How To Manage Anxiety Related to Swallowing Difficulties

Anxiety can cause many physical symptoms, including swallowing difficulties. It activates the fight-or-flight response, which releases stress hormones to prepare you for potential threats. It may cause your throat muscles to tense up, which can affect swallowing. This is known as functional dysphagia.

With anxiety, you might feel throat tightness or feel like there’s a lump in your throat. Some people become overly aware of their swallowing. It might feel forced and uncomfortable. A healthcare provider may diagnose functional dysphagia after ruling out physical causes of your swallowing difficulties.

Anxiety and swallowing difficulties can affect daily life. You might feel nervous about eating or drinking, or worry that it’s a sign of another health condition. Managing anxiety-related swallowing difficulties with these techniques may help.

Progressive Muscle Relaxation

Progressive muscle relaxation involves slowly tensing and then relaxing different muscle groups in the body, one at a time. This method helps you become more aware of where you hold tension, such as in your neck, which can affect your swallowing, and learn how to release muscle tension.

Regular progressive muscle relaxation practice may help reduce the sensation of throat tightness. This may make swallowing feel more natural. This practice also helps calm the nervous system and may help reduce overall anxiety.

Diaphragmatic Breathing

Diaphragmatic breathing is sometimes called belly breathing. It’s a breathing technique that helps calm the nervous system and relieve anxiety. It involves breathing deeply through your nose so that your belly rises (not your chest), then slowly exhaling through your mouth. This type of breathing helps slow your heart rate and reduce muscle tension. 

Diaphragmatic breathing can help ease swallowing difficulties by relaxing your throat muscles and shifting your focus away from swallowing. Diaphragmatic breathing may reduce throat tightness or choking sensations, which may make swallowing easier, especially before or during meals or stressful moments.

Mindfulness Practices

Mindfulness involves paying attention to the present moment without judgment. Practicing mindfulness can train your body and mind to respond more calmly to stress. This may help make tasks that can cause anxiety (like eating or drinking) feel less overwhelming.

Try focusing on the textures, flavors, or temperature of your food rather than the act of swallowing. This can shift your attention and help reduce anxiety.

Distraction Techniques

Distractions can help shift your focus away from swallowing and reduce anxiety in the moment. When you concentrate too much on it, swallowing can feel unnatural or forced. Doing something that takes your mind elsewhere can help break the cycle of overthinking. Consider options like listening to music, watching a show, or talking with someone.

Shifting your focus away from swallowing may help relax your throat muscles and allow swallowing to happen more naturally.

Avoid Triggers

Avoiding common anxiety triggers may help reduce swallowing difficulties. Certain habits or substances can increase anxiety and muscle tension. These include things like drinking too much caffeine or alcohol, or not getting enough sleep.

Pay attention to what tends to make your symptoms worse. Then, make minor changes to your routine to help avoid those things. Reducing these triggers makes it easier to stay calm, which may help you swallow without added stress.

Cognitive Behavioral Therapy (CBT) 

Cognitive behavioral therapy (CBT) is a form of psychotherapy that helps you understand the connection between your thoughts, feelings, and behaviors.

A CBT-trained therapist can help you identify anxious thoughts about swallowing. They can provide tips to help you work through unhelpful beliefs and develop other ways to cope. Over time, this work can reduce your fear and anxiety about swallowing.

CBT may also include gradual exposure to situations that trigger anxiety. Controlled exposure may help you build a sense of safety, confidence, and control around anxiety and swallowing.

Anxiety and swallowing difficulties (dysphagia) are connected in several ways: 

• Muscle tension: When you’re anxious or stressed, the muscles in your throat may tighten. This can make swallowing feel strained or uncomfortable. Many people with anxiety also experience a globus sensation—the feeling of a lump in the throat, even when nothing is there.
• Hyperawareness: Swallowing is usually automatic and effortless. When you’re anxious, you may become very aware of it and monitor each swallow. This focus can interrupt the natural rhythm of swallowing, and it may feel difficult or unnatural.
• Increased sensitivity to physical sensations: Anxiety can increase your awareness of bodily sensations. Minor feelings—like a dry throat or tightness—can seem much more serious or alarming when you’re already feeling anxious.

These reactions can create a feedback loop where anxiety makes swallowing harder, and the discomfort of swallowing increases anxiety.

Swallowing difficulties or feelings of throat tightness, choking, or food “sticking” in your throat can happen for reasons other than anxiety. Conditions that cause dysphagia include: 

• Gastroesophageal reflux disease (GERD): A condition that happens when stomach acid flows into the throat, irritating the lining of the esophagus. This can make swallowing uncomfortable or painful.
• Muscle tension dysphonia: Chronic muscle tightness in the neck and throat area can affect how well you swallow.
• Neurological conditions: Stroke, Parkinson’s disease (PD), or multiple sclerosis (MS) can affect the muscles and nerves involved in swallowing.
• Structural problems: In rare cases, structural issues like strictures (narrowing of the esophagus) or tumors can interfere with swallowing.
• Age-related changes: Older adults may experience weakening of throat muscles or decreased saliva production, which can affect swallowing. 

It’s important to see a healthcare provider if you have ongoing or frequent difficulty swallowing. They can ease your mind and determine a cause. Consider making an appointment if you experience:

• Swallowing difficulties that last for more than a few days
• Pain when swallowing
• Weight loss without trying
• Coughing, choking, or gagging when eating
• Feeling like something is stuck in your throat after eating
• A wet or gurgly voice after eating or drinking

Anxiety can cause tension in the muscles of your throat and lead to difficulty swallowing. Focusing too much on swallowing, being too sensitive to physical sensations, and fearing choking can all make swallowing feel forced, unnatural, or difficult.

Techniques such as deep breathing exercises, progressive muscle relaxation, and mindfulness may help ease anxiety and swallowing problems.