How to Handle Fear of Choking
People suffering with severe anxiety can develop swallowing or choking problems. This can be extremely alarming to the sufferer and cause phobias like a fear of eating, fear of taking medications, and even a fear of drinking. There is usually nothing sinister going on, but there is a tightness in the throat that is a direct result of tension from chronic anxiety.
Any swallowing problems or choking should be evaluated by a doctor, but if your GP has told you that it is purely an anxiety-related issue, then addressing the anxiety will remove the problem. However, this may not be a quick solution, so I am going to discuss ways you can address or deal with this issue.
Understanding and accepting that your swallowing or choking problem is a result of your anxiety is the first step forward.
Why Can’t I Swallow?
When we are anxious, we tend to catastrophize and internalize in reaction to many physical sensations or symptoms. We also tend to be on higher alert generally, brought about by the frequent release of adrenaline. When the flight or fight response is initiated by anxious, fearful thoughts, we experience many sensations throughout the body. This is your body preparing to run away or fight the danger. When a real threat is encountered, we don’t tend to notice the adrenaline effects on our body as we are too busy attending to the danger. The most we might remember is that our heart was beating faster than usual and perhaps an increase in breathing rate.
Things are perceived a little differently when there is no real threat. Adrenaline “excites” us and when anxious, we tend to notice every body sensation. A typical example of this is when our mouths go dry. Suddenly we don’t seem to have much saliva. An anxious mind will focus on this and alarm bells will start ringing; no saliva, nothing to swallow. This quickly becomes, “I can’t swallow”. Thereafter, the need to swallow becomes of paramount importance and the intense focus makes it appear worse.
How the swallowing reflex works
If you have a headache, have you noticed that if you lie down and have nothing to think about but the headache, the pain feels worse? The same applies with fear of swallowing. It can get so bad that eventually you fear choking. You may even feel a lump in the throat, as if something is preventing you from swallowing your food. Before long, the thought of eating can bring intense fear and some people avoid eating certain foods, even eating at all.
I had a fear of choking when I suffered with panic disorder, so I do know how terrible it feels. I even attended the casualty department on several occasions such was the severity.
I must also mention here, that anxious people might be suffering with acid reflux or gastroesophageal reflux disease. This can worsen the problem, but assuming your fear of choking is a direct result of anxiety, here are some ideas on how to deal with the issue.
Relaxing the Throat
People who are highly anxious have tense muscles throughout the body. The tightness can be felt around or inside the throat leading to a feeling that there isn’t much room to swallow. It makes sense therefore, to take up a form of relaxation. Relaxation CDs can be found on the internet and sometimes downloaded as mp3s. If you can transfer your guided relaxation to a portable player so much the better; then you can practice wherever you are. A short twenty minute practice a day can only benefit your overall anxious state and thus the tension created by it.
You are less likely to choke on food if you relax your throat muscles just before eating. Avoid cold drinks as these tend to make the throat muscles contract. Instead, sip a half glass of warm water prior to eating. Drinking warm water two or three times a day is a good start.
Eating Advice for Fear of Choking
For those who have a severe swallowing problem that is stopping them from eating, I recommend the following:
- Try cubes of jelly or jello because they will merely melt
- Eat liquid type foods such as soup, milk puddings and yoghurts
- Make smoothies with vegetables and/or fruits
- Move on to blended food and lessen the amount of blending over time
- Move on to chopped or minced foods until you feel able to attempt ordinary meals
- Always make sure your food is moist by adding gravy, stock, fruit juice or water
- Don’t put too much on the plate; small portions to start with
People who fear choking dread the time they must try to eat. This apprehension causes tension build up, so keep busy in between meals. Put an elastic band around your wrist and every time you start to feel the dread of eating, snap the elastic band hard and say “stop”. Carry on with what you were doing.
Eating alone can help as there seems to be more pressure on you not to choke (which brings on a bigger fear), if you are eating with other people present. You can gradually return to the family table as you improve. This may sound like pandering to the problem, but to be honest, you have to feel comfortable about eating and anything that provokes more worry is best avoided.
Ironically, I found that eating toast or crackers was easier than eating bread. Bread seems to stay a longer time in the mouth and soaks up the saliva more, leaving a hard to swallow bolus.
Take very small bites of food and chew slowly. It doesn’t matter if it takes you two minutes to chew a small amount. Chew, chew, and chew, until you know it’s impossible to choke on what is left! Better to have eaten something and it takes half an hour, than to have eaten nothing at all.
Swallowing medicines, especially capsules can be a real problem for those who fear choking or have swallowing difficulties. Ask your doctor for liquid forms wherever possible. You would be surprised how many of our medications do come in liquid form. Sometimes you may have to take a child medicine and therefore lots more of it, but it can help while you are going through this problem.
Emotional Freedom Technique
Summary of Techniques to Treat Fear of Choking
Address the anxiety—this is all about cause and effect. If you don’t address the anxiety, your problem is likely to remain or keep coming back
- Relaxation is a must. You could try forms such as meditation, guided visualization, yoga, and breathing exercises
- Drink several glasses of warm water through the day, especially just before a meal
- Start with very small amounts of food, from liquid leading up to normal meals
- Making sure you have a balanced diet is important, so blend or make smoothies of those vegetables, fruits, meats and fish
- Don’t rush eating and go at a slower pace; eating something is better than nothing
- Don’t feel pressured to eat with others if you know it adds to your fear
- When thinking about the next meal and getting worried, distract yourself from the apprehension
You will not choke to death because of anxiety. I had a fear of choking for years, but I never actually choked. I do know that some people have some success using the Emotional Freedom Technique (EFT). The video above gives you some idea about this technique.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.