Imagine this: It is past midnight, and you are in bed gasping for air, wondering why you are having this issue. Is it because something is physically wrong with you? Is it just a bad dream? Or are you dealing with anxiety? Without apparent reason, you will only feel the issue worsening even more.
While shortness of breath can be an indicator of many physical illnesses, anxiety is also one of the potential causes. But how to tell if shortness of breath is from anxiety or something else? Symptoms alone cannot confirm the cause. Call the local emergency number for severe breathing difficulty, inability to speak normally, chest heaviness, blue or gray lips, or new confusion. New, persistent or worsening breathlessness needs medical assessment.
When an individual feels anxious, they become restless, irritable, and unable to concentrate on anything. In some cases, anxiety may mimic the symptoms of a panic attack, including sweating, chest pain, increased heart rate, and the most dreadful of all: shortness of breath.
Both anxiety and panic share strong associations with fear. They can quickly induce several physiological and behavioral changes to prepare an individual for defense against a perceived threat. The human brain is trained to react to fearful or dangerous situations by activating the fight-or-flight response. As a part of this response, the heart rate increases to pump more blood to the organs, and the lungs start working faster to provide muscles with more oxygen. Owing to the latter, the person experiencing anxiety often struggles to catch their breath.
When a person visits a doctor with this symptom, they may first rule out all physical causes, such as heart issues or asthma. Anxiety may be considered after assessment, but an inconclusive evaluation does not prove it is the sole cause; ongoing or changing symptoms need review.
When an anxious person becomes short of breath, it can be hard to tell if this symptom is due to anxiety or another health issue. Finding out the cause can be particularly challenging when the symptom is severe enough to disturb their quality of life.
Shortness of breath does hit people with anxiety, but not everyone with anxiety disorder experiences this symptom. Other anxiety symptoms may occur alongside shortness of breath, but they cannot rule out a physical cause. These symptoms include:
- Increased heart rate
- Sweating
- Dizziness
- Dry mouth
- Nausea
- Sweating
- Chills
- Increased muscle tension
- Shakiness or tremors
- Chest pain
- Excessive jitteriness
- Irritability or frustration
- A choking sensation
- Confusion
- Poor concentration
- Frightening memories, mental images, or thoughts
- Agitation
- Fear of losing control
- Difficulty speaking
Most doctors establish the diagnosis of anxiety using the criteria described in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. While shortness of breath is not a part of these criteria, it can occur with anxiety. These symptoms can overlap with physical illness; only an appropriate clinical assessment can establish whether anxiety is contributing.
That said, keep in mind that you still need to get yourself checked by a doctor to establish a definitive cause and rule out other possibilities. Some potential causes of shortness of breath, apart from anxiety, like asthma, can be life-threatening. So do not wait to seek help and get in touch with a doctor. Only a doctor can help you decide whether your shortness of breath is due to anxious thoughts or another illness.
The best way to manage shortness of breath due to anxiety is by connecting with a mental health professional. A professional can help you overcome your high anxiety levels through medications, therapy, and self-care tips.
Medication
After assessing the cause of breathlessness and diagnosing an anxiety disorder, a clinician may sometimes prescribe short-term medication such as a benzodiazepine. These medicines can suppress breathing and should not be taken to self-treat new or unexplained shortness of breath or to delay urgent assessment.
However, remember that these medications may also have certain side effects and can potentially lead to physical dependence. Moreover, combining them with alcohol or other drugs may lead to complications like an overdose. Hence, it is imperative to follow the doctor’s instructions while using them.
Alternatively, a psychiatrist may suggest using selective serotonin reuptake inhibitors (SSRIs) as a safer class of antidepressant medication to manage anxiety symptoms.
Cognitive Behavioral Therapy
Cognitive behavioral therapy or CBT can particularly benefit people with anxiety. It works by assisting people in changing the way they think about and respond to specific situations, especially those that trigger anxiety. CBT can help many realize how their anxieties are based on false alarms of fear and encourage them to cope with these triggers instead of avoiding them.
Psychodynamic Psychotherapy
As an effective treatment for anxiety symptoms, psychodynamic psychotherapy focuses on the role of relationship and personal conflicts and their association with anxiety. It harnesses the patient-therapist relationship and uses it for personal reflection, adoption of new behaviors, and acceptance of complicated feelings.
Deep Breathing
Sufficient evidence suggests the role of deep breathing in calming down anxiety and its symptoms, including shortness of breath. Deep breathing stimulates the vagus nerve, which in turn, activates the parasympathetic system. The parasympathetic system works opposite the fight-or-flight response and introduces relaxation and calmness in the body.
Follow the steps mentioned below to practice deep breathing:
- Sit up with your back against a wall or lie on the ground
- As you close your eyes to relax the body, loosen your jaw, soften your brow, and roll your shoulders down
- Put your right hand on the lower part of your belly and your left hand on your heart
- Imagine having a balloon below your right hand and pretending that you are trying to fill it up. Take a deep breath through your nose, hold it until you mentally count to four, then slowly exhale as you further count to 8
- Repeat the steps mentioned above a couple of times
Grounding Exercises
In many people, shortness of breath occurs due to an anxious thought spiral or irrational thoughts. If this is the reason in your case, try seeking help from grounding exercises. For a familiar, medically assessed anxiety episode, grounding can help. If you feel unable to breathe, seek urgent help rather than trying to walk it off. Even if you cannot manage to be outdoors whenever you are having an anxiety attack, consider following the technique indoors with the following steps:
- Observe five things that are in your sight
- Name four things you can physically touch
- Notice three things that you can hear
- Pay attention to two things you can smell
- Focus on one thing that you can taste
Temperature Change
Do not try to shock or reset your nervous system with a cold shower or by submerging your face in ice water when you are breathless. For a familiar anxiety episode that has been medically assessed, try gentle grounding and comfortable, unforced breathing instead.
Progressive Muscle Relaxation
Research has proven the efficacy of progressive muscle relaxation, especially when you can’t get a satisfying breath due to anxiety. The technique involves tensing certain body parts, holding that tension for up to five rounds of breath, and then releasing it.
As a tip, begin with the lower half of your body and then slowly climb up in the following order: feet, legs, butt, stomach, arms and hands, shoulder and neck, and face.
Exercise
Regular physical activity may help manage anxiety after the cause of breathlessness has been assessed. During unexplained or worsening breathlessness, stop exertion and seek medical advice. When you are well and a clinician considers it appropriate, activity options may include:
- Jumping jacks
- Jumping rope
- Yoga
Choose an activity and intensity suited to your health and fitness. Do not use high-intensity exercise as a treatment for an episode of unexplained shortness of breath.
With so much going on in life, you can easily brush off the self-help techniques unless you are knee-deep in a crisis. But just like any disaster-preparedness plan, it becomes easier to get through tough moments when you have practiced your defense mechanisms a few times.
Consider learning and practicing the following tips to prevent getting short of breath due to uncontrolled anxiety:
Meditation
Meditation helps you detach from anxiety-provoking thoughts and allow you to focus on the present moment. If possible, consider spending some time every morning to observe your thoughts in a peaceful corner of your accommodation to keep your anxiety symptoms well-managed.
Journaling
In most people, anxiety is a signal that indicates that their life needs some kind of adjustment. Journaling about anxious feelings and thoughts can help them identify the problematic area and address it.
Limiting Social Media
Research suggests that watching up to 2 hours of the COVID-19 news daily can significantly contribute to anxiety, stress, and depression. Similarly, spending too much time on other social media platforms can also contribute to these issues. If you feel like excessive use of social media is contributing to high anxiety levels and the consequent shortness of breath, consider limiting it. One way to do this is by setting a 30-minute-long time every time you start scrolling. As soon as the timer rings, shut down whatever you are doing and engage in some other activity.
Lifestyle Adjustments
You can make many tiny tweaks in your daily life to increase the element of relaxation, calmness, and happiness. These include:
- Getting 6 to 8 hours of sleep every night
- Spending time with loved ones
- Working out at least five times a week
- Engaging in hobbies, you enjoy the most
- Following a nutrient-dense diet plan
