Behavioral Symptoms

Anxiety Speech Problems: Trouble Concentrating and Swallowing While Speaking

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

Anxiety Speech Problems: Trouble Concentrating and Swallowing While Speaking

Speaking in a public setting, whether to a large group or simply to another person, can be a difficult, and even embarrassing, task when anxiety is involved. Many people with anxiety disorders experience speech problems including difficulty concentrating and feeling the need to swallow while they are speaking. These types of speaking problems can cause you to avoid speaking entirely, or to panic whenever you do speak.

If you are suffering from these symptoms of anxiety it can help to know exactly what is happening in your body when you experience these speech problems as well as what you can do to prevent them.

How Anxiety Can Make It Hard To Concentrate

Anxiety is a mentally and physically overwhelming condition. Your mind (and your brain) can only focus on a certain number of things at any given time. When you have anxiety, it takes up much of that space, making it considerably harder for you to concentrate on the tasks at hand. Indeed, not only does it take over your thoughts, but there is a great deal of evidence that anxiety can actually shut some parts of your brain down temporarily because it can't handle all of the work.

When you really need to concentrate, anxiety is right there to get in the way. Whether it is preventing you from applying your mind to a problem, crowding your mind with other problems, or refusing to let you rationalize your thoughts, anxiety can cause real difficulties when you are trying to speak well and make a good impression on others (for example, at a job interview, meeting someone you are attracted to, or making a presentation in front of a group). Speaking can involve unrealistic anxieties about the negative ways people may perceive you or irrational worries about your body malfunctioning while you speak. Additionally, having a speech impediment can make it even more difficult to speak in public.

Here are some of the effects that anxiety has which may stop you from concentrating when speaking:

  • Deer in the Headlights Effect Anxiety, like fear, can cause your brain to freeze up (like a deer in the headlights). The thing that disturbs you becomes so overwhelming that your mind and body don't know what to do, tensing up and leaving you feeling unable to operate.
  • Conflicting Concerns Having anxiety about other things, unrelated to speaking, can make it difficult to concentrate. If you are worrying about something going on in your life, something coming up in the future, or worrying about having a panic attack it will keep your mind from focusing on the task at hand.
  • Negative Thought Spirals People who suffer from anxiety often find themselves caught in negative thoughts that spiral out of control. They may catastrophize the situation as well. For example: I can't speak because I'll sound like an idiot, if I sound like an idiot everyone will laugh at me, if everyone laughs at me people will lose respect for me, if they lose respect for me I'll be ostracized, and so on. Thought patterns such as this do not give you the headspace necessary for formulating ideas, much less trying to figure out how to articulate them clearly.
  • Distracted by Others' Faces One symptom of social anxiety is often that you are too distracted by the faces of others because you're trying to see how they're interpreting you. That distraction means you are not concentrating on what you're about to say.
  • Overthinking Another problem is actually overthinking. Many people with anxiety find that they try too hard to figure out what they should say next in order for it to be "perfect", only to find that they've lost their place and are unable formulate thoughts.

These experiences can lead to you doubt yourself, lose self esteem, and even increase your anxiety.

Swallowing While Speaking

Swallowing, like many bodily functions we never or rarely think about, becomes strange and challenging the moment we do focus on it. Overthinking simple physical acts such as swallowing, which are meant to happen unconsciously, may lead to hysterical reactions and socially inappropriate physical responses in attempting to compensate for the imagined problem.

Symptoms of this problem can include:

  • Choking Swallowing while trying to speak can be too much for your body to process at once, which can lead to a feeling of choking. Choking is a frightening experience that can make you feel like you can't breathe properly and lead to further anxieties about suffocation and death.
  • Gagging If your throat is triggered by saliva or by enough swallowing, it can result in gagging. Gagging is unpleasant to hear and to experience, as it is the result of signals in your brain suggesting that you may need to throw up, and may even result in feelings of nausea.
  • Spitting Thinking too much about swallowing can actually prevent you from swallowing enough, which leads to excess saliva in the mouth and the unfortunate consequence of spitting unintentionally while speaking.
  • Frequent Pauses During Speech If you are thinking about swallowing you may find yourself having to stop mid-speech to consciously do so, as you are interrupting your body's unconscious swallowing mechanisms (which controls how much saliva you produce and regulates when you need to swallow so it doesn't interfere with speech).
  • Blushing The embarrassment caused by this problem can result in blushing uncontrollably. This can have the cyclical effect of causing further embarrassment which further stimulates blushing, and so on.

Being unable to concentrate can be mentally and socially uncomfortable, but difficulty swallowing can lead to physical consequences that can be even more unpleasant. Overcoming these barriers is crucial for people suffering from them to be able to live a normal and productive life. The list below will give you an idea of the types of mental exercises you can try in order to overcome them.

How to Defeat Your Public Speaking Anxiety Symptoms

The problem with anxiety is that it blows your fear of speaking and being judged out of proportion and makes you worry about things that just aren't realistic. You won't be ostracized for life if you stutter a little. You won't die from swallowing strangely. You won't lose friends simply because you lost your place in the conversation, and your life won't be over if you ever did lose a friend.

The fact is, most people get nervous when they have to speak publicly, and will usually be understanding of other people who feel the same way. Difficulty concentrating is a common experience for those who struggle with public speaking. And while difficulty swallowing may be less common, it is not something that should keep you from publicly speaking.

Here are some ways to calm your public speaking anxiety so that it stops getting in your way when you need to make yourself heard:

  • Practice Speaking If you are preparing in advance for an event, read or review in your mind what you are going to say until saying it is practically second nature. To help you, you can come up with mnemonic cues to help you remember what you need to say if your mind suddenly goes blank. In situations that aren't as important (i.e., outside of a job interview or presentation), you can conscientiously practice your speech with others, trying to sound as natural and relaxed as possible.
  • Pretend Your Audience Is Someone You Know Imagining your audience is a person you are comfortable talking to (a close friend, a grandmother, or maybe even yourself) can help get you in a more relaxed frame of mind. You won't worry so much about what they will think of you, and may even find yourself enjoying talking to them (when you are relaxed, you audience will react to you in a more comfortable and natural way).
  • Think of Something Important to You Before speaking, you can relax yourself by calling to mind something you have a firm devotion to of belief in, like your family, your religion, or your ethical standpoint on an important issue. This will make you feel grounded and confident in yourself, which can help keep your mind from wandering in a state of uncertainty to unimportant things like monitoring your swallowing or obsessing about how you sound rather than focusing on what to say.
  • Picture Yourself Succeeding When you vividly imagine everything going as well as you want it to (by imagining how comfortable your body will feel, how confidently you will speak, and how positively the audience will respond to you), your body will be prepared for that to happen rather than crippling you with the certainty that the opposite will happen.

Getting stuck on anxious thoughts and physical symptoms does not have to keep you from doing the important things in life that require you to speak with confidence and ease. Now that you are more informed about your body and have some strategies to cope with your speech anxieties, it is time to try them out and start making some positive impressions.

It is important to note that anxiety about public speaking often goes hand in hand with having other anxieties. The only way to truly cope with a fear of public speaking is to address your anxiety as a whole. While these strategies will help reduce your anxiety about public speaking, learning to manage your general anxiety is something that will take time and a commitment to treatment.

Questions? Comments?

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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