Can Anxiety Cause Shortness of Breath?
While shortness of breath is often caused by panic attacks or anxiety, it can also indicate an emergent medical condition. If you believe you are experiencing an emergency, do not delay in calling 911 or visiting your nearest Emergency Room.
As anyone struggling with anxiety knows, this condition can cause a slew of uncomfortable physical symptoms that can be anything from uncomfortable to frightening. It can sometimes be challenging to discern when these physical sensations are an actual cause for concern or if it is just an innocuous symptom.
One of the most common physical symptoms of anxiety is shortness of breath. This symptom can be quite frightening to experience because we often associate it with an acute physical health issue such as a pulmonary embolism, heart attack, or asthma exacerbation. Further, online searches of this symptom can lead patients down a rabbit hole of conditions and stories that can lead to fatalistic thoughts.
In this article, we will explore what causes shortness of breath in people experiencing anxiety, how to distinguish if the cause is anxiety, potential treatment options, and when to seek help from a medical professional.
What Causes Shortness of Breath From Anxiety?
Anxiety is a mental health condition that is largely marked by a feeling of panic and fear. Our autonomic nervous system regulates our fear response, the branch of our nervous system that controls our involuntary physical actions, such as the rate at which our heart beats, blood pressure, and breathing patterns.
The autonomic nervous system can be divided into two parts: the “rest and digest” state, known as the parasympathetic branch, which slows our body down and prioritizes non-essential functions such as digestion, and the “fight or flight” state, which is an innate neural network that prepares our body to deal with a perceived threat by running or fighting.
When our mind perceives a situation as causing fear or panic, it can signal our autonomic nervous system that we are not okay and better prepared to fight or flee. This fear response will send the body into “fight or flight” mode, which can cause physiological changes in the body, such as an increased heart rate pumping blood to our muscles to run, dilating our pupils to improve our vision, and increasing our rate of breathing to better oxygenate tissue, resulting in shortness of breath.
Shortness of Breath In Anxiety
Anxiety can be a passing feeling, but anxiety disorders are a more pervasive and persistent state of experiencing this unease. According to the Diagnostic and Statistical Manual of Mental Disorders, a diagnostic tool physicians use to diagnose mental health disorders, anxiety disorders can fall under various categories. These varying forms of anxiety disorders can cause physical symptoms including:
- Increased heart rate
- Chest pain or pressure
- Choking sensation
- Palpitations
- Shortness of breath
- Rapid breathing
- Dizzy and light-headed
- Trembling
- Shaking
- Tingling or numbness in arms and legs
- Weakness
- Sweaty
- Hot flashes
- Chills
- Tense muscles
- Dry mouth
- Upset stomach
- Nausea
- Diarrhea
- Faintness
- Unsteadiness
The specific anxiety disorder someone is diagnosed with can impact the physical symptoms they experience. People with panic disorder are prone to experiencing panic attacks, which are marked by often severe and debilitating physical symptoms such as shortness of breath, sweating, chest pain, and chills. On the other hand, generalized anxiety disorder (GAD) may have subtle physical symptoms, such as tense muscles.
Is This Anxiety or Something More?
Although anxiety can cause shortness of breath, it can also indicate a severe medical condition. There are a few tips to distinguish if shortness of breath stems from anxiety or something else.
Was There a Trigger?
Often when shortness of breath is caused by anxiety, you might be able to identify a trigger. A person with agoraphobia may look back and notice their shortness of breath suddenly came on when they left the house to go to the mailbox. Or if you are diagnosed with social anxiety disorder, perhaps it came on while at a new restaurant with new colleagues or acquaintances. If you can identify a potential trigger, the shortness of breath may be due to anxiety.
Is It Responding to Deep Breathing and Other Calming Techniques?
Shortness of breath caused by anxiety can be overwhelming, but it often will respond to techniques aimed at calming the fight or flight response. Studies have shown that certain practices that activate the parasympathetic nervous system, such as diaphragmatic breathing, can effectively reduce feelings of anxiety.
If you are experiencing shortness of breath, try taking deep breaths in through the nose to a count of four and exhaling to a count of six. This prolonged exhalation has been shown to reduce the respiratory rate and improve shortness of breath.
Did Medication Help?
People with anxiety disorders, particularly those who experience panic attacks, are often prescribed medications that can quickly ease symptoms in an acute situation. Doctors prescribe a class of medications known as benzodiazepines for treating short-term anxiety because they are fast acting and provide quick relief. Most prescribed medications include alprazolam, clonazepam, diazepam, and lorazepam. We discuss the potential concerns regarding benzodiazepines or benzos in a separate blog post.
If you are prescribed medication for anxiety and are feeling short of breath, these medications may alleviate this symptom. Typically, within 30 minutes to 1 hour, symptoms will subside. If you experience relief after taking short-acting anxiety medication, your shortness of breath may be due to a flare of anxiety symptoms.
When To Seek Medical Attention
If you have tried various relaxation techniques and treatments but have not had any relief from the shortness of breath, it is essential to get evaluated by a doctor immediately. Shortness of breath, or dyspnea, can be a sign of an acute health condition such as:
- Pulmonary embolism
- Myocardial Infarction (heart attack)
- Anaphylaxis or allergic reaction
- Pneumonia
- Asthma
- Pneumothorax
Shortness of breath may also indicate a chronic health condition that is deteriorating or worsening. These conditions include:
- Congestive Heart Failure
- Chronic obstructive pulmonary disease (COPD)
- Anemia
- Lung disease
- Heart disease
These medical conditions can lead to serious and permanent damage if left untreated. Always discuss the onset of new symptoms or worsening symptoms with your healthcare team to ensure that you are receiving proper management.
Next Steps
Shortness of breath can be caused by many medical conditions, with anxiety being one of them. The sensation of shortness of breath is often caused by the nervous system branch responsible for our fight or flight response triggered by fearful or anxious thoughts. If you are diagnosed with anxiety and experiencing shortness of breath, trying techniques such as deep breathing may help. Speak to your doctor or mental health professional about medications that may alleviate the symptoms. If your shortness of breath is persistent, worsening, different, or severe, seek immediate medical attention for proper evaluation.
Related Topics:
References:
- Chand, S. P., & Marwaha, R. (2022, May 8). Anxiety. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470361/
- Chen, Y.-F., Huang, X.-Y., Chien, C.-H., & Cheng, J.-F. (2016). The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety. Perspectives in Psychiatric Care, 53(4), 329–336. https://doi.org/10.1111/ppc.12184
- Deepa Rawat, Hajira Basit, & Sandeep Sharma. (2019). Dyspnea. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499965/
- Komori, T. (2018). The relaxation effect of prolonged expiratory breathing. Mental Illness, 10(1). https://doi.org/10.4081/mi.2018.7669
- Parekh, R. (2017). What Are Anxiety Disorders? Psychiatry.org; American Psychiatric Association. https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
