What's the link between anxiety and shortness of breath?

Source: By Jessica Caporuscio, Pharm.D. https://www.medicalnewstoday.com/articles/326831.php

Anxiety is very prevalent, but its triggers vary among individuals, who will also experience it in many different ways. Some people with anxiety may notice that they have shortness of breath.

Shortness of breath, or dyspnea, is a common symptom of anxiety. As with other anxiety symptoms, it can feel worrying, but it is ultimately harmless and will go away when the anxiety lifts.

Feeling short of breath can make people more anxious. It can make a person feel as though they are experiencing a breathing or heart problem. However, it is likely to be due to the physiological changes that anxiety can cause, such as an increased heart rate and higher levels of adrenaline. When doctors evaluate people with shortness of breath, they will first rule out any serious physical causes.

In this article, we explore the link between anxiety and shortness of breath. We also take a look at other possible causes of shortness of breath.

What's the link?

Everyone feels anxious sometimes, but for some people, anxiety can significantly get in the way of daily life. Generalized anxiety disorder (GAD) affects 3.1% of people in the United States in any given year. It is more common in females than in males.

One of the symptoms of anxiety is shortness of breath. Shortness of breath may also occur in people with panic disorder.

Anxiety has an association with fear, and it can cause the behavioral and physical changes that prepare people to defend themselves against a threat. In situations that cause anxiety, certain areas in the brain activate as part of a fear response. Researchers have seen that people with high levels of anxiety have persistent activations in these areas of the brain.

The brain is wired to react to fearful situations with a fight or flight response. This response includes an increased heart rate so that the blood pumps to the organs faster and readies the muscles for action. It also causes a person to breathe more quickly to provide more oxygen to the muscles. The result can be a feeling of being out of breath.

When people consult a doctor for shortness of breath, the doctor must check for physical causes, such as breathing and heart conditions.

Depending on the cause of the shortness of breath, doctors will treat people differently. When emotions cause shortness of breath, doctors will often suggest relaxation techniques and diaphragmatic breathing.

People with persistent anxiety or chronic panic attacks may require medication and psychotherapy to reduce or control their symptoms.

How to know if it's anxiety or something else

When experiencing anxiety, it can be difficult to tell whether the symptoms are due to anxiety or another problem. Determining this can be particularly hard when anxiety symptoms are severe.

Shortness of breath is just one symptom that people with anxiety may experience, but not everyone with anxiety has episodes of difficulty breathing.

Anxiety can cause a range of physical and mental symptoms. These include:

an increased heart rate rapid breathing chest pain a choking sensation dizziness sweating chills nausea diarrhea shaking muscle tension fear of losing control agitation, feeling jittery or frustrated frightening thoughts, mental images, or memories poor concentration confusion poor memory difficulty speaking a dry mouth

Doctors diagnose anxiety disorder using criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Shortness of breath is not one of the criteria to diagnose anxiety, but it can be present in some people with this condition.

People with panic disorder or panic attacks may experience shortness of breath as well. Shortness of breath is one of the symptoms that experts have included in the criteria for diagnosing panic disorder.

Anxiety symptoms can be severe, especially in the case of a panic attack. Panic attacks bring on extreme anxiety symptoms and can involve a feeling of doom or a fear of dying. Some symptoms are similar to those of a heart attack.

Learn more about the difference between a panic attack and a heart attack here.

Although people who suspect that they have anxiety or panic disorder should consult a doctor for a diagnosis and treatment, they can find free diagnostic tools online.

The Generalized Anxiety Disorder Assessment (GAD-7)Trusted Source is a questionnaire that people can fill out on their own, but a doctor should interpret the results. The Severity Measure for Panic Disorder is another questionnaire that helps doctors diagnose panic disorder.

If a person experiences shortness of breath, they may not know why this is happening, which may cause anxiety and worsen their breathing further.

To determine the cause of shortness of breath, doctors will need to rule out any physical causes. Other causes can include asthma, lung problems, or heart problems. Read about other possible causes of shortness of breath here.

How to manage symptoms

Doctors can offer different treatments for people with anxiety, such as psychotherapy, medications, or a combination.

For short term relief of anxiety symptoms, such as shortness of breath, doctors may prescribeTrusted Source benzodiazepine medications. These include:

alprazolam (Xanax)clonazepam (Klonopin)Diazepam (Valium)lorazepam (Ativan)

People use benzodiazepines to get fast relief from their anxiety symptoms. Within about 30 minutes, people may start to feel better. Doctors tend not to prescribe benzodiazepines for long durations because they can cause side effects, and misuse can have harmful results.

Cognitive-behavioral therapy (CBT) can be beneficial for many people with anxiety. This method helps people modify how they think and behave in certain situations. In this way, it can help people confront situations that trigger their anxiety.

People who practice CBT can learn that their anxiety is based on false alarms of fear. It also trains people to cope with certain conditions that cause anxiety symptoms instead of avoiding those situations.

For immediate relief of shortness of breath due to anxiety, people can try relaxation techniques or diaphragmatic breathing. Some relaxation techniques include:

box breathing guided imagery progressive muscle relaxation

Some doctors may recommend diaphragmatic breathing to help people reduce anxiety. People who practice diaphragmatic breathing may feel that it helps provide emotional balance. This breathing technique involves contracting the diaphragm, expanding the belly, and deepening inhalation and exhalation.

A study in Frontiers in PsychologyTrusted Source demonstrated that 20 sessions of diaphragmatic breathing improved stress and negative emotions. It is not clear from this study how many sessions are necessary for symptom improvement. The authors note that other studies have shown that fewer sessions of diaphragmatic breathing can reduce stress.

Diaphragmatic breathing plays a role in meditation, Ancient Eastern religions, and martial arts, and it is a core component of yoga and tai chi.

When to see a doctor

People who feel as though they may have an anxiety or panic disorder can see a doctor to talk about treatment options.

If breathing exercises and relaxation techniques do not reestablish regular breathing patterns, people may need to seek immediate medical attention.

Chronic shortness of breath may be a sign of asthma, a chronic obstructive pulmonary disorder, interstitial lung disease, heart dysfunction, or obesity. These conditions also require medical attention because they may indicate the worsening of a condition or a severe flare-up.

Summary

Doctors need to determine the cause of shortness of breath. Sometimes, people may have shortness of breath because of a heart or lung condition.

When people experience shortness of breath because of anxiety or panic, they can feel more anxious, which can worsen their breathing. Doctors often recommend relaxation techniques and diaphragmatic breathing to help people relieve shortness of breath.

Some people may benefit from temporarily using benzodiazepine medications to control anxiety symptoms, such as shortness of breath. Chronic anxiety and panic may require other medications and psychotherapy.

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Anxiety / StressMental HealthPsychology / PsychiatryRespiratoryMedically reviewed by Timothy J. Legg, PhD, CRNP on October 29, 2019 New — Written by Jessica Caporuscio, Pharm.D.