Cough is usually the first sign of a disease, and chronic cough can have people worried. Chronic cough may be caused by asthma, obstructive pulmonary disease, gastroesophageal reflux disorder, and lung damage, and possibly even heart problems.
What few realize is that chronic cough may also be a sign or symptom of anxiety. Those with anxiety coughing often show signs of poor breathing, and coughing may be the result.
Coughing = Anxiety?
Coughing is always something worth checking out with a doctor, but regular cough may be a serious anxiety issue. Fill out my free symptoms checklist to find out more about your possible problems with anxiety.
The Mind and Coughing
Before learning to understand the link between anxiety and coughing, it's important to note that anxiety has a way of affecting the way you think. Those that have coughed before from their anxiety are going to be more prone to thinking about coughing later, and when you think about coughing you become more likely to cough.
That's why the only true way to respond to coughing is to control your anxiety. Click here to take my 7 minute anxiety test and learn more.
Why Anxiety Causes Coughing
Medically, there are very few reasons for anxiety to cause coughing fits. For safety, it's always a good idea to check with a doctor about your cough just in case. But one of the key reasons anxiety causes coughing is through hyperventilation. Those that have anxiety are prone to regular hyperventilation, as a result of poor breathing habits (a common side effect of anxiety). During periods of hyperventilation, it can feel as though your throat is closing, and coughing is a very common result.
However, there are tangential reasons for coughing as well. While hyperventilating, many people use coughing as a way to feel like they're getting a breath. For reasons that are not quite clear, coughing can make people feel as though they're clearing their lungs and improving their ability to breathe, even though there is also no medical reason that coughing should improve breathing ability.
Another problem comes from the damage that both of those issues cause. Chronic coughing can irritate the nerves that control the cough reflex. When irritated, these nerves may cause you to cough more.
The Cyclical Nature of Coughing and Anxiety
What makes matters worse is that not only does anxiety cause hyperventilation - coughing can also cause hyperventilation, and hyperventilation can cause anxiety. Those that have developed chronic cough for any reason (including from hyperventilation or irritated nerves) may become more prone to hyperventilation as a result of coughing, which in turn causes more coughing, and so on.
Those that are prone to panic attacks may also be at risk for severe anxiety during times of hyperventilation. This causes people to hyperventilate more, which can cause temporary but painful stress on the lungs and eventually more coughing.
Coughing, hyperventilation, and anxiety all contribute to each other in a way that is difficult to stop without help.
Further Issues That May Complicate Anxiety and Coughing
There are also minor health issues that can contribute to coughing. Those that have developed Laryngopharyngeal Reflux Disease, a form of acid reflux, may be more prone to chronic cough. In some this cough is manageable, but others with anxiety may find that the way they hyperventilate and the lightheadedness they feel after large coughing fits further complicates their anxiety, and may trigger severe anxiety attacks that produce coughing themselves.
Coughing and anxiety have a very complex and contributory relationship. It's a relationship you need to stop if you hope to stop both anxiety and coughing.
How to Stop the Anxiety Cough
Generally, the best way to stop symptoms of anxiety is to prevent anxiety itself. With coughing though, it's not quite that simple. You'll also need to breathe in a way that is healthier for coughing and figure out easy ways to avoid contributing to the cough.
Many people recommend daily deep breathing exercises to essentially re-train your body to breathe more efficiently. It requires daily commitment, but many argue it is the only way to regain control of the way you breathe.
Every day spend anywhere from 10 minutes to a half an hour breathing in a way that is more efficient at maintaining carbon dioxide levels. Sit with your back straight in a comfortable place and try the following:
- Breathe in very slowly through your nose. Try to count to at least five seconds.
- Hold your breath for two seconds
- Breathe out very slowly through pursed lips as though whistling. Try to last at least seven seconds.
This is a relaxation exercise at its heart, but it also shows your body how to breathe more efficiently. Do not try to force your body to breathe in more air than it needs either. If you try to expand your chest (like through yawning) you increase your risk for hyperventilation.
You can also try many of the following simple tricks:
- Avoid wearing belts that are too tight or tight clothes, as these may push on your stomach and contribute to shallower and faster breathing.
- Try to lose weight if possible. Excess weight has a tendency to push on your stomach and lead to faster breathing.
- Go jogging. Jogging trains the body to breathe in a healthier way and may be useful for combatting your anxiety as well.
Make sure that you're always hydrated and if you feel that you are more prone to coughing when you bend over, try to sit with your back straight more often.
You will need to combine these breathing exercises with an anxiety reduction strategy as well. Even if you re-learn to breathe, your anxiety will often train you out of your better breathing habits and cause you to breathe more shallow.
I've helped thousands of people with chronic cough reduce their anxiety. I start them all off with my free 7 minute anxiety test. This test is specifically meant to help those struggling with anxiety understand their anxiety symptoms and recommend potential treatments.
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McGarvey, Lorcan PA, et al. Prevalence of psychomorbidity among patients with chronic cough. Cough 2.1 (2006): 4.
Rietveld, Simon, Ilya Van Beest, and Walter Everaerd. Psychological confounds in medical research: the example of excessive cough in asthma. Behaviour research and therapy 38.8 (2000): 791-800.
Harding, Susan M., and Joel E. Richter. The role of gastroesophageal reflux in chronic cough and asthma. CHEST Journal 111.5 (1997): 1389-1402.
Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.