterred them;
• 22.65% cited time constraints;
• 11.35% said they did not think it would help;
• 10.85% said they did not have such services in their area; while
• for 3.37% social stigma stopped them.

Of the respondents, 46.66% said they were “very concerned” or “somewhat concerned” about the long-term effects of stress on their mental health.

Looking more closely at the above reasons, Profmed clinical executive Justine Lacy agreed that cost could be a barrier to one-on-one therapy with a clinical psychologist.

“Time and workload may be paired together as a second barrier to seeking help. Professionals often prioritise work over wellbeing. Work culture and stigma could be viewed as a third barrier because mental health issues may be seen as a weakness in professional settings. There may be fear of judgment or a loss of credibility, which prevents many professionals from seeking help,” Lacy said.

In terms of the costs of mental health support:

• almost half said they believed support should be free;
• 27.89% said they would pay R501-R800 a month; and
• 9.19% said they would pay more than R1,000.

Regarding the form of mental health support respondents said they would be most willing to try:

• just more than half said they would choose in-person therapy or counselling (50.71%); while
• 48.04% opted for fitness and nutrition plans.

The study found that wellness apps are gaining popularity, with:

• 17.37% choosing them;
• 17.69% saying they were open to online counselling; while
• 12.47% said they would consider joining a support group.

‘A self-perpetuating loop’

Sustained stress is associated with fatigue, disrupted sleep and reduced emotional capacity. When asked whether they had changed their sleep and exercise habits over the past year due to stress:

• 33.32% of respondents said their sleep schedule had changed;
• 31.89% said their exercise frequency was down; while also affected were
• eating patterns (29.61%);
• social engagement (22.6%); and
• work productivity (29.38%).

Commenting on the physical and mental health implications of prolonged stress, Lacy said something called “the body-mind feedback loop” demonstrated how stress does not exist in isolation.

“Almost every system in the body is affected by stress, which causes the creation of a cycle that affects both body and mind.

“Stress triggers physical symptoms such as tension headaches, fatigue and digestive problems. Stress also impacts mental wellbeing, leading to unhealthy coping behaviours such as overeating, lack of exercise or increased alcohol use. These behaviours further strain the body, reinforcing the physical and emotional effects of stress.

“In essence, stress, physical symptoms and coping behaviours interact in a self-perpetuating loop, making early recognition and intervention critical

“What is key to understand is that the longer stress persists without effective management, the greater the risk of chronic diseases and serious mental health issues. Early recognition, coping strategies and lifestyle adjustments are essential to break this cycle.”

Stress ‘a multifaceted reality’ since Covid-19

Several events contributed to the present-day reality, according to the report: “The Covid-19 pandemic fundamentally reshaped stress, introducing health anxiety, uncertainty and lifestyle disruption. Before 2020 the major stressor was financial pressure, though comparatively many professionals were able to make positive shifts towards healthier coping mechanisms.

“The years following the pandemic were characterised by a fear of loss of income and the potential of losing a family member to Covid. In 2022, against the backdrop of a severe economic downturn, systemic pressures (including the cost of living, job security and unreliable infrastructure) overtook pandemic concerns as primary stress drivers.

If anything, this year’s findings have re-emphasised the pressing need for proactive, preventative support that can protect your health before it is compromised

—  Justine Lacy, Profmed clinical executive

“During 2023 and 2024, work-life imbalance, toxic workplace environments and sustained financial pressure led to mounting stress levels, leading up to the present where stress has become a multifaceted reality.”

Lacy adds: “The results for 2025 have demonstrated a clear turning point in stress dynamics. Stress is no longer seen as being self-contained but rather compounded by many different interconnected and often complex factors, making stress a multidimensional issue, with fewer professionals seeking help despite the rising impact.

“If anything, this year’s findings have re-emphasised the pressing need for proactive, preventative support that can protect your health before it is compromised. Stress is no longer a single event; it’s a network of pressures amplified by modern life and global crises. These factors make it more persistent and harder to manage.”

Lacy continues: “What’s striking in the 2025 findings is how many professionals know the impact stress is having on their health yet still feel unable to act on it. Cost, lack of time and unsupportive work environments mean help is often delayed or avoided altogether. So people push through, adjust and tell themselves it’s temporary, even when the signs say otherwise.

“Stress is not a personal weakness; it is a natural response to sustained pressure. If we genuinely want healthier professionals, we can’t keep placing the responsibility solely on individuals to cope better. We need systems that step in earlier and support people before stress takes hold.”

Business Day