How to Tell if Shortness of Breath is From Anxiety

Understanding Anxiety and Shortness of Breath

Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult with a healthcare provider for medical guidance.

Have you ever found yourself out of breath in a stressful situation? You may notice that your breath starts to become shaky, too fast, or too slow, or you may feel as if you cannot breathe at all. If with shortness of breath, you are also experiencing stress, worry, and other overwhelming thoughts and feelings, it may be a sign that you are experiencing anxiety.

In this article, we will talk about how to tell if shortness of breath is from anxiety or other medical conditions. We will also take a deep dive in exploring tools and strategies to manage anxiety-induced shortness of breath.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), anxiety is a complex response produced by our body when it senses any danger in our environment. When there is a real danger, the feeling of anxiety is incredibly useful. It helps us to pay attention to the situation and deal with it effectively. For example, if we are feeling anxious about our upcoming performance review, we may feel more motivated to prepare for it.

However, in some situations, our body can sense danger when there is no real threat. For example, we may misinterpret our manager’s feedback about our performance as a critique and feel anxious about a negative score on the work review. When this unwarranted worry happens frequently and disturbs our daily lives, it is a sign that we may be suffering from anxiety disorder.

The feeling of anxiety is often accompanied by some physical and emotional symptoms. You may think excessively, feel as if you are on the verge of a breakdown, are unable to sleep, etc. One of the core features of anxiety is changes in breathing patterns, like hyperventilation (irregular breathing) and unexplained dyspnea (shortness of breath).

The research suggests the role of the amygdala in anxiety-induced shortness of breath. People with anxiety are shown to have a smaller amygdala which increases sensitivity towards carbon dioxide. This in turn can increase C02-induced fear and reduce cognitive functions.

Symptoms of Anxiety-Induced Shortness of Breath

The anxiety-induced shortness of breath is accompanied by heavy and rapid breathing which usually resolves after anxious feelings begin to dissipate. In a research study conducted by Woodgate et al. (2021), a 17-year-old participant described anxiety-induced shortness of breath as:

“when my breathing’s acting up [with anxiety] it feels like, you know how like you’re underwater and your lungs start to get tight . . . . That’s what it kind of feels like for me . .”

Some other ways of how to tell if shortness of breath is from anxiety are:

The shortness of breath lasts between a few seconds to minutes.
It is triggered by a sense of fear or threat about something.
You experience other symptoms of anxiety.
There is no history of medical illness related to shortness of breath.
You experience relief from mindfulness and emotional regulation techniques.

It can be difficult to identify on your own whether the root cause of shortness of breath is anxiety or other medical conditions. If the issue is recurrent and severe, immediately consult a physician or a psychologist near you. A doctor can help you to identify and treat any potential medical cause whereas a psychologist helps you to manage your emotions and treat for anxiety-induced shortness of breath if needed.

Differentiating Between Anxiety and Other Causes

Difficulty in breathing can be caused due to a lot of problems in the body which include but are not limited to anxiety. Here are some ways you can differentiate anxiety-induced shortness of breath from other medical causes. Again, it is important to understand that self-diagnosis about shortness of breath can be limiting and inaccurate. Always consult a doctor and a psychologist to make treatment decisions.

Anxiety or Heart Problems

The anxiety-induced shortness of breath is caused by a trigger that induces a real or imagined sense of thereat in the surroundings. However, the shortness of breath related to heart problems is usually because of structural anomalies (e.g., valve leakage, blockage of arteries, etc.) that disturb cardiovascular functioning (e.g., flow of blood, elevated pressure around the heart, etc.). The common symptoms of heart failure include difficult breathing when lying down, unusual fatigue in doing activities, etc.

Anxiety or Asthma

In Asthma, the patient has narrower air pathways than usual. It leads to breathing difficulties as the air gets entrapped while exhaling. Usually, there is a history of allergies and the shortness of breath in Asthma can be accompanied by wheezing.

In anxiety, the person is able to take a full breath but may find themselves unable to do so because of induced panic that activates our sympathetic system, a part of our nervous system responsible for fighting the threat at hand.

Anxiety or Lung Conditions

Lung conditions include (but are not limited to) infections like bronchitis and tuberculosis, cancer and other tumors, scarring and damage of lung tissues, etc. Depending upon the cause, the shortness of breath in lung conditions is accompanied by discolored phlegm, fever, appetite, weight loss, etc.

The anxiety-induced shortness of breath may come with appetite and weight loss but it is not because of problems in the respiratory system. There might be an overlap of contributing causes (like smoking history), and it is best to understand the underlying cause with the help of medical and mental health professionals.

When to Seek Emergency Care

You may want to seek emergency care when there are any sudden changes in breathing patterns that cause extreme distress. Some signs are chest pain, sudden onset of shortness of breath, and trouble breathing while lying down.

In general, any level of breathing difficulty may warrant clinical attention unless you are in rare circumstances where shortness of breath is expected (for example, climbing a mountain, intense levels of physical activity, etc.).

If the issue is severe and persistent, there is likely medical concern and/or points towards mental health issues. To understand the treatment options, it is highly recommended that you avoid self-diagnosis and seek out a consultation from a doctor.

Coping Strategies

The Indian traditions have a long history of using breathwork, or pranayama, to regulate breathing. This looks like being mindful of how breath travels within and out of our body and slowly altering its pace, rhythm, and depth (Brendel et al., 2023). This practice is incredibly useful for managing anxiety-induced shortness of breath because:

It activates the parasympathetic response of our nervous system which signals to our body that the impending that is over and we can calm down, easing us into taking full breaths.
By using slow deep breaths, we utilize our mind-body connection to stop the spiral of anxiety. When our body feels rested and relaxed, all bodily responses like breath, heart rate, and digestion go back to normal, signaling us that the danger is over.

Some strategies that you can use can regulate your anxiety-induced shortness of breath are:

Breathing awareness: Sit in a relaxed position and observe how the breath travels in and out of your body. You will start noticing how you are feeling in the body, where are you holding the tension, what are you thinking about, and what your body needs in the moment to feel safe. It is a mindfulness practice that helps us to ground ourself in reality instead of being stuck in what happened in the past or worried about the future.
Taking deep, controlled breaths: Use a 4 – 4- 4 rule to take deep, controlled breaths. It is also called box breathing. Here you inhale for 4 seconds, hold your breath for another 4, and exhale for 4 seconds. After you have taken a full breath, you wait for 4 seconds before taking another. It is a great way to feel relaxed and centered quickly. If you need a visual cue to guide you through the process, check this out.
Progressive Muscular Relaxation: This technique involves targeting various muscle groups in the body, for example, legs, arms, neck, etc. The idea is to notice where you are feeling the tension in the body, contact and hold the muscle for some time, and then release to experience relaxation. Once you experience relief in one part of the body, you can notice what else needs attention.

While these breathing strategies are great tools in your mental health journey, they are not a substitute for professional support. Reach out to a Mave Health therapist today to understand your treatment options.

Medication Options

Some of the commonly used medications for anxiety management are:

Selective Serotonin Reuptake Inhibitors (SSRIs): help to improve mood by increasing serotonin levels.
Anxiolytics, like Benzodiazepines: help to regulate mood, anxiety, and sleep.

There are a lot of medications available for the treatment of anxiety disorders. The dosage type and size may vary depending on your history and symptoms. It is important to consult a doctor to take medications and avoid self-medication.

Long-Term Management

A holistic approach works best for long–term anxiety management. In this section, we discuss some ways you can plan for long–term management of your anxiety symptoms.

Developing a Comprehensive Anxiety Management Plan

A professional can help you determine how severe your anxiety levels are and develop a comprehensive anxiety management plan that meets your needs. This can include a combination of therapy, medications, coping tools, and alternative mental health practices.

Mindfulness and Meditation

Mindfulness is the degree to which we are able to be present in a given moment. Often, we are either ruminating about what happened in the past or are too worried about the future. Mindfulness practices help us to bring our attention to the present, making us feel more relaxed and in control. Therefore, it is a very effective way to manage anxiety-induced shortness of breath.

A simple strategy to incorporate mindfulness in daily life is sensory grounding (5-4-3-2-1). Be in a comfortable position and take a moment to notice:

5 things you can see
4 things you can hear
3 things you can touch
2 things you smell
1 thing you can taste

While you are spotting these objects in the environment, take your time to observe the details and experience the sensation. If you practice this at least once a day, it is likely that you will notice a drop in your anxiety levels. Please note that mindfulness practices are not a substitute for professional services. Reach out to a healthcare provider today if you need more support.

Support Groups

Support groups can offer invaluable support in our mental health journey. In anxiety support groups, people come together to discuss their struggles in dealing with anxiety in the presence of a professional facilitator. Apart from learning tools to manage anxiety, the participants are able to feel a sense of belonging and know that they are not alone in their struggles.

Prevention Strategies

While it might not be possible to completely prevent anxiety-induced shortness of breath, with the help of a therapist, you can work on decreasing the intensity and frequency of such instances by working on the underlying causes of your anxiety.

In therapy, you can work towards preventing anxiety-related shortness of breath by:

Identifying triggers: With the help of your therapist, you can uncover the chain of events that leads to anxiety, and think about ways to interrupt it. For example, if you find yourself anxious during social interactions, you may find it useful to work on your confidence, social skills, and self-regulation techniques.
Incorporating relaxation strategies: A regular practice of relaxation practices like meditation, mindfulness, and PMR helps to relax faster when you are distressed compared to when these practices are sparsely used.

Healthy Lifestyle Choices

A healthy lifestyle helps to keep the stress at bay and decrease anxiety levels. It includes regular exercise, balanced diet, and a night of sufficient sleep. While these changes may seem too daunting to implement at once, try incorporating healthy habits in whatever ways it is accessible and enjoyable for you.

For example, it may not be possible for you to go to the gym daily but you can go for a walk, stroll between work breaks, go out to get some sunlight, etc. Small, consistent habits build into big health gains.

Conclusion

Shortness of breath is a common symptom of anxiety. It can be difficult to determine if the shortness of breath is due to anxiety or other medical reasons. Usually, anxiety-induced shortness of breath is accompanied by an emotional trigger, lasts for a few seconds to minutes, and resolves after the anxiety is over. Since there is a great overlap in physical and mental health symptoms, it is not wise to make a self-diagnosis. If you notice any changes in your breathing, connect with a local healthcare provider at the earliest. A combination of therapy, medications, and relaxation practices works well for anxiety management.

REFERENCES

American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American Psychiatric Association.

Anxiety and Depression Association of America (n.d.). Medications. Retrieved from https://adaa.org/sites/default/files/Medications-Chart_updated-1209.pdf

Banushi, B., Brendle, M., Ragnhildstveit, A., Murphy, T., Moore, C., Egberts, J., & Robison, R. (2023). Breathwork interventions for adults with clinically diagnosed anxiety disorders: A scoping review. Brain Sciences, 13(2), 256.

Bozkurt, B., & Mann, D. L. (2014). Update: shortness of breath. Circulation, 129(15), e447-e449.

Pugle, M (November 27, 2023). GABA Uses and Risks. verywell Health. Retrieved from https://www.verywellhealth.com/gaba-5095143

Woodgate, R. L., Tennent, P., & Legras, N. (2021). Understanding youth’s lived experience of anxiety through metaphors: A qualitative, arts-based study. International journal of environmental research and public health, 18(8), 4315.