Do you sometimes have difficulty swallowing? Perhaps you feel as though something is stuck in your throat, or your throat feels scratchy? You may even have a choking sensation as you try to swallow. While these feelings can be related to a number of illnesses and diseases they may also be related to anxiety as part of the body’s physical response to stress. This article focuses on the latter issue. It begins with a brief description of what anxiety is and how it relates to swallowing difficulties. It is then considered an indicator of anxiety. It focuses specifically on swallowing difficulties. Some tips for managing these difficulties are then discussed.
Background: What is anxiety?
Mental health professionals and researchers often differentiate between normal levels of anxiety and anxiety disorders.
Anxiety is a normal reaction we have when we find ourselves in potentially stressful situations such as taking a test, attending a job interview or even dealing with happy events like going on an overseas trip. It involves physiological, psychological and behavioural responses that help us to prepare for, and manage, such situations. We don’t consciously control this response. It is a function of the autonomic nervous system that regulates things like blood flow, heart rate, and breathing. Indicators of normal anxiety include feeling nervous, sweating, rapid breathing, increased heart rate, nausea and tight muscles. This includes throat muscles. They indicate that our mind and body are preparing to deal with stressful situations. It is sometimes referred to as the fight or flight response. Most of us experience anxiety from time to time. It is generally a response to a specific situation or challenge and usually lasts only until that particular situation has been resolved. (Herndon, 2021; Beyond Blue, 2021).
However feeling anxious can become recurrent, ongoing and intense, reaching a level where it begins impacting our daily activities and relationships. This level of feeling may indicate a disorder. People with anxiety disorders can have intense feelings of worry or distress that are not easy to control. They may also have the physical indicators referred to above. There are different types of anxiety disorder and the specific symptoms can vary from person to person. However, they are all generally associated with intense fear or worry that is out of proportion to the situation at hand.
The feelings associated with anxiety, even at normal levels, can make us uncomfortable or worried, leading us to seek ways to ameliorate them. Fortunately, there is a range of health professionals and services offering advice, diagnosis or treatment. The type of treatment will depend on the type of anxiety being experienced and the particular symptoms identified. For example, for less intense symptoms the health professional might suggest self-help strategies and lifestyle changes, while for more severe symptoms, therapy or even medication may be recommended.
Difficulty swallowing from anxiety
It is not uncommon to experience difficulty trying to swallow if we are feeling anxious. This can occur because we become overly sensitive to the automatic bodily functions that are normally controlled by the autonomic nervous system. For example, swallowing is a natural reflex. We don’t think about it. When we feel anxious, the autonomic nervous system tightens the muscles in our throat (of which there are more than forty). At the same time, our mind becomes focused on automatic bodily functions. We become conscious of this tightness. When we try to swallow, these tight muscles may not work properly. We can still swallow, but it no longer feels like a natural reflex. It feels as though something is wrong. The literature suggests a number of self-help strategies for managing swallowing difficulties that are related to anxiety rather than to an underlying medical disorder.
When considering suggestions about how to manage the condition it is important to understand that different strategies will work for different people. Some strategies may focus directly on easing throat discomfort while others may more broadly address the anxiety causing the discomfort. It may therefore be a good idea to consult a professional or therapist to provide the appropriate advice, diagnosis and therapy for your particular situation.
It is important to note that trouble swallowing could be a sign of other disorders, such as gastroesophageal reflux disease (GERD). While stress can be a component in these conditions, they frequently require some medical or other intervention. Therefore it may be a good idea to consult with a doctor or therapist to ensure that the swallowing difficulties are not indicators of any underlying medical conditions.
Many of the recommended strategies for managing swallowing anxiety include an element of distraction (Ankrom, 2021; BeyondBlue, 2021). Distractions can be helpful as they can stop us from focusing on the swallowing reflex. Distractions can include:
- Spend time playing a musical instrument or become immersed in a favourite soundtrack or piece of music.
- Singing: this can distract thoughts and help to ease tightness in the muscles while regulating breathing. It gives people experiencing anxiety something to focus on.
- Participating in a favourite activity: practising a favourite hobby, reading, playing a game, doing a puzzle, watching something that makes you laugh, can be absorbing and distracting. This diverts attention from worries about swallowing
- Socialising with friends or family. If this can’t be done face to face, using social media can be a good option.
Meditation and relaxation
Relaxation techniques like yoga and meditation can help reduce swallowing difficulty anxieties by providing a sense of perspective about the perceived concerns. For example, mindfulness is a type of meditation that focuses on being really aware of the present without trying to interpret or judge what you are experiencing. It encourages you to be fully focused on where you are and what you’re doing, thus taking your mind off the stress symptoms. Mindfulness techniques can include breathing exercises, meditation, mind-absorbing activities, creative hobbies and puzzles.
Many relaxations and meditation techniques may be more effective with some professional guidance.
Breathing is a relaxation strategy that can reduce anxious feelings and relieve muscle tensions. When we are feeling anxious, we tend to breathe too rapidly. Suggestions for effective breathing exercises include finding a quiet, comfortable place, sitting with eyes closed. Breathe slowly and deeply in through the nose and out through the mouth (Abraham, 2021).
Studies suggest that water is easier to swallow than other food and liquids while swallowing may help to relax the throat. Feeling the water going down our throat reminds us that our swallowing reflex is working. This may have a calming effect. Some liquids such as tea, coffee or cola are thought to have a drying effect on the throat and it is recommended that these be limited. There are also some indications that hydration, in general, can reduce the sensation of a lump. Sipping water frequently may be helpful (Abraham, 2021).
Physical exercise such as jogging can reduce the level of stress hormones such as adrenaline. At the same time, physical exercise produces endorphins. These hormones can help you to feel more optimistic and relaxed which may contribute to relaxing the muscles in your throat.
Throat massage, yawning, chewing
The literature suggests that:
- Massaging the throat can relax the muscles. This helps to eliminate feelings of tension.
- Yawning is considered to be a very good technique for relaxing the muscles in the throat. It is suggested that you yawn on an in-breath and gently release a sigh on an out-breath.
- Chewing can relax tight jaws: you move your tongue, lips, and jaw as if you were chewing on a hard lolly. Exaggerating these movements to work all the muscles of the mouth. (Johnson, 2021)
Self-help strategies can be very effective. However if feelings become so intense that they’re causing extreme distress or disruption to daily life, it’s important to seek professional help (Ankrom, 2021; BeyondBlue, 2021; Herndon, 2021; Hull University Teaching Hospital, 2021; Johnson, 2021; Legg, 2020; NHS, Great Britain, 2021).
This article discussed difficulty swallowing as related to anxiety. It noted that this is a common condition associated with both normal anxiety and anxiety disorders. A number of self-help strategies for managing swallowing anxiety were outlined. Some of these focussed directly on easing throat discomfort while others focus more broadly on managing the feelings of stress which may contribute to the discomfort.
The discussion emphasised that it is important to understand that different strategies will work differently for different people and that the important thing is consulting an appropriate health professional to get the most relevant advice, diagnosis or therapy for your particular situation.
The information in this article is not a substitute for informed professional advice. For expert advice, it is recommended that appropriate professionals be consulted.
Abraham, M (2021), How Anxiety Causes Trouble Swallowing, CalmClinic https://www.calmclinic.com/anxiety/symptoms/trouble-swallowing
Ankrom, S., (2021), Nervous vs anxious what’s the difference? Verywellmind; Medically reviewed by Steven Gans, MD https://www.verywellmind.com/is-it-normal-anxiety-or-an-anxiety-disorder-2584401#what-it-means-to-be-nervous
Beyond Blue (2021), Anxiety Management Strategies https://www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety/anxiety-management-strategies
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