If you deal with anxiety or panic attacks on a regular basis, you might find that your symptoms are centered around your throat. You may struggle to breathe or swallow, and as your anxiety increases you may even worry about your throat closing. The fear of swallowing is also known as phagophobia; if you experience this, you’re not alone. Learning how to overcome swallowing anxiety can have a powerful impact on your overall anxiety and confidence in yourself. This article will break down what anxiety is, how difficulty swallowing can become a symptom, and proven strategies for how to overcome swallowing anxiety.

What is Anxiety?

Oftentimes, anxiety has multiple levels, and it is up to the health professional you speak with to determine whether you are experiencing “normal” levels of anxiety or an anxiety disorder.

Anxiety is absolutely a normal reaction to stress. Even those on medication to suppress anxiety will still experience it from time to time. You tend to feel it in situations that make you nervous, such as taking an important test, meeting someone new, delivering a presentation, or even going on a vacation.

The goal of anxiety is to help you mentally prepare for what’s coming. It can cause feelings of nervousness, sweating, breathing more quickly, increased heartrate, nausea, and tight muscles. This indicates that your body is ready to face the threat that is coming. It is a perfectly normal response that usually only lasts until the situation at hand has been dealt with.

That being said, anxiety can get much more intense and become recurring over time, eventually reaching a level that does not allow you to function in your daily life. If you find that you’re not able to accomplish work tasks, see friends, or run errands without forcing yourself because your anxiety is trying to stop you, that could indicate a disorder.

When anxiety interferes with life

Those people with anxiety disorders often have intense feelings of worry, nervousness, or apprehension that are incredibly difficult to control. They may give into their anxiety regularly, avoiding tasks that trigger uncomfortable feelings or coming up with ways to get tasks done without having to face their anxieties. For example, someone with anxiety around phone calls may often text, email, or not reach out at all if a phone call is the only option. This avoidance behavior can create havoc in one’s life.

On the other hand, some people with anxiety disorders may fight their way through their anxiety, but become mentally exhausted in doing so. For example, a person may feel constant anxiety about their finances, even when they are financially well-off. They also feel anxious when driving to the grocery store, walking around among other shoppers, and spending money on groceries. Yet, the person with anxiety does it all, then comes back home and immediately crashes. Sometimes it can be hard to tell if a person has anxiety because of this. Still, in this case, the person with anxiety may know that avoidance behavior creeps up on them, and so they are avoiding the act of avoidance, and exhausting themselves in the process.

Feelings associated with anxiety are uncomfortable, so it makes sense that we avoid them. Thankfully, mental health professionals have seen great success treating chronic anxiety with both talk therapy and medication, so there are ways to mitigate your anxiety if you find it hindering your life.

Swallowing Anxiety

Difficulty swallowing when you’re feeling anxious is not uncommon, but it is definitely a frightening symptom. It also probably doesn’t make a lot of sense. What does nervousness have to do with being able to swallow?

The reality is – a lot! Those with anxiety have an over-sensitivity within their body during times of panic, and this is what makes swallowing so difficult. Usually, your body does most things automatically. You don’t think about breathing, about where your tongue is placed in your mouth, about where your fingers are when you grab something, or about swallowing.

What happens during anxiety?

During anxiety, a few things happen. Your nervous system tightens your muscles, including the ones in your throat. At the same time, you become highly focused on your bodily functions. You start to realize that you’re tensed up, and you may even feel slight pain in your tightened muscles. (As an aside, if you have health-related anxiety, remember that anxiety CAN cause physical discomfort.) Perhaps you’re salivating, and you try to swallow. Because your throat muscles are tight, it can be difficult to swallow. And, because you’re in a hyper-aware state, you notice the act of swallowing, and you notice that it feels wrong. This can cause you to tighten your throat muscles more, or even choke or have difficulty breathing. 

If you’ve experienced any of these symptoms, the good news is that there are some very simple ways to mitigate them. Do keep in mind that different strategies may work better for different people. Some strategies focus on easing throat muscles, and others will focus more on mitigating anxiety on the whole. If you are experiencing large amounts of anxiety, it is always a good idea to speak with a therapist or your doctor so that you can be provided with the right advice and diagnosis for you.

How To Overcome Swallowing Anxiety

Before getting into the strategies, it should be noted that there are a number of other disorders that can cause difficulty with swallowing. These include gastroesophageal reflux disease (GERD), as well as bone spurs for older folks and those with osteoarthritis. This is why it is a great idea to speak with a doctor if you have frequent trouble swallowing so that you can rule out any other health issues or underlying medical conditions.

Deep breathing

Deep breathing works double-duty. During an anxiety attack, we tend to inhale for longer than we exhale. This is partially how our muscles tighten up. This breathing also increases our blood pressure, accelerates the heart rate, and puts us into fight mode. This is all caused by the sympathetic nervous system.

The antidote here is to activate the parasympathetic nervous system. That can be done if you focus on breathing in for half as long as you breathe out. This is a technique called 2-to-1 breathing. A pattern of 4-7-8, or breathing in for 4 seconds, holding for 7 seconds, and breathing out for 8 seconds, is usually recommended to help relax muscles and relieve anxiety.

Deep breathing also helps with opening the larynx, which can help with your ability to swallow. Some exercises include saying “ah” as you breathe out to help relax the muscles around your throat specifically. Often, exercises for opening the larynx involve breathwork in some way.

Drink water

A study found that people who drink five-plus of water per day were at lower risk for anxiety and depression. Comparatively, those who drink less than two cups of water per day double that risk. 

Additionally, if you tend to drink a lot of water but suddenly decrease that amount, you’re likely to feel less calm, more hostile, and more tense and anxious when dehydrated.

Drinking water may sound impossible when you’re experiencing swallowing anxiety. But taking small sips and getting them down can both help relieve tension in the throat and help increase feelings of calm when you are able to get it down.

Some beverages, like coffee, tea, and soda, can have a drying effect on the throat. Some medications can cause dry mouth as well, which can hinder swallowing. Drinking water can relieve these effects, making it a little easier if anxiety and difficulty swallowing do come on.

Movement

Physical exercise such as walking, running, or cycling, is another effective strategy for how to overcome swallowing anxiety. Simultaneously, physical exercise reduces adrenaline and increases your endorphin levels, which are hormones that your body secretes that decrease pain and increase positive feelings in the body, similar to morphine.

Additionally, shoulder and neck exercises can relieve the tension in your throat causing your difficulty swallowing in the first place. During an anxiety attack where you are having difficulty swallowing, follow any of the exercises below. You can also follow along with this Youtube video from the Cleveland Clinic to relieve the tension in your neck and shoulders and see if it helps you swallow a little easier:

• Roll your shoulders backward slowly five times. Roll your shoulders forward slowly five times.
• Keeping your eyes forward, tilt your head to the left and hold for five seconds. Tilt your head to the right and hold for five seconds. Be sure not to lift your shoulders.
• Tilt your head back and look at the sky (or the ceiling) for five seconds. Tilt your head forward and look at the ground for five seconds.
• Slowly roll your neck in a circle clockwise, followed by counterclockwise. If I find any tension, I like to roll my neck back and forth “across it” to work it out. If you do this a few times, you’ll know what I mean.
• Push your shoulders back like you’re trying to crack an egg between your shoulder blades. Combine this with the deep breathing technique mentioned above for my personal go-to anxiety reliever.
• Intertwine your fingers and press your palms up toward the sky (or ceiling). Try to feel a stretch in your neck and shoulders with this. Feel free to bend side to side to also get a good stretch in your sides.

Other techniques to overcome swallowing anxiety

Yawning: Yawning can be a great way to help release the neck muscles and open the throat. Yawn on a deep breath in, and then gently release a sigh on your out breath.

Chewing: Chewing can relax your jaw, which is frequently one of the first things to tighten when you experience anxiety. Move your tongue, lips, and jaw as though you were chewing, and try to exaggerate the movements if you can. Chewing gum can also help, although if you have trouble swallowing note that chewing can cause you to salivate, which in turn will cause you to need to swallow more. This can be helpful or harmful depending on you.
Massaging: Like exercise, massaging the throat and neck muscles can relieve tension. Cup one hand in a C shape and run your fingers and thumb down either side of your neck repeatedly to target the throat muscles, and press the fingers of both hands into the sides and back of your neck to relieve tension.

Don’t give in to anxiety

This is the hardest part, but it is the best way to combat anxiety in general. Remember the avoidance behaviors we discussed previously? Avoiding your anxiety triggers will only reinforce those triggers. Facing them head-on (when it is safe to do so,) over and over again will begin to reinforce that there is no real danger, and over time, your anxiety can be reduced or even eliminated around certain triggers. 

If you recall, one of my examples did just this. Yet still, he was mentally taxed at the end of the day. Acknowledging and facing your triggers head-on is a challenging, exhausting process, and you also need to be aware enough to note when something you thought would be scary turned out not to be. This is why it is absolutely vital to work with a therapist if you have recurring anxiety. A therapist can teach you techniques for coping with anxiety that were not covered in this article. This is because they are therapeutic techniques that can be difficult or dangerous to do without guidance.

If you are experiencing anxiety or are interested in exploring how to overcome swallowing anxiety further, we can help! At Modern Era Counseling, our team of premiere therapists has extensive training and experience working with clients who struggle with anxiety. The techniques they can teach you can help to relieve your anxiety in as little as a few months. If you live in North Carolina, give us a call at (704) 800-4436 or shoot us an email to learn more and get started today.