Shortness of breath, also called dyspnea, is one of many symptoms of anxiety — though not everyone experiences it with the same frequency or intensity.
A person with an anxiety disorder may be more likely to experience persistent shortness of breath than someone who may experience anxiety occasionally.
Learning about common features and symptoms of anxiety may help you work out if feeling out of breath is likely a result of anxiety.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) lists four main anxiety disorders:
- Generalized anxiety disorder: Intense fears or worries that persistently manifest across situations.
- Panic disorder: Frequent panic attacks or severe anxiety about experiencing one.
- Social anxiety disorder: Intense anxiety in social situations and fear of being judged in everyday situations.
- Specific phobias: Severe fear of something that does not always respond to a real threat but affects how you navigate the world. For example, this could be a fear of birds.
Temporary or long-term (chronic) anxiety activates the stress response. This is a physiological process where your body gets ready to “fight” or “flee” a threat. This response often leads to quick and shallow breathing and a faster heart rate.
How to know if shortness of breath is due to anxiety
If your shortness of breath results from anxiety, you are likely to experience other symptoms. Checking whether these are present before or during shortness of breath may help you know if it is due to anxiety.
According to the National Alliance of Mental Illness (NAMI), in addition to shortness of breath, common symptoms of anxiety may also include:
Physical symptoms
- racing or pounding heart that does not match your activity level
- difficulty falling or staying asleep
- tiredness
- dizziness or tunnel vision
- headaches
- twitches, tremors, and sweating
- diarrhea or upset stomach
- frequent urination or dry mouth
Emotional and cognitive symptoms
- feelings of dread
- thoughts of doom or feeling something terrible is about to happen
- repeating conversations or events in your head over and over again
- excessive worry about one or more situations that may or may not happen
- feeling jumpy or tense
- feeling irritable or restless
- difficulty concentrating and completing tasks
Not everyone experiences all of these symptoms or with the same intensity. It also may depend on what causes your anxiety.
If you experience panic attacks, you may notice intense rapid breathing that causes a smothering sensation. Your chest may feel tight, and you may get lightheaded. You may also experience panic attacks or increased anxiety at night, so you may feel short of breath at bedtime, even when resting.
If you have social anxiety, you may experience shortness of breath when you’re about to meet someone or while eating in front of others.
For some people with generalized anxiety disorder, persistent or recurrent shortness of breath is possible.
Talking with a mental health professional may help determine if you live with an anxiety disorder.
Other causes of shortness of breath
If you do not experience other anxiety symptoms, a healthcare professional may help you identify the root cause of your shortness of breath.
Other possible causes of persistent shortness of breath may include:
- New physical routines: Some people may get breathless during exercise, particularly if living with a chronic condition or starting a new routine. Usually, the more you exercise, the stronger you become and the less breathless you may feel. Adjusting your activity intensity may help you feel less out of breath.
- Sedentary lifestyle: Not being physically active, having overweight, or living with chronic conditions may lead to shortness of breath even when doing simple tasks like chores or running errands.
- Exposure to allergens: Some allergies go undiagnosed for a long time, especially if they are not severe. If you are allergic to pollen or dust, you may feel short of breath during exposure to this allergen.
- High altitudes: There is less oxygen at higher altitudes, which may cause short-term breathlessness in some people.
Shortness of breath may also result from living with medical conditions such as:
- Asthma: This causes the narrowing and inflammation of the tubes that carry air to and from your lungs. Symptoms may include chest tightness, shortness of breath, coughing, and wheezing.
- Anemia: When your body does not produce enough healthy red blood cells, you may experience weakness, paleness, tiredness, chills, headaches, shortness of breath, dizziness, and bleeding.
- Obesity: Research from 2022 suggests that obesity may cause persistent shortness of breath and make it more difficult for your lungs to work properly.
- Chronic obstructive pulmonary disease (COPD): In COPD, less air flows through your airways, making it difficult to breathe. Symptoms may include an ongoing cough, wheezing, chest tightness, and shortness of breath.
- Cardiovascular conditions: Acute and chronic heart problems may cause shortness of breath. Other symptoms may include chest pain, cold sweats, dizziness, feeling sick, neck pain, trouble sleeping, and weakness.
- Low blood pressure: Hypotension may sometimes cause shortness of breath as well as dizziness, light-headedness, chest pain, an irregular heartbeat, a stiff neck, and tiredness.
- Pneumonia or other respiratory infections: Pneumonia or the flu may cause inflammation in your airways and make it more difficult to breathe.
Only a healthcare professional may accurately diagnose the cause of your shortness of breath. Learning to identify other symptoms and discussing those with a doctor may help them and you work out how to move forward.
How is anxiety treated?
If you have identified that shortness of breath is due to anxiety, your healthcare team may recommend attending psychotherapy sessions.
Cognitive behavioral therapy (CBT) can help you manage fears and worries that may activate your anxiety symptoms.
You may also find it helpful to make some lifestyle changes, such as reducing your caffeine intake, moving more, and improving your sleep quality. Relaxation techniques like deep breathing and meditation may also help.
If your symptoms do not improve or are severe, your doctor may recommend these medications:
- selective serotonin reuptake inhibitors (SSRIs) like escitalopram (Lexapro) and sertraline (Zoloft)
- serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor)
- tricyclic antidepressants like amitriptyline
- short-term benzodiazepines like alprazolam (Xanax)
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