How to tell if shortness of breath is from anxiety

Many of us know what shortness of breath feels like: your chest tightens, you feel like no matter how big of a breath you take, you’re not getting in enough air. You may try and breathe more quickly, which can sometimes make you feel worse.  

Shortness of breath can be a concerning feeling, especially if you aren’t sure of the cause. While shortness of breath can be a symptom of a physical health condition, it can also be a symptom of anxiety. So how can you tell the difference and when should you start to worry?  

Our psychiatrists are here to help. Below, we explain some signs that your shortness of breath is likely to be caused by anxiety versus a physical health condition, and what you can do about it.

What is anxiety?

To understand why and how anxiety causes shortness of breath, it’s important to first understand what anxiety is.  

Anxiety is defined as a feeling of physical, mental, or emotional stress. When you’re anxious or stressed, you may feel symptoms such as:

• Increased heart rate and feelings of heart palpitations
• Difficulty breathing
• Tense muscles
• Sweating
• Worry
• Digestive issues and stomach pain
• Repetitive, uncontrollable worries
• Irritability

Understandably, these sensations can feel uncomfortable, but they’re a normal, protective response to a stressful situation. Anxiety disorders, on the other hand, occur when one worries uncontrollably or at a level out of proportion to the severity of an event or situation.

Want to learn more about anxiety disorders and how they are treated? Check out: Get Anxiety Relief from an Online Psychiatrist

Why does anxiety cause shortness of breath?  

When you encounter a stressor (whether it’s environmental or psychological), your body releases two chemical messengers: the stress hormones cortisol and adrenaline. These hormones set off changes in your body that help you prepare to face potentially dangerous situations in what’s called the “fight-or-flight response.” Your blood flow and blood pressure increase, sugars are released into the bloodstream, the digestive system slows, and yup-- your breathing pattern quickens in an attempt to get in more oxygen. As your breathing pattern changes, you may start to feel like you are short of breath (the technical term for which is dyspnea). You may also begin to take shallow breaths which can make your breathlessness worse.  

But what if you feel shortness of breath even when a stressor isn’t there? Many of us occasionally feel the physical effects of anxiety even when we’re not in any kind of real danger.  

If you find yourself feeling anxious often and to the point where it is starting to affect your daily life—this may be a sign of an anxiety disorder. If this is you, it’s a good idea to get evaluated by a mental health professional. Treatment works and can help you get back to feeling like yourself.  

How can I tell if my shortness of breath is from anxiety?

To find out whether anxiety is actually the culprit behind shortness of breath, ask yourself if you’re experiencing any of the other symptoms of anxiety listed above. Anxiety doesn’t typically manifest as one single symptom, so if your shortness of breath is accompanied by uncontrollable worry, nervousness, and irritability, for example, anxiety may be the cause. Also, if anxiety is in fact the cause of your shortness of breath, it should be short-term and resolve once the stressor goes away.  

That said, if you’re experiencing shortness of breath, it’s always recommended to seek medical care regardless of the suspected cause.  

When should I seek medical attention for rapid breathing or shortness of breath?

If you experience shortness of breath that is sudden, affects your ability to function, and/or is accompanied by any of the following symptoms, you may be experiencing a medical emergency and should seek emergency medical care from a healthcare professional:

• Chest pain or chest tightness  
• Lightheadedness/fainting
• Nausea
• Blue tinge to your lips or nails
• Shortness of breath at nighttime
• Coughing  
• Wheezing
• Vomiting
• Confusion  
• Fever  
• Swelling in your feet and ankles
• Trouble breathing when you lie flat
• Worsening of preexisting shortness of breath

How can I ease shortness of breath from anxiety?  

There are several easy relaxation techniques that you can use to combat a bout of anxiety. Practice them now so you’ll be ready to use them next time anxiety strikes.  

Deep breathing exercises

Breathing directly impacts heart rate, which is regulated by the sympathetic nervous system (fight-or-flight response) balanced with the parasympathetic nervous system (rest and relaxation). This is why deep breathing patterns can be an effective grounding technique to help ease symptoms of anxiety  

Belly breathing (aka abdominal breathing or diaphragmatic breathing)

This practice, which entails breathing deeper into the stomach rather than the chest, is often used for those with chronic obstructive pulmonary disease (COPD) since it helps strengthen the diaphragm. But it can also be effective for those with common symptoms of anxiety, like shortness of breath.  

How to do it:  

• Lie on your back in a comfortable position (e.g., flat surface or bed).  
• Place one hand on your upper chest and the other just below your rib cage on your belly.
• Slowly breathe in through your nose as the hand on your belly rises and the one on your chest remains still.
• Exhale through your lips as the hand on your belly relaxes back to its original position.
• Repeat this exercise for 5-10 minutes per day as needed.  

Box breathing (aka 4x4 breathing or 4-4-4-4 breathing)

Try this exercise at a pace that feels comfortable. You should never feel like you’re straining your breath.

• Breathe in for a count of 4
• Hold your breath for a count of 4
• Slowly breathe out for a count of 4
• Hold on empty for a count of 4
• Repeat  
  

Gentle exercise

Turns out exercise isn’t just good for your heart and muscles...it’s also good for your brain. Researchers have found that regular exercise is linked with positive changes in your brain and nervous system that help protect against and reduce the negative effects of everyday stress and anxiety.    

To reap the stress-relieving benefits of exercise, choose a routine that you can stick with — whether it’s a high-intensity workout like running sprints, a brisk walk, or even yoga. Aim for about 30 minutes of exercise a day.    

Play your favorite song

If you’re experiencing anxiety, sometimes your brain can benefit from a bit of a distraction. Playing music or your favorite song is a great way to take your mind away from your thoughts, easing your anxiety and any physical symptoms (like shortness of breath) that come with it.  

Looking for other ways to calm your anxiety? Check out 17 Grounding Techniques for Coping with Anxiety  

When should I seek professional help from a mental health professional?

Some anxiety in daily life is to be expected. But if anxiety is making it difficult for you to function or get through the day or is out of proportion to the stress at hand, you may be experiencing an anxiety disorder. Anxiety disorders are treatable, and the first step is to get evaluated by a mental health professional. Treatment may include talk therapy (like cognitive behavioral therapy or CBT), medications (like antidepressants), or both.  

At Talkiatry, you can see a psychiatrist from the comfort of your home. Take our 10-minute assessment to see if Talkiatry is right for you.    

Struggling with anxiety and not sure where to start?  

The first step in treating anxiety is booking an appointment with a qualified health professional like a primary care doctor, therapist, or psychiatrist. They will be able to conduct a thorough evaluation, provide a diagnosis, and discuss treatment options so you can start feeling better.  

If you believe you have an anxiety condition like generalized anxiety disorder (or are not sure), start by taking our free, easy assessment, see if Talkiatry is a good fit, and get matched with a psychiatrist that meets your needs and takes your insurance.    

About Talkiatry  

Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, depression, bipolar disorder, ADHD, and more. Get started with a short online assessment.  

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

Sources:

Emergency Medical Clinic of North America | Approach to Adult Patients with Acute Dyspnea

Front Psychiatry | Effects of Exercise and Physical Activity on Anxiety