How to Tell if Shortness of Breath is from Anxiety: Signs, Symptoms, and When to Seek Help

Shortness of breath can be a frightening experience that leaves you feeling like you can't get enough air.

While this symptom is commonly associated with physical conditions like asthma or heart disease, it's also a frequent manifestation of anxiety and panic disorders. Understanding whether your breathing difficulties stem from anxiety or another medical condition is crucial for getting the right treatment and managing your symptoms effectively.

Key Takeaways

• Anxiety-related shortness of breath affects approximately 70% of people with panic attacks, making it one of the most common anxiety symptoms alongside rapid heartbeat and sweating.

• Look for specific patterns: Anxiety breathing difficulties typically occur during stress, come with other anxiety symptoms (racing heart, sweating, trembling), and improve with relaxation techniques, unlike medical conditions that worsen with exertion.

• Effective management is available: Breathing exercises, relaxation techniques, and professional treatment, including therapy and medication, can significantly reduce anxiety-related breathing problems and improve quality of life.

What Is Anxiety-Related Shortness of Breath?

Anxiety-related shortness of breath, medically known as dyspnea, occurs when psychological stress triggers your body's fight-or-flight response. When experiencing anxiety, it can be difficult to tell whether anxiety or another health issue is responsible for the symptoms, making proper identification essential for effective treatment.

During periods of anxiety or panic, your nervous system activates a protective mechanism designed to prepare your body for perceived danger. The brain reacts to fearful situations with a fight-or-flight response.

The heart rate increases to pump blood to the organs faster, readying the muscles for action. It also causes a person to breathe more quickly to provide more oxygen to the muscles. This rapid breathing can create a sensation of breathlessness even when your oxygen levels are normal.

The Anxiety-Breathing Connection

When people experience shortness of breath because of anxiety or panic, it can make them feel more anxious, which can worsen their breathing. This creates a challenging cycle where breathing difficulties increase anxiety, which in turn worsens the breathing symptoms.

How Common Is Anxiety-Related Shortness of Breath?

Breathing-related symptoms are remarkably common in anxiety and panic disorders. Among subjects with panic attacks, the respiratory group represented up to 70% of cases, and was associated with increased health services utilization. The lifetime prevalence of respiratory panic attacks was 6.77% (3.14% in the nonrespiratory group), while the 12-month prevalence was 2.26% (1% in the nonrespiratory group).

Research indicates that approximately 2.7% of U.S. adults had panic disorder in the past year, with many experiencing respiratory symptoms. The prevalence of dyspnea was 10.7% in the first and 12.6% in the second survey in population-based studies examining the relationship between psychological symptoms and breathing difficulties.

The connection between mental health and breathing symptoms is bidirectional. The data indicates that there is a causal relationship between the development of symptoms of anxiety and depression and dyspnea, suggesting that anxiety can both cause and result from breathing difficulties.

Signs Your Shortness of Breath Is From Anxiety

Identifying anxiety-related breathing difficulties involves recognizing specific patterns and accompanying symptoms that distinguish them from medical conditions.

Timing and Triggers

Anxiety-induced shortness of breath typically:

• Occurs during periods of stress, worry, or panic

• Develops suddenly without physical exertion

• Happens in specific situations that trigger anxiety

• Improves when you feel calmer or more relaxed

Anxiety-induced shortness of breath often comes with other symptoms of anxiety, such as: Uncontrollable worry. Nervousness. Rapid heart rate. It's also typically associated with specific situations that trigger anxiety.

Accompanying Physical Symptoms

When shortness of breath stems from anxiety, it's usually accompanied by other anxiety-related symptoms:

• Rapid or irregular heartbeat (palpitations)

• Sweating or hot flashes

• Trembling or shaking

• Chest tightness or pressure

• Dizziness or lightheadedness

• Nausea or upset stomach

• Feeling of impending doom

When shortness of breath stems from anxiety, it's usually accompanied by other anxiety-related symptoms, including rapid heartbeat, sweating, and trembling.

Duration and Pattern

Anxiety-related breathing difficulties often:

• Last for shorter periods (typically less than 10 minutes during panic attacks)

• Come and go rather than persisting constantly

• Respond to relaxation techniques or breathing exercises

• Don't worsen with physical activity like climbing stairs

How Anxiety Affects Your Breathing

Understanding the physiological mechanisms behind anxiety-related shortness of breath can help you recognize and manage these symptoms more effectively.

Hyperventilation Response

During anxiety episodes, many people begin breathing rapidly and shallowly, a condition called hyperventilation. This rapid breathing can actually make you feel more breathless because it disrupts the balance of oxygen and carbon dioxide in your blood.

Muscle Tension

Anxiety often causes tension in the muscles around your chest and diaphragm, making it feel harder to take deep breaths. This physical tension can create a sensation of tightness or restriction in your breathing.

Increased Sensitivity

Previous investigations have shown that individuals with anxiety disorders show altered breathing characteristics or altered responses to manipulating breathing. People with anxiety may become more aware of normal breathing sensations, interpreting them as threatening or problematic.

Distinguishing Anxiety From Medical Conditions

While anxiety is a common cause of shortness of breath, it's important to rule out medical conditions that require different treatment approaches.

Heart Conditions

Heart-related breathing difficulties typically:

• Occur with physical exertion (climbing stairs, walking uphill)

• May be accompanied by chest pain that radiates to the arm or jaw

• Often include swelling in the legs or ankles

• Worsen when lying flat

• Persist for longer periods

Respiratory Conditions

Breathing problems from lung conditions usually:

• Include audible wheezing or coughing

• Worsen with allergens, exercise, or respiratory infections

• Persist for extended periods

• Don't improve with relaxation techniques alone

• May include sputum production or changes in mucus

When to Consider Medical Evaluation

Seek immediate medical attention if your shortness of breath:

• Develops suddenly and severely

• Occurs with chest pain, especially pain radiating to your arm or jaw

• Is accompanied by fainting, severe dizziness, or confusion

• Includes blue or gray coloring of lips, fingers, or skin

• Persists even when you're at rest and calm

Effective Management Strategies

If you've determined that anxiety is likely causing your shortness of breath, several evidence-based techniques can provide relief.

Breathing Exercises

A 2017 study demonstrated that 20 sessions of diaphragmatic breathing improves stress and decreases negative emotions in participants. Specific breathing techniques that can help include:

Diaphragmatic Breathing: Place one hand on your chest and one on your belly. Breathe slowly through your nose, allowing your belly to rise while keeping your chest relatively still.

Pursed Lip Breathing: Inhale slowly through your nose for two counts, then exhale slowly through pursed lips for four counts.

4-7-8 Breathing: Inhale for 4 counts, hold for 7 counts, and exhale for 8 counts.

Relaxation Techniques

Research supports that breathing exercises and relaxation techniques such as meditation or mindfulness can help alleviate shortness of breath due to anxiety. Effective relaxation methods include:

• Progressive muscle relaxation

• Mindfulness meditation

• Guided imagery

• Grounding techniques (focusing on five senses)

Lifestyle Modifications

Regular lifestyle changes can significantly reduce anxiety-related breathing difficulties:

• Regular exercise (which strengthens both heart and lungs)

• Adequate sleep (7-9 hours per night)

• Limiting caffeine and alcohol

• Stress management through hobbies or social support

• Maintaining a consistent daily routine

Professional Treatment Options

When self-management techniques aren't sufficient, professional treatment can provide substantial relief.

Psychotherapy

Cognitive-behavioral therapy (CBT) is particularly effective for anxiety-related breathing problems. CBT helps you:

• Identify thought patterns that trigger anxiety

• Develop coping strategies for stressful situations

• Practice exposure techniques to reduce fear of breathing sensations

• Learn long-term anxiety management skills

Medication Options

For severe anxiety-related breathing difficulties, healthcare providers may recommend:

• Short-term options: For short-term relief of anxiety symptoms, including shortness of breath, doctors may prescribe benzodiazepine medications. These may provide some relief from anxiety symptoms within about 30 minutes.

• Long-term treatment: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can help manage chronic anxiety symptoms.

When to Seek Professional Help

If you're unsure whether your shortness of breath is related to anxiety, you should seek support from a healthcare professional for a proper evaluation. Consider professional treatment if:

• Breathing difficulties interfere with daily activities

• You avoid certain situations due to fear of breathing problems

• Self-help techniques provide minimal relief

• You experience frequent panic attacks

• Breathing symptoms worsen over time

Medical Disclaimer

This article is for educational purposes only and does not constitute medical advice. The information provided should not replace consultation with a qualified healthcare provider. Individual responses to medications can vary significantly, and what applies to one person may not be safe for another.

Always consult with your doctor or pharmacist before making any decisions about medication changes, discontinuation, or interactions with other substances. If you're experiencing concerning symptoms or side effects, please seek professional help from a healthcare provider. In case of a medical emergency, contact your local emergency services immediately or call 911. For mental health emergencies, contact the National Suicide Prevention Lifeline at 988.

Important: This information is not a substitute for professional medical advice. Never stop taking prescribed medication or make changes to your treatment plan without consulting your healthcare provider first. Your safety and well-being are the top priorities.

Sources

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Jansson-Fröjmark, M., & Lindblom, K. (2008). A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. Journal of Psychosomatic Research, 64(4), 443-449.

Paulus, M. P. (2013). The breathing conundrum – interoceptive sensitivity and anxiety. Depression and Anxiety, 30(4), 315-320.

Smoller, J. W., Pollack, M. H., Otto, M. W., Rosenbaum, J. F., & Kradin, R. L. (1996). Panic anxiety, dyspnea, and respiratory disease: Theoretical and clinical considerations. American Journal of Respiratory and Critical Care Medicine, 154(1), 6-17.

Strand, M. (2024, February 23). How to tell if shortness of breath is from anxiety. HealthCentral.