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How to Tell If Shortness of Breath Is From Anxiety

Сan anxiety cause shortness of breath
Written by:

Wafaa Amjad Dar

Pharm-D

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Anxiety is a common emotion, but sometimes, it can manifest as intense restlessness that disrupts daily life, indicating an anxiety disorder. In the case of having such a condition, a person may experience a variety of symptoms, with shortness of breath being one of them.

However, the causes of breathing difficulties can be both physical and psychological. Read on to learn how to tell if shortness of breath is a consequence of anxiety, if it’s harmful, and how to manage it using medical and self-help techniques.

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Can Anxiety Cause Shortness of Breath?

Shortness of breath is a common symptom of panic attacks. In this case, it is likely accompanied by intense fear, rapid heartbeat, and chest tightness. However, breathlessness may also occur because of other anxiety disorders. It’s caused by the bodily fight-or-flight response in stressful situations, so let’s review this process in more detail.

Why Does Anxiety Cause Shortness of Breath?

The connection between anxiety and breathing lies in the body’s physiological response to stress [1*] . When a person encounters danger or a terrifying situation, the sympathetic nervous system is activated, and the body enters a fight-or-flight mode for self-defense. This involves physical and mental reactions that trigger you to fight or run away.

For example, the release of stress hormones like adrenaline and noradrenaline causes heart palpitations and stimulates changes in breathing patterns. The heart rate increases to ensure more blood goes to the muscles in readiness to run or fight. Likewise, the increased depth and rate of breathing help to supply more oxygen to the tissues. Such changes often result in breathlessness and shallow breathing, and you may feel like you’re suffocating and hungry for air even though oxygen levels in the blood may remain normal. Sometimes, the response also leads to muscle tension, including in the muscles involved in breathing, which may result in chest tightness.

The Specifics of Shortness of Breath From Anxiety

While breathlessness [2*] and other symptoms occur to protect you during the fight-or-flight response, they may be out of proportion to the real triggering event. Also, you might experience additional psychological and physical symptoms besides feeling short of breath if the cause is a panic attack or another anxiety disorder. These symptoms [3*] may include the following:

Breathing difficulties and other reactions from experiencing anxiety can occur during normal daily activities, such as making presentations at work.

What Conditions May Cause Breathlessness

Breathing problems might be a harmless symptom if it’s caused by anxiety. However, dyspnea may occur because of specific physical illnesses, and in this case, it requires treatment. Some examples include:

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Heart attack
  • Arrhythmia
  • Anemia [4*]

Seek medical attention when experiencing breathing issues because if its episodes are prolonged and severe, they can potentially lead to other health complications.

Panic Attack vs Heart Attack

Since they share a few symptoms, it’s important to know what shortness of breath from anxiety feels like compared to breathlessness caused by a heart attack:

  • A panic attack often comes with tachycardia (an increased heart rate), and if there is chest pain, it usually doesn’t spread to other parts of the body. A panic attack may happen even at rest and typically lasts from a couple of minutes to an hour.
  • Heart attacks don’t usually happen at rest but rather during or after physical activity. Pain in the chest may feel like pressure or squeezing, may spread to an arm, jaw, or shoulder, and can come in waves without getting better with time.

Stressful events may be the reason for both panic attacks and heart attacks, and some of their symptoms overlap (such as sweating, nausea, a feeling of impending doom, etc.). Therefore, if your symptoms are severe and you are unsure about their nature, consult with a healthcare provider promptly. Also, note that anxiety disorders are associated with a higher risk for cardiovascular issues [5*] , so it’s important to attend check-ups regularly according to your health history.

How to Help Shortness of Breath From Anxiety

Managing shortness of breath from anxiety involves treatment options that aim at reducing anxiety levels and improving breathing patterns. Here are some helpful strategies:

Therapy and Medication

Therapy for breathing difficulty from anxiety typically involves several approaches. They focus on primarily addressing the underlying anxiety disorders and managing associated symptoms:

  • Cognitive Behavioral Therapy (CBT): CBT [6*] focuses on identifying and challenging negative thought patterns and beliefs that contribute to anxiety. It can help individuals recognize and change maladaptive thoughts and behaviors related to breathing issues with anxiety.
  • Exposure Therapy (ET): It involves gradually exposing individuals to situations or stimuli that trigger anxiety, such as situations where people find it hard to breathe, in a controlled and supportive environment. Over time, it helps them to learn to tolerate and manage their anxiety responses more effectively.
  • Respiratory Biofeedback: Biofeedback [7*] therapy involves using electronic monitoring devices to provide real-time feedback on physiological responses, including breathing patterns, empowering individuals to manage anxiety-related shortness of breath effectively.
  • Medication: In some cases, medication may be prescribed in conjunction with therapy to manage anxiety symptoms, including shortness of breath. This may include anti-anxiety medications (buspirone [8*] ), antidepressants, or beta-blockers, depending on individual needs and preferences.

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Self-Help Relaxation Tips

To get rid of shortness of breath from anxiety, focusing on your breathing is one of the effective strategies. Concentrating on the breathing rhythm helps control the amount of oxygen getting into the lungs thereby easing breathing.

Diaphragmatic Breathing

Diaphragmatic breathing [9*] can help you control your breathing. Instead of breathing from the chest or mouth as it usually occurs, you use the diaphragm to regulate the air volume you inhale and exhale. The steps are the following:

  • Lie back on a flat surface, support your head, or sit comfortably in a chair.
  • Feel your diaphragm by putting one hand below the rib cage while the other rests on the upper chest.
  • Slowly and deeply inhale through the nose and feel the stomach moving out against the hand below the ribcage.
  • Tighten your stomach muscles and let them fall in you slowly exhale through the nose or mouth.
  • Continue for a few minutes taking deep breaths as you hold and then slowly exhale, feeling your stomach move.

Diaphragmatic breathing stimulates the relaxation response of the parasympathetic nervous system. It can slow down the breathing rate, reducing the body’s oxygen demand, and minimizing the effort and energy needed for breathing.

Note: Breathing through the nose alleviates anxiety-related breathlessness or hyperventilation more efficiently than mouth breathing.

Other Relaxation Techniques

Other techniques for relieving anxiety and the associated breathlessness include:

  • Grounding techniques help individuals manage anxious thoughts [10*] or sensations by anchoring themselves to focus on the present moment.
  • Mindfulness practices in which you shift your attention from the anxiety trigger and focus on other lighter things promote relaxation.
  • Light exercise like walking and other types of physical activity can also help you reduce anxiety symptoms.
  • Box breathing (4-4-4-4) involves breathing in, holding the breath, exhaling, and then holding the breath again, all for a count of four seconds each.
  • 3-3-3 breathing entails inhaling deeply through the nose for three seconds, holding the breath for three seconds, and then exhaling slowly through the mouth for another three seconds.
  • Pursed lip breathing involves inhaling slowly through the nose for two seconds, then exhaling through pursed lips, like blowing out a candle, for four seconds.

When to Seek Professional Help

It’s important to seek professional help or medical attention for shortness of breath from anxiety in the following situations:

  • Severe Symptoms: If you are experiencing severe shortness of breath that is interfering with your ability to function or causing significant distress, it’s essential to seek immediate medical attention. Severe symptoms may include air hunger, chest pain, dizziness, or fainting.
  • New or Worsening Symptoms: If you are experiencing new or worsening shortness of breath from anxiety, it’s essential to go through an assessment and ensure appropriate treatment.
  • Persistent Symptoms: If your shortness of breath persists despite attempts to manage anxiety through relaxation techniques and breathing exercises, it’s important to seek guidance from a healthcare provider. 
  • Concern for Underlying Conditions: If you have pre-existing medical conditions like asthma, COPD, or heart disease, it’s crucial to differentiate anxiety symptoms from potential exacerbations and receive appropriate treatment.

Consult with a mental health professional to learn whether your shortness of breath is from anxiety and receive a legitimate diagnosis and treatment.

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Conclusion

Anxiety and shortness of breath have a bidirectional relationship. If you feel breathless while experiencing other psychological symptoms like panic attacks or fear of losing control, then anxiety is the likely cause of your symptoms. If the symptoms are severe or happen frequently, contact a medical provider to get professional help.

FAQ

Yes, stress can cause breathlessness. When you experience stress, your body instinctively activates the fight-or-flight response, releasing stress hormones like adrenaline as a natural reaction. This physiological response can lead to rapid breathing and shallow breaths.

The choice of anxiety medication for shortness of breath typically depends on various factors, including the exact disorder, individual medical history, and the severity of symptoms. Benzodiazepines like lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin) are among the most commonly used short-term medications for anxiety, but your healthcare may suggest other options based on a detailed assessment.

Yes, you may have trouble breathing all day because of anxiety, especially when anxiety is severe and goes unmanaged. However, such prolonged breathlessness can be a sign of another health condition, so it’s advised to see a healthcare professional.

Sources

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10 sources
  1. Interoception of breathing and its relationship with anxiety
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  2. Breathlessness: From Bodily Symptom to Existential Experience
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  3. Anxiety Disorders
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  4. A Review on Nutritional Anemia
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  5. Anxiety disorder and cardiovascular disease: a two-sample Mendelian randomization study
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  6. Cognitive Behavioral Therapy for Anxiety and Related Disorders: A Meta-Analysis of Randomized Placebo-Controlled Trials
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  7. Respiratory biofeedback-assisted therapy in panic disorder
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  8. Buspirone effect on breathlessness and exercise performance in patients with chronic obstructive pulmonary disease
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  9. Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review
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  10. Practical applications of grounding to support health
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Written by:

Wafaa Amjad Dar

Pharm-D
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This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.