Physical Symptoms
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How Anxiety Causes Trouble Swallowing

Daniel Sher, MA, Clin Psychology
How Anxiety Causes Trouble Swallowing

One of the biggest fears that people have when they suffer from anxiety is the idea that their experience actually represents a physical or medical condition, rather than just a psychological one. For example, you may worry about having a disease that has not yet been discovered by medical professionals, and you may feel that doctors have been repeatedly making mistakes when they say your symptoms are simply due to anxiety.

That's a big problem for those suffering from anxiety because when you're worried that you have something more serious than anxiety, you'll find that your anxiety increases every day. You become more attuned to your body, and you start to worry more about your health, increasing your risk for anxiety attacks. A difficulty with swallowing is a common symptom for people who are stuck in this anxiety cycle. 

GERD, Anxiety, and Other Diseases

It's important to note that trouble swallowing may be a sign of other disorders, such as gastroesophageal reflux disease (GERD). While these disorders don't cause anxiety on their own, those with anxiety often find that these disorders contribute to their existing anxiety, sometimes making it worse. 

That's why it's important that you really understand what symptoms you have that could be attributed to anxiety; and how you can respond to them. At times, it may be necessary to consult with a doctor in order to rule out possible medical conditions that are underlying your symptoms. 

Anxiety and Body Consciousness

Trouble swallowing is a frightening anxiety symptom and one that doesn't make much sense to those who struggle with it. Why would nervousness make it hard to swallow?

Yet there are several reasons that trouble swallowing occurs, and they all relate to a common problem for those with anxiety - an oversensitivity to their bodily sensations.

Most of what your body does is automatic. You breathe and blink without thinking about it. Your hand grasps things without thinking about the motions of each finger. And you also swallow automatically, without consciously deciding to move the muscles in your throat yourself.

But when you struggle with anxiety - particularly anxiety attacks - your mind focuses too much on actions that are normally automatic and forces them into your consciousness. You still have the ability to swallow, but when you swallow it no longer feels like a natural reflex, because your mind is too focused on how it feels. 

Other Examples of Over-Sensitivity to Body Movements

This type of problem is common in people experiencing or approaching an anxiety attack. The symptoms are not just related to swallowing:

Swallowing is another example of this. The motions and the sensations become less automatic. You're unlikely to choke (although choking can occur in rare cases), but your body is so overwhelmed with anxiety that what has always been an automatic response for your body now seems like something that you need to perform consciously and intentionally. This thought is not accurate, however: you’re still able to swallow naturally, even though it doesn’t feel that way. 

Sometimes You're Not Having Trouble

When you have anxiety, your anxiety may also make you focus on a specific sensation - such as needing to swallow. Any time you focus on a sensation, you may find yourself trying to force it. If you try to force swallowing too often, you may occasionally find that you’re not quite able to do it because your body doesn’t really “need to.” 

So you may not be having trouble swallowing, but you may be trying to swallow more often than your body needs to. 

How to Reduce the Anxiety From Swallowing Difficulty

If you find that you're having trouble swallowing, the first thing to do is take a slow breath. By taking a slow breath, you’re often able to relax sufficiently to realize that you're not actually choking on the food - it's just taking its time going down your throat.

See if you can swallow a bit of water as well. Water tends to be easier to swallow than other foods and liquids. As long as you can swallow water, you'll be able to remind yourself that your swallowing reflex does work and that perhaps you're simply overthinking the problem.

Also, distractions are helpful. During periods of intense anxiety, you need to stop focusing so much on the sensations you're experiencing. You can't always stop your panic attack immediately once it's started, but you can try to head it off by distracting yourself so that you're not focusing so much on the swallowing reflex. You can try:

These strategies can decrease the severity of your anxiety or panic symptoms. If your anxiety levels are lowered, you reduce the likelihood of feeling like you have trouble swallowing.

Long Term Anxiety Reduction

Difficulty swallowing is a symptom of anxiety, so on its own it is difficult to stop without some type of broader intervention. You'll need to find a way to stop experiencing anxiety symptoms overall if you want to avoid difficulties with swallowing. What can you do to control your anxiety in the long term? 

First, always visit the doctor. While trouble swallowing is very often an anxiety symptom, you'll want to be sure that you're not suffering from acid reflux or any of the other disorders that can contribute to the issue. Those types of disorders can be treated separately, and knowing that you do or don't have them is an important part of controlling anxiety.

You'll then need to commit to an effective anxiety reduction program - one based on your anxiety symptoms so that you will be able to experience less overall anxiety. You should look into local therapy options, particularly therapists that work with cognitive behavioral therapy. There are also medication options available (speak to your doctor or psychiatrist) and plenty of effective self-help techniques to consider. Anxiety is a manageable condition, so consider taking an opportunity to start addressing it.

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