Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 12/19/2022
Anxiety can really choke out some of the joy in life — and sometimes, that choking can be literal. If anxiety has ever given you a lump in your throat, you’re probably invested in learning how to overcome swallowing anxiety — a condition that causes that choking sensation when your anxiety levels peak.
When it comes to symptoms, anxiety can manifest in many ways, from physiological symptoms to irrational fears. But when anxiety starts to feel like a hand around your throat, this Darth Vader of mental health conditions really needs to be cut down to size.
Difficulty with swallowing may or may not be related to your mental health symptoms, so you need to know how to tell whether your problem is anxiety-based or the result of something else causing your throat to constrict.
Before we jump into swallowing anxiety treatment options, let’s start by examining the connection between anxiety, your throat and that “lump” you’re feeling.
Anxiety is a mental health condition characterized by an activated fight or flight response — a type of fear response — in situations where you perceive a threat or imminent danger that isn’t based in reality. When this happens, there are many anxiety symptoms that can occur.
We tend to think about cold sweats, shaking, rapid heartbeat and panic attacks as the classic signs of intense anxiety, but one sensation that can grip people while they are in the grip of an anxiety attack is a choking sensation.
That choking sensation can be mild or severe, or anything in between. It can make it seem like you’re struggling to breathe, or simply that something is stuck in your throat. And there’s a specific name for this sensation: globus pharyngeus.
In the most basic terms, a globus sensation is really just a lump in your throat, and strictly speaking, it can have many causes. Muscle spasms, swollen tonsils, hernias, reflux, post-nasal drip, foreign bodies and other physical triggers can cause this sensation. But there’s one psychological trigger that can also cause globus pharyngeus: anxiety.
So here’s the bad news: While we know this sensation exists and we have a name for it, that’s about where our knowledge stops. Most of what we know about why anxiety causes this sensation of choking or difficulty swallowing is conjecture at this point.
To be clear, there are known triggers of this condition, like reflux, that have been proven to cause irritation and inflammation and result in the “lump in throat” sensation. Anytime you had swollen tonsils as a kid, you experienced another clear cause. But when it becomes psychological, our knowledge comes to an abrupt halt.
The best guess at this point is that a lump in the throat is a psychologically-triggered misperception in your senses — you really just sense something that isn’t there.
It would be in keeping with the other symptoms of panic — the sensation that you’re having a heart attack when really you’re just panicking, the sensation that you’re being suffocated when really the struggle to breathe is coming from your fear.
Experts really haven’t cracked the code on this one, and as for treatment, the same is essentially true.
There are two avenues to swallowing anxiety treatments: Treat the sensation itself and treat the anxiety at its root.
Let’s start with the sensation itself. Preventative measures are a great way to address swallowing anxiety sensations. Avoiding cigarette smoke, alcohol and caffeine can help reduce some people’s symptoms, as can sipping chilled carbonated water instead of clearing your throat.
That’s right — instead of clearing your throat. One of the biggest no-nos with this condition is dry swallowing or clearing the throat. It can cause irritation, especially if the lump is somatic rather than physiological.
If a lump in your throat is a persistent or constant presence and you’ve ruled out non-anxiety triggers, therapy might also be an option. Treating the sensation itself might be as simple as discussing the sensation in therapy. Cognitive behavioral therapy with a mental health professional has been shown to offer some benefits.
Unfortunately, experts currently believe that there’s very little benefit for anxiety medications in the treatment of globus sensations.
If your throat muscles are tensing up so badly that you’re having swallowing issues, you’ve got more than a swollen, sore throat to worry about. And the best way to get help is with the support of a medical professional.
However, treating the symptoms of anxiety is kind of useless without treating anxiety disorders themselves. And whether you have panic disorder, generalized anxiety disorder or another form of anxiety disorder, there are several treatments that are effective in the management of anxiety.
These treatments include therapy, medication and lifestyle changes, and all three may be beneficial to you. Here are the tl;dr basics on each:
Therapy is a system for treating the mental and cognitive side of anxiety disorders, and there are several ways to do that. One of the most popular forms of therapy is cognitive behavioral therapy. CBT teaches you practical skills for learning to spot anxious thoughts and question their validity, which can sometimes stop anxious thoughts from intruding.
There are a variety of medications for anxiety, including antidepressants, beta blockers and benzodiazepines, that can help reduce anxiety symptoms and severity. Depending on what help you might need, beta blockers can treat physical symptoms like a racing heart, while antidepressants can moderate your overall mood by helping balance your brain chemicals.
Because anxiety has many causes, a holistic approach to treatment almost always makes sense. Reducing your consumption of caffeine, tobacco, alcohol and recreational drugs can reduce your risk of anxiety attacks, as can improving areas of your life like exercise, diet and sleep.
Let’s get serious for a moment. An unexplained lump in your throat or swallowing problem can be caused by a long list of medical conditions. From gastroesophageal reflux disease and acid reflux to allergic reactions to certain types of food, these are problems you shouldn’t ignore.
That said, anxiety-based problems with your swallowing process might be a frightening anxiety symptom. If you’ve got a lump in your throat you can’t seem to get rid of, swallow your pride and go seek some help.
For real, a throat issue due to anxiety is bad enough, but that sensation could also be linked to numerous other health conditions like the ones we mentioned earlier. We’re not trying to give you a panic attack here, but ignoring this stuff isn’t smart.
More importantly, you can gain so many benefits from talking to a healthcare professional about your anxiety and swallowing problems. A healthcare provider can guide you to resources like medication, therapy or an ear nose and throat specialist if you need one.
If you’re ready to get to the bottom of this problem, talk to someone today. We can even help — our mental health resources are a great way to start your treatment journey, and you can even find a therapy professional fast and conveniently with our online therapy platform.
A clear throat and a clear mind are waiting.