Shortness of breath can be a scary thing. How to tell if anxiety is to blame.

The inability to catch one's breath can be a scary thing. Whether it's caused by something minor like having the wind knocked out of one's lungs, or something more serious like an asthma attack, it's a feeling most of us don't want to experience often. 

Sometimes adding to an already difficult experience is not knowing why one is having difficulty breathing in the first place. For many people, anxiety is the surprising culprit. "Anxiety presents differently in everyone," says Juanita Guerra, PhD, a clinical psychologist in New Rochelle, New York. "Some people feel a churning in their stomach, others experience an increased heart rate or faster breathing." 

It can be helpful to understand when anxiety is behind shortness of breath and how to prevent it. 

What causes shortness of breath when you feel anxiety?

Someone experiencing shortness of breath relating to anxiety might be having the problem for a variety of reasons. Most often though, it's the body going into its flight-or-fight response mode after a distressing situation occurs. "In this stress response, our brain sends signals to the rest of our body to prepare it to fight or run," explains Amanda Darnley, PsyD, a practicing psychologist based in Philadelphia. Such signals result in one's muscles tightening or constricting, including those located in the chest and abdomen, "which may make it harder to take a deep breath," she says.

During that time, one's heart beats faster and one's body breathes harder, creating a feedback loop that makes it difficult to catch one's breath. "It's almost like they are trying to race each other on who can be the fastest," says Jimmy Noorlander, LCSW, a clinical social worker at Deseret Counseling in Utah. 

How to tell if shortness of breath is from anxiety

Of course, many other things and conditions can cause one to feel short of breath. Heart failure or other heart problems can be serious culprits, as can a blood clot in an artery or lung or an airway obstruction. Obesity, lung conditions such as asthma or COPD and sicknesses such as tuberculosis, pneumonia or COVID-19 are all known to cause trouble breathing as well. 

Because of this, knowing if one's shortness of breath is from anxiety or something else can be difficult to ascertain. One sure sign is to learn to recognize common triggers that have created distress or similar response before. And if the shortness of breath immediately follows a stressful event emotionally, it's a good bet that its anxiety-related. 

Being able to come out of the difficult breathing episode within 10-20 minutes is also a good sign as many other breathing related physical conditions require medical interventions. "Difficulty breathing in response to anxiety is common and usually improves when the anxiety subsides," says Guerra, "however, if the individual continues to have trouble breathing when the anxiety diminishes, that can be an indicator of a more serious underlying medical condition and should be evaluated by medical professionals." 

How to stop shortness of breath

Darnley agrees that it's always better be safe than sorry if one is experiencing difficulty breathing for unknown reasons and advises to "seek urgent care if you are unsure as to whether your shortness of breath is due to anxiety or a medical concern;" but she says there are ways to help one's body calm down if a person knows their shortness of breath is from anxiety.  

One step is to "acknowledge that it is not a medical emergency and remind yourself that it will pass," she says. Managing breathing by taking deep breaths, placing one's hands over one's chest to each feel breath going in and out, or breathing into a paper bag. The latter returns lost carbon dioxide back into one's lungs, helping to balance the flow of oxygen. Nose breathing is another technique that can return normal breathing, as can directing one's focus away from the stress by repeating a mantra or counting out loud with each intake of breath. Light exercise, placing one's hands under warm running water, or stretching techniques can also be helpful. 

Above all, it's important to address whatever underlying anxiety caused the episode to prevent such triggers from occurring more often. Professionals can also help with personalized tips for coming out of it faster. "Psychologists and other specialists will help teach you relaxation techniques and coping skills that will enable you to confront the triggers," Darnley explains. 

Is stress making you sick?Symptoms of stress-related illness, tips for stress management.