Experiencing shortness of breath (dyspnea) or other breathing difficulties can feel scary. But it’s not an uncommon symptom of anxiety.

Many people worry that a symptom affecting their breathing must come from a physical issue. In fact, your mental health affects your physical health in a number of ways.

While anxiety can cause shortness of breath and other physical symptoms, it’s important to acknowledge that experiencing shortness of breath for other reasons may also create anxiety.

Here’s what you need to know about this symptom and when to see your doctor.

Anxiety is your body’s natural fear response. This is known as the the fight-or-flight response. Your body reacts in physical and mental ways to prepare you to either fight or run from the situation.

Shortness of breath is one of those responses. You may feel like you can’t catch your breath, tightness in your chest, or like you’re suffocating or hungry for air.

Studies have shown a strong association between anxiety and respiratory symptoms, including shortness of breath.

Other symptoms that can occur during this response and as a result of anxiety include:

  • faster breathing (hyperventilation)
  • chest tightness
  • breathlessness or a feeling of suffocation
  • feeling like you have a lump in your throat
  • muscle tension
  • heart palpitations (feels like a stronger, faster heartbeat)
  • feeling faint, dizzy, or unsteady
  • nausea or stomach discomfort
  • restlessness, irritability, or feeling on edge

Shortness of breath and other physical symptoms happen in the fight-or-flight response to protect you. With anxiety, you may not be running for your life. But your body still responds as if you are.

You experience chest tightening, shortness of breath, and faster breathing because your body is trying to get more oxygen to your muscles, preparing you to run. Your heart rate increases and you may feel hot as more blood pumps to your muscles, preparing you to fight.

All of these symptoms are normal body responses designed to save your life.

Of course, you probably aren’t often running or fighting for your life — from wild bear attacks or men with chain saws. But your body still reacts to your trip to the crowded grocery store, your work presentation, and other anxiety-provoking events as if you were.

When you’re experiencing shortness of breath from an anxiety attack, it may seem counterintuitive that your breathing is what you should focus on.

But by focusing on your breathing, you can get it under control and the right amount of oxygen into your lungs.

Experts recommend practicing diaphragmatic breathing. This is a type of breathing technique that uses your diaphragm. The diaphragm is the most efficient breathing muscle we have.

When you’re experiencing shortness of breath, you’re generally breathing from your mouth or chest. Diaphragmatic breathing can:

  • slow your breathing rate
  • decrease your demand for oxygen
  • use less effort and energy to breathe

Here’s how to practice diaphragmatic breathing:

  1. Sit up comfortably in a chair or lie back on a flat surface, like your bed, with your head supported.
  2. Place one hand on your upper chest and the other below your rib cage. This will allow you to better feel your diaphragm as you breathe.
  3. Breathe in slowly through you nose so your stomach moves out against your hand.
  4. Tighten your stomach muscles. Let them fall inward as you exhale through your nose or your mouth (depending on what’s easier for you).
  5. Continue to take deep breaths in and out, feeling your stomach rise in and out. Do this for 5 to 10 minutes a day.

Tips: You’re less likely to experience shortness of breath or hyperventilation while breathing in and out through your nose. It’s also normal to get tired or feel like it’s a lot of effort when you first begin this breathing practice. With more practice, this breathing technique will become automatic and easy.

“The more you can slow down the physical sensations during periods of high anxiety, the more you can use your rational mind to assess what is going on.” — Elke Zuercher-White in “An End to Panic”

You can also try these anxiety-relieving techniques:

  • Grounding techniques. One type of grounding technique involves clenching body parts and slowly releasing them. Focus entirely on these sensations.
  • Mindful distractions. Find something to distract your mind from panicking to help you calm down. Try describing things around you to keep your focus on something else. What color is your couch? What is its texture?
  • Talk to yourself. Now that you know these symptoms are a part of your body’s automatic response, remind yourself this. In the moment of panic or anxiety, tell yourself “I can’t breathe because my body is trying to get more oxygen” or “I’ve been evaluated and my heart is fine.” Talking to yourself rationally can pull you out of the anxiety.
  • Exercise. It may seem strange to exercise in the midst of an anxiety attack, but going for a quick run or expending some of that built-up energy may actually work for you. Your body is preparing itself to run anyway — you might as well take advantage of it.
  • Self-care. You can practice self-care in simple ways. Drink herbal tea (but avoid caffeinated tea, as it can increase anxiety). Light candles with a pleasant aroma. Write down your feelings. Turn on some soothing music.
  • Shock yourself. Shocking your system by dipping your face in a bowl of ice water is actually a technique recommended by therapists to help pull you out of a thought spiral.

If you notice shortness of breath before experiencing a full-blown panic attack, learn to recognize it and don’t ignore it. Start focusing on your breathing before the anxiety escalates.

For long-term strategies, consider seeing a mental health professional. They can evaluate your needs and teach your coping mechanisms that’ll work for you.

Practicing your breathing daily, other forms of mindfulness, and taking up relaxing yoga may also help.

The main way to prevent shortness of breath and other physical symptoms of anxiety is to practice techniques and learn your triggers when you’re not experiencing them.

You don’t prepare for an earthquake during an earthquake; you prepare beforehand. Anxiety is the same.

One of the most helpful preventive techniques is to maintain a thought log. In a thought log, you write down the automatic thoughts you had in your last moment of anxiety or panic. It’s helpful for discovering triggers as well as helping you reflect on your anxiety in a calmer state.

You can also write down what sensations you’re experiencing while you’re experiencing them. This can help your doctor understand what’s going on.

There are several types of thought logs. Check out this one focusing on dysfunctional thinking or a general anxiety tracker. You can even make your own by recording:

  • the date
  • the specific trigger (the situation or physical symptom, such as shortness of breath)
  • the automatic thought (what you think will happen due to this physical symptom or situation)
  • how strongly you believe this thought (1 to 100 percent)

If you’re experiencing shortness of breath, your automatic thought may be that you must have a serious health condition. In the moment, you may have believed it — almost 100 percent.

However, after challenging this thought now in your recording, you only believe it 20 percent. Recording, reviewing, and challenging these thoughts is an essential way to prevent future anxiety.

You can also use an app to track your anxiety.

Practicing regular meditation may also help you reduce your anxiety. Numerous studies have shown that meditation can reduce anxiety symptoms to help treat anxiety.

You can also practice mindfulness in everyday activities to help you become more aware of your body and what makes you anxious. Try a mindful eating exercise or a mindful walk around the block.

Finally, consider working with a mental health professional to come up with more strategies. They can help you work out negative thought processes that occur when you’re experiencing anxiety, especially if this anxiety is severe or causing you great distress.

Shortness of breath and other symptoms of anxiety can mimic other conditions. It’s a good idea to monitor your symptoms and get a checkup with your doctor to rule out any other conditions.

Getting a physical to ensure you don’t have any other issues can also alleviate some of your anxiety. For instance, in a panic attack, many people believe they’re having a heart attack. This fear only increases their panic.

Other causes of shortness of breath include:

  • exercise
  • altitude changes
  • tight clothing
  • a sedentary lifestyle

Other conditions where you may experience shortness of breath include:

If you experience shortness of breath consistently, or when unconnected to anxiety, see your doctor.

Seek emergency medical attention if you experience symptoms of a heart attack, including:

  • tightness or pain in the chest, neck, jaw, back, or arms
  • fatigue
  • lightheadedness, nausea, or vomiting
  • discomfort in your arm or shoulder
  • sweating more than usual without a logical reason

It’s important to remember that anxiety attacks can’t kill you. You won’t suffocate, won’t stop breathing, and won’t die from an anxiety attack. An anxiety or panic attack won’t turn into a heart attack, either.

If you’re worried about your physical health, get checked out. Once you’ve been cleared of any physical reasons for your shortness of breath, hold onto that clean bill of health as a reminder when you’re back in an anxious moment.

See a mental health professional for further help and assistance with coping techniques.