How to tell if shortness of breath is from anxiety

Feeling short of breath is a scary but not uncommon symptom of anxiety. Shortness of breath is also a symptom of other medical conditions including heart failure, respiratory infections, and asthma. 

You might be wondering how to tell if shortness of breath is from anxiety or something completely unrelated. Distinguishing what’s causing your breath to catch can be difficult in the moment, but it often depends on environmental triggers, underlying health conditions, and any medications you take. 

Understanding the source of your breathing troubles can help alleviate any anxiety––particularly if that’s the source of it. Here we’ll explore the relationship between anxiety and shortness of breath, plus share some helpful hints for breathing easier again.

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Anxiety disorders are common and cause a wide range of mental and physical symptoms. Feeling anxious can surface emotions like apprehension, worry, and fear. Anxiety can also manifest itself in physical ways like chest pain, stomach aches, and shortness of breath (dyspnea). 

And while a fleeting bout of difficulty breathing isn’t usually a reason to worry, shortness of breath can feel uncomfortable and contribute to anxiety, sparking a vicious cycle (Chand, 2022). 

In addition to shortness of breath, other physical symptoms associated with anxiety include (Chand, 2022):

• Hyperventilation (rapid breathing)

• Heart palpitations (fast, pounding heartbeat)

• Chest pain or tightness

• A choking or suffocating sensation

• Muscle tension 

• Tingling or numbness in the arms or legs

• Dizziness or lightheadedness

• Nausea

• Dry mouth

• Trembling or shaking

Beyond these, you may also feel frightened, wound up, on edge, apprehensive, or like you’re losing control.

If you’re experiencing shortness of breath, you might worry that something else is going on. There are many health issues that can cause difficulty breathing, including (Hashmi, 2022):

• Asthma This breathing condition causes the airways of the lungs to become narrow and inflamed, making it difficult for air to move in and out. The shortness of breath from asthma can feel like chest tightness, difficulty breathing, or wheezing when you breathe out. For the most part, people with asthma are diagnosed in childhood and can recognize the symptoms. 

• Chronic obstructive pulmonary disease (COPD)This progressive lung disease is associated with a long history of smoking. Shortness of breath from COPD is often described as an inability to get all the air out of your lungs. Early on in the disease, symptoms typically occur with exertion. As COPD progresses, shortness of breath happens at rest as well. COPD is commonly marked by a cough that doesn’t go away.

• Congestive heart failure: Like COPD, heart failure is a chronic condition that tends to get worse over time. Symptoms are due to a weakened heart that’s unable to effectively pump out enough blood to the body. Shortness of breath is a common symptom that worsens over time, though initially it only appears with exertion. Shortness of breath from heart failure is often worse when lying down and feel better when you sit up.

• Heart attacks: A heart attack is a medical emergency that occurs when one or more of the arteries supplying the heart muscle with blood becomes blocked. Classic symptoms of a heart attack are chest pain and tightness that extends down the arms or to the neck and jaw. Other more subtle signs (more often seen in women) of a heart attack include shortness of breath, nausea, and fatigue. Difficulty breathing associated with a heart attack doesn’t feel better and gets worse with time.

• Obesity: People with overweight or obesity may experience shortness of breath while exerting themselves. Breathing trouble can also occur at rest as excess weight against the chest makes it harder to take deep breaths. People with obesity also have an increased risk of asthma. 

• Pneumonia: This is inflammation of the lungs caused by an infection. Severe pneumonia causes symptoms like shortness of breath, fever, cough with phlegm, and chest pain when breathing.

The most important factors in figuring out what’s causing shortness of breath are whether you have an underlying medical condition or if you’ve been ill recently. If you have concerns, a healthcare professional can do an evaluation to help determine the source.

It might not feel pleasant, but anxiety and its accompanying symptoms are in our DNA. It’s part of our fight-or-flight response, which kicks in when we sense a threat. 

During this acute stress response, your heart rate speeds up. This gets blood and oxygen flowing faster to your muscles as you prepare to fight or flee a perceived threat. A faster heart rate also contributes to shortness of breath and hyperventilation (Chand, 2022).

While this was very useful for our ancestors when faced with a threat such as a lion running toward them, today, non-life-threatening sources of stress can often serve as a trigger. Anxiety-inducing scenarios like public speaking may set off similar internal alarm bells, and sometimes it goes off from nothing discernable at all. 

When you’re under physical or psychological stress, difficulty breathing can increase your anxiety further. This can lead to a vicious cycle that makes it even more challenging to feel calm and breathe easily again (Paulus, 2013).

If you feel signs of anxiety coming on––like a racing heart or shortness of breath––try to stay calm. Focus on stabilizing your breathing patterns. Here are some techniques that can help quell your anxiety and get your breathing back to its regular rhythm.

Diaphragmatic breathing 

This deep breathing technique can be used for immediate anxiety relief. It’s also called belly breathing. It focuses on expanding your stomach during a deep inhale, then contracting it on the exhale. 

Diaphragmatic breathing is often used in yoga and other mind-body exercises. It’s been shown to reduce anxiety and depression and lower levels of the stress hormone cortisol (Ma, 2017). Here’s how to do it:

• Sit down somewhere comfortable and close your eyes. Place one hand on your belly and the other on your chest.

• With your mouth closed, inhale deeply through your nose for several seconds. Hold your hand on your belly so you can feel your abdomen expand. 

• Contract your ab muscles and exhale as slowly as possible through your nose.

• Repeat for 5–10 minutes or until your symptoms subside.

Grounding techniques

You may have heard of or even tried common grounding techniques including mindfulness, meditation, and guided imagery. The goal with these is to root or ground yourself in the present moment. This brings you back to reality, helping to relieve anxiety and negative or stressful thoughts (Hofmann, 2017). 

There are many ways to ground yourself, but all involve focusing on the present moment or an image in your mind. Continuously trying out grounding techniques like these can help push out worries and fears, and return your breathing to its regular state (Paulus, 2013).

Talk yourself through it

Research finds that talking to yourself in the third person can help during a panic attack. It might feel weird at first, but talking to yourself when emotions are high can reduce the intensity of your feelings (Wallace-Hadrill, 2016). 

Remind yourself that shortness of breath and other anxiety-related symptoms are your body’s fight-or-flight response. The phenomenon is a natural physical response when we feel fearful and symptoms do go away––sometimes very quickly. Remembering that whatever symptoms you’re experiencing are temporary may help you feel more at ease.

Move your body 

We tend to get pretty tense when we’re stressed. All those stress hormones have your body worked up and ready to rid itself of some energy. Do a set of jumping jacks or take a brisk walk around the block. 

An analysis of studies that looked at the effect of exercise on anxiety symptoms found there was a significant reduction in symptoms with regular exercise compared to none. Of note, when comparing high-intensity vs low-intensity aerobic exercise it seems the first option may be more effective in reducing anxiety (Aylett, 2018).

Try hydrotherapy 

It sounds fancy, but hydrotherapy is simply the use of water as a treatment method. Dip your face in a bowl of ice water, take a cold shower, or jump in a cool pool if you have access to one. 

Cold water affects the way your nervous system controls your heart rate and blood pressure. It does the opposite of fight-or-flight, lowering your heart rate to make you feel calmer and less anxious (Mooventhan, 2014). 

Calm your senses 

If you were to relax, what would you do? Turn to whatever you find relaxing in moments of elevated anxiety. Breathe in the scent of an aromatherapy candle, listen to a favorite album, or sip on a cup of herbal tea. Give yourself permission to take a few moments that are just for you.

Here’s how to manage and prevent uncomfortable reactions like shortness of breath from anxiety. 

• Practice stress management and relaxation techniques. Even if you don’t feel stressed, practice stress relief techniques on a daily basis. Find something that works for you, like meditation, yoga, breathing exercises, or spending time in nature (Cackovic, 2022; Paulus, 2013).

• Talk to a mental health professional. Psychotherapy can be helpful in managing anxiety disorders. Cognitive behavioral therapy teaches you to recognize and replace negative thinking patterns that can trigger anxiety. Exposure therapy is what it sounds like––in a safe environment, you’re exposed to the things or situations that trigger your anxiety. The goal is that you’ll gradually experience fewer symptoms when encountering whatever obstacle is causing you distress. 

• Medication: There are cases where medications are prescribed alongside talk therapy to help manage symptoms. Medications commonly used include antidepressants, selective serotonin reuptake inhibitors (SSRIs), buspirone (Buspar; see Important Safety Information), beta-blockers, and benzodiazepines (Chand, 2022).

• Keep an anxiety tracker. There are many ways to record anxiety symptoms, whether it be a notebook, smartphone app, or anxiety tracker (Drissi, 2020). If you experience shortness of breath, record the date, time, what triggered it, and any other symptoms. If you were apprehensive about something specific, write down what you were afraid would happen and how sure you were it would happen on a scale of 1–10. Then note if it happened or not. Over time, this helps you recognize triggers so you can proactively calm yourself down. It also shows how often your greatest fears didn’t turn into reality, which you can remind yourself of when feeling anxious.

If you’re experiencing shortness of breath often or it happens without other symptoms of anxiety, talk to your healthcare provider. 

Shortness of breath can occur during a heart attack and is a medical emergency. If you recognize these additional symptoms, seek medical attention immediately (NHLBI, n.d.):

• Pain or tightness in the chest, neck, jaw, back, arms, or shoulder

• Fatigue

• Lightheadedness

• Nausea or vomiting

• Increased sweating

Shortness of breath is a treatable symptom that can often accompany anxiety. If you’re feeling anxious often, talk to a mental health professional about what may be the cause and your treatment options (Cackovic, 2022; Chand, 2022).

If you have recurrent feelings of anxiety that interfere with your ability to function on a daily basis, consider speaking with a healthcare provider who can evaluate your symptoms and recommend treatment to provide relief.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

May 06, 2022

Written by

Amelia Willson

Fact checked by

Addie Ganik, MD

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About the medical reviewer

Addie Ganik, MD