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How to Handle Fear of Choking

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Meloncauli is a former nurse and anxiety management therapist. She hopes everyone can take something away from her articles.

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.

Blending foods for fear of choking

Blending foods for fear of choking

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
Scared you will choke in front of others

Scared you will choke in front of others

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.

Comments

The peaceful African on May 17, 2019:

I survived drowning in a lake and shocked for about 2 minutes after being pulled out of the lake. Since then drinking water is my big challenge. I can even shock on a drop of water if am not extremely careful. it's more of a psychologic problem. Have anyone ever faced the same problem here?

Jackie Lynnley from the beautiful south on May 20, 2018:

I had a problem with this at an early adult age and I am sure it was tied to stress and I managed to control it somewhat but the main thing that helped me almost get completely over it is having my throat X-ray for another reason and seeing all the pink soft tissue there. It looks nothing like it feels when we are sure something in blocking our throats. Whatever the reason I just have had no troubles since. I would advise a good look for anyone with this problem and if you had a photo of that here it would help immensely I am sure.

Sue Scrabble on November 01, 2017:

I've just come across this article as I'm about to attempt to overcome my swallowing fear again. I've had this for 10 years - I've not drunk a glass of water, juice, a cup of tea or any other liquid drink for 10 years now. It has to stop. When this started for the first 3-4 years I struggled with eating to (I lost 8 stone; luckily I had that to lose). Homemade smoothies were the only thing that kept me going - still to this day. I've let things be for the last few years, which has also meant avoiding lots of social situtaions but I really want to see the back of this problem now. I hope I haven't left it too late.

Bina on July 03, 2017:

By all appearances I am a fear free successful person. Yet, I quietly have a fear of choking while eating. Sometimes, I don't even think about it when I am eating and then there are other days eating is so uncomfortable. I have to drink a lot of water with each bite. I chew and chew and I'm still afraid I might choke. Going out to eat socially once was something I loved but now it depends on the day. This began in my early 40's. I had a bad experience in my early 20's when my son choked as a small child. The Heimlich remover worked but it was difficult and I can still feel the trauma of that situation.

Maykol on May 19, 2017:

Thank you for the tips.

meloncauli (author) from UK on December 31, 2016:

I will write another hub giving more detail soon. Thanks for sharing your experience @brigsnla

brigsnla on December 30, 2016:

Hi Meloncauli, I developed a fear of choking on Sept 18, 2016 (about 3.5 months ago). Eating food in general makes me nervous and sometimes with high spikes of anxiety. I noticed that the act of chewing is some kind of trigger for "checking" that food is "safe" to swallow. This checking (which I label as a compulsion) is one of the main causes of such high anxiety for me. I also noticed that NOT checking can sometimes REDUCE the anxiety, but it doesn't come without limits. For example, I can't seem to have a conversation with someone while eating because it makes me feel very anxious that I can't CHECK before swallowing. Anyway, I have been trying ERP (Exposure and Response Prevention) on eating, but I'm not quite sure I'm doing it right. Obviously I'm probably not doing it completely right since I'm still quite anxious almost every time I eat a meal. Can you please go into more details on HOW you were able to overcome your fear of choking? Your post is great, but would love to know exactly when you started to feel less scared, and what you did to continue to feel less and less scared! Greatly appreciate your feedback!

meloncauli (author) from UK on December 09, 2016:

Hi. Sorry to hear your problem is so bad. Lots of people who have choking problems do turn to using a liquid to not only help food go down, but also to remind them that they can actually swallow ok. 15 minutes or so before you eat, relax in a chair and let your whole body go as limp as possible. Sag. From your head to your toes, make sure you are as relaxed as possible. This choking sensation, if down to anxiety, is all about tension. The anticipation of eating starts it off so you need to go from as relaxed as possible straight into eating. Distraction can help a bit too. Put a video on your tablet or phone and watch while you eat. You can't be thinking about two things at the same time! Good luck.

Michelle on November 17, 2016:

Hi. Are you still active? If you are then, I have a little problem...

Every time I eat I have a cup of Sprite with me. Everytime I swallow something, hard or liquid, I drink a sip of Sprite, as I am VERY scared to choke. Eat, sip of Sprite, eat, sip of Sprite... Every meal, solid or liquid as I said, I pretty much almost finish a whole bottle of Sprite. I really want to end this. I'd be glad if you have any advice for me.

sharne on October 10, 2016:

Thanks for this, ive been suffering from this for around 3 years now and it keeps getting triggered to the point where im only drinking liquids, im slowly eating different solid foods and trying to control my anxiety without seeing a proffessional or being on medication . Glad to know im not the only one, i think the hardest part is eating out in resturants because some people just don't comprehend what is wrong with me because they think its a silly problem

Sue on September 22, 2016:

Hi I chocked on some pizza thee other week it's happened a few time bit thee other week really scared me I could not breathe as it was lodged my hubby had to hit my back and put his arms under my ribs

I have a narrow wind pipe I went the doctors as I was suffering from blocked nose and ear

I now can't eat properly as I am scared to swallow

meloncauli (author) from UK on August 14, 2013:

For some strange reason your comment has only just showed up in my spam folder after seven months, so a belated thank you kingsingh. Glad you found the subject interesting. :)

meloncauli (author) from UK on January 21, 2013:

Thanks for your comment Christine. Acid reflux can indeed cause a feeling of choking, but sometimes when acid reflux is playing up very bad, it can be caused by higher levels of anxiety! When I was going through a severe spell of acid reflux, the swallowing and choking symptoms always felt worse.

Thanks for the recommendation.

Christine on January 20, 2013:

This was such a great article. For the past 2 years I've had a chronic gagging sensations, to the point I literally have gagged for hours straight and was out of work for a few weeks. Doctors have told me it's either anxiety and/or acid reflux, but I haven't found much about how those are related to gagging and choking. What helps me through the rough patches are chewing gum or sucking on candy, but what I need is a real solution! If anyone wants to try a great meditation cd, I highly recommend Belleruth Naperstek's panic attack one.

meloncauli (author) from UK on January 19, 2013:

Hi vibesites!

Yes, swallowing tablets and capsules can be a nuisance for many. I used to ask my doctor for all medicines in liquid form. Of course, this was avoidance.

It's funny you should mention a narrow esophagus, because I used to think that too. I remember my mum saying she thought she had a narrow gullet too! No doctor ever diagnosed my mum or me with a narrow esophagus though.

Anxiety can have awful effects!

Thanks for the vote, share and follow.

vibesites from United States on January 18, 2013:

I usually have a difficulty swallowing medicines, especially tablets (either flat, round ones or capsule-like ones). I had to cut them in half, or even in quarters. I would like to think I have a narrow esophagus. So thanks for these helpful and even life-saving tips. Up, interesting, shared and a following. :)

meloncauli (author) from UK on January 14, 2013:

I am glad you found it useful Glimmer Twin Fan!

meloncauli (author) from UK on January 14, 2013:

Thanks for comment and vote bodylevive!

Claudia Mitchell on January 14, 2013:

This is quite useful. My daughter can choke sometimes and has a strong gag reflex. Thanks!

BODYLEVIVE from Alabama, USA on January 14, 2013:

Thanks for sharing, useful and voted up

meloncauli (author) from UK on January 14, 2013:

Thanks Dreamhowl. I hope you found it an interesting read.

meloncauli (author) from UK on January 14, 2013:

Hi teaches12345. Thanks for reading and leaving a comment.

Jessica Peri from United States on January 14, 2013:

Congrats on hub of the day! I had no idea there was a fear of choking. You provide a lot of information.

Dianna Mendez on January 14, 2013:

I know it's hard to believe, but as you wrote, people do experience trouble swallowing due to anxiety. Your suggestions are excellent and your article is very interesting. I learned much from your post.

meloncauli (author) from UK on January 14, 2013:

Thanks for reading ComfortB. I am glad you learned something.

Comfort Babatola from Bonaire, GA, USA on January 14, 2013:

I had no idea that there are those who actually have the fear of choking. I know someone who had neck/back surgery and needed to be very careful when swallowing for fear of choking.

Well, I learned something today. Thanks for sharing, and congrats on the HOTD award.

meloncauli (author) from UK on January 14, 2013:

Thanks for your comment Pedro2012.

meloncauli (author) from UK on January 14, 2013:

Thanks Sunshine625!

meloncauli (author) from UK on January 14, 2013:

Glad you found it interesting AlanMalmcom!

Pedro from Spain on January 14, 2013:

Great article

thank you very much

Linda Bilyeu from Orlando, FL on January 14, 2013:

I know there are fears of many things, but I never heard of fear of choking until now. Thanks for teaching me something new today! Congrats on HOTD. Well done!

Alan Malmcom from Las Vegas, Nevada on January 14, 2013:

Wow, this is very interesting! I've definitely been there at a few restaurants and had to watch my brother-in-law perform the Heimlich maneuver.

meloncauli (author) from UK on January 14, 2013:

Many thanks for your comment and vote kingkos!

meloncauli (author) from UK on January 14, 2013:

Thanks for dropping by ryokowaren!

Distraction, particularly in the build up to eating can be help you stay calm. The fearful apprehension can build until it severely hampers eating generally.

Thanks for the vote.

meloncauli (author) from UK on January 14, 2013:

Thanks so much for the kind comments kingsingh.

meloncauli (author) from UK on January 14, 2013:

Thanks seanorjohn!

We tend to feel our emotions in our throats. People often use the expression 'choked up' when describing high levels of emotion. Also people say 'I got a lump in my throat' when describing something emotional.

Thanks for the vote.

kingkos on January 14, 2013:

nice hubs thanks for this

vote up

ryokowaren from USA on January 14, 2013:

Great article. Voted up! I have suffered with recurring anxiety since I was 8 years old and in my recent years have started to have this choking sensation. I try to think of something else to help relax my throat. Also, hot water, coffee, or tea helps to relax the throat, too. If anyone else is suffering from this side effect from anxiety, just remember to stay calm and the sensation will pass.

kingsingh from Maryland on January 14, 2013:

I know someone that has trouble eating and they do get nervous when they are chewing food that requires a bit more work. This is very helpful in understanding an issue that I never even knew was an issue. Congrats on being the hub of the day. Very well deserved.

seanorjohn on January 14, 2013:

Well done on HOTD. I have seen many incidents with choking when swallowing. It is much more widespread than realised. Must be very distressing when anxiety prevents people from eating normally. Good advice about the elastic band. I have heard about this for other psychol;ogical interventions. Voted up.

meloncauli (author) from UK on January 14, 2013:

Hi Marcy, thanks for your comment and vote :)

Marcy Goodfleisch from Planet Earth on January 14, 2013:

Excellent choice for HOTD! More people suffer from anxiety than many realize, and this is definitely one way it manifests. I like your useful tips for overcoming the fear, and for managing your life to avoid the problem.

Voted up and up!

meloncauli (author) from UK on January 05, 2013:

Thanks for dropping by Judi!

I watched my mum choke on a fish bone when I was very small and I have never forgotten it. I grew up being scared to eat fish because of that. I am over it now, but still very wary. I'm glad you are over your fear :)

meloncauli (author) from UK on January 05, 2013:

Thanks for your comment Nell! That must be truly awful. We take the act of swallowing food without choking for granted.

Thanks for the vote up too. :)

Judi Brown from UK on January 04, 2013:

I went through a spell of this when I was younger. I had a nasty experience with a fish bone stuck in my throat when I was a child and a small choking incident in my twenties triggered bad memories of that and set me up with a problem for a while. I'm well over it now, but it was horrible for a time.

Nell Rose from England on January 04, 2013:

Reading this I did feel sympathy towards anyone who suffers from it. When I was born I had a hole in my trachea, or farther down slightly, so swallowing has always been a bit hit and miss for me, I have to really chew in small pieces, if I do get too much down my throat or to dry, it will stick and I have to either drink water to get it down or bring it back up, it's a right pain when I am in a cafe or restaurant! great hub, and voted up! nell

meloncauli (author) from UK on January 04, 2013:

Thanks gsidley!

Yes, that's a great idea. It is, after all, another trick that anxiety plays on us; another way that anxiety says " you have lost control". We just don't realize how super the body is at keeping things running smoothly no matter what and our control isn't needed.

Best wishes to you too for 2013!

Dr. Gary L. Sidley from Lancashire, England on January 03, 2013:

Another quality hub about a common disorder.

Another useful approach is to encourage sufferers to experiment with their focus of attention, to experience how this influences their throat sensations. Also, in a group setting I have often asked people (sufferers and non-sufferers) to try to swallow 3 or 4 times on the trot (a strategy sufferers often employ to "check" that their throat is still open); of course, by doing this everyone finds that they are unable to swallow - a perfectly normal consequence.

Best wishes for 2013 - may your hubs continue to thrive.

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