It is a medication even though it's a plant and available over the counter.
Across South Africa's pharmacies and wellness studios, a centuries-old Ayurvedic herb has become an unlikely mirror of a modern crisis. The surge in ashwagandha use — now a $9.1 million market projected to nearly double by 2033 — speaks less to a nation embracing wellness than to one quietly overwhelmed by unmet mental health needs. With more than a quarter of South Africans showing clinical signs of moderate to severe depression in the pandemic's wake, the reach for an unregulated supplement reflects a gap between suffering and care that the formal healthcare system has yet to close.
- South Africa's post-pandemic mental health landscape has deteriorated sharply, with psychiatrists reporting surges in first-time patients and relapses as depression and anxiety grip over 25% of the population.
- Ashwagandha has flooded shelves in Cape Town and Durban almost overnight, with consumers self-medicating for stress, burnout, and sleeplessness — often without any medical guidance.
- The supplement remains classified as an unregistered complementary medicine, leaving dosage, formulation, and safety largely ungoverned in practice despite existing labelling requirements.
- Psychiatrists warn of a dangerous pattern: patients abandoning prescribed antidepressants in favour of ashwagandha, unaware that the herb can interact harmfully with prescription medications and is processed by the liver like any drug.
- The healthcare system, stretched beyond capacity, cannot reach the growing number of people in need — and the supplement industry quietly fills that vacuum, profiting from desperation dressed as wellness.
Walk into a Cape Town wellness studio or a Durban pharmacy and ashwagandha is everywhere — capsules, teas, powders, all promising relief from the weight of modern life. The Ayurvedic herb has become a mainstream fixture in South Africa's wellness market almost overnight, and the surge reflects something deeper than consumer trend: a country struggling with its mental health.
Bonga Chiliza, who heads the Department of Psychiatry at the University of KwaZulu-Natal, acknowledges the plant has genuine merit for mild depression and anxiety. But he is careful with his words. The herb's explosive popularity, he believes, is not wellness culture thriving — it is a symptom of intensifying mental health pressure. Since the pandemic, psychiatrists have documented a significant rise in patients arriving with depression and anxiety, some for the first time. Research from Wits University found that 25.7% of South Africans show clinical symptoms of moderate to severe depression. Lockdowns restricted movement, made in-person consultations dangerous, and cut people off from the system meant to help them.
The market numbers confirm the scale of unmet need. South Africa is the largest ashwagandha consumer in the Middle East and Africa region, with the local market generating $9.1 million in 2024 and projected to reach $15.7 million by 2033. Demand for psychiatric services keeps climbing. People are waiting, struggling, and turning to what they can buy without a prescription.
But the story darkens here. Ashwagandha is classified under South Africa's regulatory framework as an unregistered complementary medicine, and the reality on the ground is messier than the guidelines suggest. Consumers take varying formulations at varying doses, often unaware that the herb interacts with the body — and with prescription medications — like any other drug. Chiliza has seen patients stop taking prescribed antidepressants in favour of ashwagandha, a decision made without medical consultation and carrying real, often invisible risk.
The ashwagandha boom is not really about ashwagandha. It is a window into a mental health crisis the pandemic accelerated and the country has not yet addressed — a population under pressure, seeking relief wherever it is available and affordable, too often without the guidance it needs.
Walk into a wellness studio in Cape Town or a pharmacy shelf in Durban and you'll find ashwagandha everywhere now—capsules, teas, powders, all promising relief from the weight of modern life. The herbal supplement, rooted in Ayurvedic medicine for centuries, has become a mainstream fixture in South Africa's wellness market almost overnight. People are reaching for it to quiet stress, to ease anxiety, to sleep through the night, to recover from burnout. The surge is real, and it reflects something deeper: a country struggling with its mental health.
Bonga Chiliza, who heads the Department of Psychiatry at the University of KwaZulu-Natal, acknowledges that ashwagandha does have merit. For people with mild depression and anxiety, there is evidence the plant can help. "It is quite a useful medicinal plant," he says, noting that research supports its ability to reduce stress and anxiety in some cases. But Chiliza is careful with his words, and his caution matters. The herb's explosive popularity, he believes, is not a sign of wellness culture thriving—it's a symptom of mental health pressures intensifying across the country.
Since the Covid-19 pandemic ended, psychiatrists have documented a significant uptick in patients arriving at their doors with depression and anxiety. Some are seeking psychiatric care for the first time. Others are experiencing relapses. Research from Wits University found that more than one in four South Africans—25.7 percent—show clinical symptoms of moderate to severe depression. The pandemic itself was a crucible: fear, uncertainty, economic collapse, social fracture. Mental healthcare was deemed essential, but lockdowns made it nearly impossible for many people to access. Movement was restricted. In-person consultations became dangerous. Transport was difficult. Money was tight. The system that was supposed to help people failed them when they needed it most.
The market numbers tell part of the story. South Africa is the largest consumer and importer of ashwagandha in the Middle East and Africa region. The local market generated approximately 9.1 million US dollars in 2024 and is projected to reach 15.7 million by 2033. That growth trajectory reflects something real: demand for mental health relief that the formal healthcare system cannot meet. Chiliza sees it clearly. Demand for psychiatric services continues to climb. People are waiting, struggling, and turning to what they can buy without a prescription.
But here is where the story darkens. Ashwagandha remains poorly regulated. The South African Health Products Regulatory Authority classifies it as an unregistered medicine under Category D—Complementary Medicines. There are labelling requirements and safety guidelines, yes, but the reality on the ground is messier. Consumers take different formulations at different dosages, often without any medical guidance. They don't know what they're taking or how much. They don't know that ashwagandha, despite being a plant and available over the counter, is still a medication. It affects the body's systems. The liver processes it like any other drug. It can interact with prescription medications in ways that cause harm.
Chiliza has seen people stop taking prescribed antidepressants in favor of ashwagandha, a decision made in isolation, without consulting a doctor. The risk is real and often invisible. A person feels better on the supplement, thinks they no longer need their medication, and stops. What they don't understand is that they may be trading a regulated, monitored treatment for something unmonitored and potentially dangerous. The supplement industry benefits from this confusion. The healthcare system, stretched thin, cannot reach everyone who needs it. And people, desperate for relief, fill the gap with whatever is available and affordable.
The ashwagandha boom is not really about ashwagandha at all. It is a window into a mental health crisis that the pandemic accelerated and that the country has not yet addressed. Experts warn that the growing use of the supplement highlights not wellness but desperation—a population under pressure, seeking relief wherever they can find it, often without the guidance they need. The real question is not whether ashwagandha works. It is why so many people feel they have no other choice.
Notable Quotes
It is quite a useful medicinal plant for people with mild depression and anxiety. There's certainly some evidence of that.— Bonga Chiliza, head of the Department of Psychiatry at the University of KwaZulu-Natal
It is a medication even though it's a plant and available over the counter. It affects the body's systems and is processed by the liver like other medicines.— Bonga Chiliza
The Hearth Conversation Another angle on the story
Why is ashwagandha suddenly everywhere if it's been used for centuries?
Because the conditions that make people want it have gotten worse. The pandemic didn't create mental illness, but it accelerated it—fear, isolation, economic collapse. People are more anxious and depressed now, and they're looking for answers. Ashwagandha is cheap, available, and doesn't require a doctor's appointment.
But if psychiatrists say it only helps mild cases, why are people with serious depression turning to it?
Because serious depression is expensive to treat properly. Psychiatric care is hard to access, appointments are scarce, and many people can't afford it. A bottle of ashwagandha costs a fraction of what therapy or medication costs. When the system fails you, you take what you can get.
The regulation issue seems critical. How bad is the lack of oversight?
Bad enough that people don't know what they're taking or how much. They're mixing dosages, switching formulations, sometimes stopping prescribed medications without telling their doctor. Ashwagandha is still a drug—it affects your liver, your hormones, your other medications. But it's sold like tea.
Is there a scenario where ashwagandha becomes part of a proper mental health response?
Only if it's integrated into a system where people have access to real psychiatric care first. Right now it's filling a void. If that void closed—if people could actually see a psychiatrist, get proper medication, get therapy—ashwagandha would find its real place: a supplement for mild cases, used under guidance, not a substitute for treatment.
What happens to someone who stops their antidepressants for ashwagandha?
They might feel fine for a while. Then they might crash. Depression can return suddenly and severely. They've essentially conducted an uncontrolled experiment on themselves, and they did it alone, without medical oversight. That's the real danger.