Anxiety Cough Symptoms, Persistent Cough, Nervous Cough Symptoms description:
You experience:
- An anxiety cough, persistent cough, nervous cough, coughing when anxious and nervous
- A frequent tickling in the throat and/or lungs that makes you cough
- A persistent dry cough
- A persistent non productive cough
- Coughing, worse during anxious or stressful times and better when relaxed and less stressed
- Difficulty taking a deep breath without coughing
- Persistent wheezing that seems to be associated with your cough
These anxiety cough symptoms can come and go rarely, occur frequently, or persist indefinitely. For example, you may feel the tickle and/or urge to cough once in a while and not that often, feel it off and on, or feel it all the time.
These anxiety cough symptoms may precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.
These anxiety cough symptoms can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur ‘out of the blue’ and for no apparent reason.
These anxiety cough symptoms cough can range in intensity from slight, to moderate, to severe. They can also come in waves, where it’s persistent one moment and eases off the next.
These anxiety cough symptoms can change from day to day, and/or from moment to moment.
All of the above combinations and variations are common.
For many people, anxiety cough diminishes and subsides when resting, at night, or when sleeping. For others, however, anxiety cough can increase late in the day, at night, or when resting, relaxing, and/or sleeping.
Because anxiety affects each person uniquely, each person can have a unique anxiety cough experience.
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Why does anxiety cause a persistent anxiety cough?
Medical Advisory
There are many reasons why anxiety can cause a persistent cough. For example:
1. Suppressed immune system
Anxiety causes the body to produce the stress response. They are designed to give us an “extra boost” when danger is perceived so that we have an enhanced ability to either fight with or flee from the source of the danger. This “extra boost” occurs because the body suppresses all non-essential functions so that maximum awareness and energy can be diverted toward those systems, organs, and glands required for action when danger is perceived. This system works well when stress responses occur infrequently. When they occur too frequently, however, problems can occur.
For example, the body’s immune system is responsible for fighting off intruders, such as viruses and infection (bacteria). Since the body’s immune system isn’t part of the emergency response system, it is suppressed when we are anxious or stressed.[1] When the immune system is suppressed for prolonged periods, the body doesn’t have the resiliency to defend itself against these foreign invaders, which can allow them to take root.[2] Once the intruders have gained a foothold in the body, they can become entrenched if persistent elevated anxiety and stress continue to suppress the immune system. Even the use of antibiotics may not be successful in helping the body overcome infection when stress and anxiety remain high.
Because viruses and infections can cause coughs, persistently elevated stress and anxiety can cause coughs to linger much longer than they normally would because of the body’s diminished ability to win the fight. A healthy immune system is the body’s best defense against viruses and bacteria.
2. Vagus nerve hyperstimulation
The Vagus nerve, also referred to as the Cranial Nerve X, runs from the brain stem to the viscera – the internal organs of the body, specifically those within the chest (the heart or lungs) or abdomen (liver, pancreas or intestines). The Vagus nerve supplies nerve fibers to the pharynx (throat), larynx (voicebox), trachea (windpipe), lungs, heart, esophagus, the intestinal tract, and as far as the transverse portion of the colon. The Vagus nerve also brings sensory information back to the brain from the ear, tongue, pharynx, and larynx.
Because the Vagus nerve is a part of the nervous system, it can also be adversely affected by stress-response hyperstimulation,[3] since the stress response has its most dramatic effects on the body’s nervous system.
A stress-response hyperstimulated nervous system can cause all sorts of problems, including those associated with the Vagus nerve and its functioning.[3] A common consequence of Vagus nerve overstimulation is a persistent dry cough and/or nervous cough. As hyperstimulation increases, so can the persistence of anxiety cough.
3. Shallow and rapid breathing
When stressed and/or anxious, many people breathe rapidly and shallowly.[4][5] While this type of breathing pattern generally isn’t harmful in short durations it can cause the throat to become dry and raw if stress and/or anxiety are sustained.
Once the throat becomes dry and raw, it can cause a persistent tickling sensation that can cause a persistent dry cough. Moreover, persistent coughing can also irritate the throat, which can cause a persistent cycle of dry throat, coughing, irritated and dry throat, coughing, and so on.
There are other reasons why anxiety can cause a persistent cough. We describe two more common reasons in the Recovery Support area of our website. The above are the most notable.
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How to eliminate persistent anxiety cough?
Since all of the above reasons are related to anxiety and the stress it causes, reducing stress and dealing with your anxiety issues are the most effective ways to eliminate anxiety cough. Yes, reducing your body’s stress can be helpful in alleviating anxiety cough, but dealing with the root of your anxiety issues is the most successful and long lasting solution to anxiety and its many sensations and symptoms, including anxiety cough.
There are some short-term remedies to consider. Here are a few:
- Breathing in a more relaxed and regulated manner can prevent a dry throat and the coughing that can result from it.
- Reducing your body’s stress as much as possible can reduce anxiety cough relatively quickly.
- Working at containing your anxious thinking can reduce stress responses and your body’s overall reaction to elevated stress.
And so on (we list others in Chapter 9 in the Recovery Support area of our website).
Most importantly, however, is addressing the underlying factors associated with your problematic anxiety. Working with an experienced anxiety disorder therapist is the most effective way of identifying and addressing anxiety’s underlying factors.[6][7][8] Once you’ve eliminated the cause of overly apprehensive behavior, you also eliminate the stress it causes and its resulting symptoms. The less anxious you are, the less anxiety symptoms you’ll experience, including anxiety cough.
We also have to keep in mind that it can take a long time for the body to recover from stress-response hyperstimulation. We have to persevere with our recovery strategies in spite of the lack of apparent progress, and remain patient as the body recovers.
While anxiety cough can be bothersome, it’s NOT an indication of something more serious. Therefore, it needn’t be a cause for concern. It will disappear when the body’s stress has been returned to a healthy level and you’ve learned to contain your apprehensive behavior.
If you are having difficulty with anxiety, its symptoms, and troublesome worry, you might want to connect with one of our recommended anxiety disorder therapists. Working with an experienced anxiety disorder therapist is the most effective way to overcome problematic anxiety.
All of our recommended therapists have experienced anxiety disorder, have successfully overcome it, and are medication-free. Their years of personal and professional experience make them an excellent choice to work with on your road to recovery.
Visit our “Why Therapy” and “What Makes Our Therapists Unique” articles for more information.
Anxiety can cause all sorts of physical symptoms, like a headache or an upset stomach. It can also make you cough.
Do you live with anxiety and have a persistent cough? If so, you might suspect that your anxiety could be causing your cough.
Evidence suggests that anxiety can indeed induce a cough, although research in this area is very limited.
Anxiety-induced coughing is known as somatic coughing syndrome. It was previously known as a psychogenic cough.
How can anxiety cause a cough?
We often think of anxiety as an emotional or mental symptom, but anxiety can show itself in our physical bodies, too. You may be familiar with the feeling of a lump in your throat, butterflies in your stomach, or anxiety making you blush or tremble.
A somatic cough is one in which there’s no physical explanation, and where psychiatric reasons appear to be the source. When psychological distress leads to physical symptoms, this is known as somatization.
So, how might anxiety lead to a cough? Researchers have a few theories:
- Anxious breathing. When we’re anxious, our breathing often becomes shallow and rapid (hyperventilation). This can cause a dry or irritated throat, which can trigger coughing.
- Acid reflux. A 2018 study involving more than 19,000 people found that anxiety and stress may contribute to acid reflux, or gastroesophageal reflux disease (GERD). If the stomach acid reaches the esophagus, it can cause coughing.
- The immune system. Anxiety and high levels of stress may lower your immune system response. This could make you more susceptible to irritants or infections that can cause coughing.
- Stress affecting the vagus nerve. Chronic stress can affect the vagus nerve — a major nerve that runs from the brain stem to several organs, including the lungs. Some researchers suggest this might be the cause of some unexplained coughing.
The anxiety-cough cycle
There’s a complex association between mental health issues and chronic cough. These two symptoms can contribute to or worsen each other.
While anxiety can sometimes result in a persistent cough, having a chronic or untreatable cough (from any cause) can also lead to anxiety.
A chronic cough can have physical, social, and emotional effects, all of which can cause anxiety. For example, a person with a chronic cough may avoid daily activities, have relationship problems, have urinary incontinence, or avoid talking (to avoid triggering a cough).
In general, there seems to be a link between coughing and several types of psychological symptoms.
Research shows that cough and respiratory symptoms are more common in people with psychological symptoms. The most frequently reported symptoms among people with chronic cough are:
- anxiety
- insomnia
- somatic symptoms
- social dysfunction
- severe depression
What type of cough can anxiety cause?
There’s some confusion regarding what type of cough can be seen in a somatic cough disorder.
Experts have long believed that a barking or honking cough is a central feature of somatic coughing syndrome, but the latest guidelines suggest that healthcare professionals shouldn’t use this when making a diagnosis.
While a barking or honking cough may be present, this could be due to other reasons, like the common cold.
Also, while coughing tends to stop at night in somatic cough disorder, other cough disorders also have this feature. Therefore, it’s no longer used in diagnosis.
Coughing varies from person to person, and there’s no single type of cough related to anxiety. Still, the cough is likely to be dry and nonproductive.
Symptoms of an anxiety-induced cough may include the following features (but not necessarily):
- coughing when feeling anxious or nervous
- less coughing while feeling relaxed
- a persistent dry cough
- difficulty taking a deep breath without coughing
- a tickling sensation in the throat or lungs causing you to cough
- a persistent nonproductive cough
- a barking or honking sound
- no coughing while sleeping
Coughing symptoms may be sporadic or persistent. Many of these symptoms overlap with other conditions, so it’s important to see a healthcare professional for a correct diagnosis.
Is it a cough or a tic?
What’s the difference between a cough caused by anxiety and a tic disorder?
Telling them apart can be complicated, but in general, a person with a tic cough would likely show signs of other tic behaviors.
Tics are defined as rapid and repetitive muscle contractions that manifest as involuntary movements or sounds. A tic cough would likely include the presence of an urge sensation just before the tic with attempts to suppress it.
Tics can happen at random. Sometimes they’re related to stress, tiredness, or anxiety. Other causes include provisional tic disorder or Tourette disorder.
Other causes of cough
There are many causes of coughing that do not involve anxiety. Coughs can present in a variety of ways and for different reasons, such as:
- Asthma. An asthma-related cough often causes wheezing. This will sound like a whistling sound on exhalation.
- A viral infection. The common cold, flus, and other chest infections are common causes of cough.
- Allergies. If your cough gets worse when you’re around pollen, dust, or animals, you might have allergies.
- Whooping cough. Also called pertussis, this is caused by a bacterial infection. It’s characterized by back-to-back coughing followed by a deep inhale that makes a “whooping” sound.
- Air quality. You might cough due to cold air, tobacco smoke, or air pollution.
Diagnosis
The American College of Chest Physicians (ACCP) guidelines recommend that a diagnosis of somatic cough syndrome — a part of somatic symptom disorder — only be made after:
- an extensive exam has been given
- uncommon causes of cough have been ruled out
- the person meets the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria
The DSM-5 criteria for somatic symptom disorder include:
- One or more somatic symptoms are distressing or lead to notable disruption to daily living.
- There may be constant or disproportionate thoughts about how serious the symptoms are, high levels of anxiety about the symptoms, or significant time and energy devoted to the symptoms.
- Symptoms are persistent, usually lasting more than 6 months.
Diagnosis may be difficult in a person who has a chronic cough and a history of psychological symptoms. According to a 2017 paper, it’s often unclear whether the mental health problems contributed to or maintained the cough, or if they’re separate diagnoses.
If this is the case, the healthcare professional should confirm any causality in this relationship and not assume the psychological issues are causing the cough.
Similar diagnoses
The distinction between somatic cough syndrome and other similar diagnoses is not entirely clear, according to the same 2017 paper.
Other potential diagnoses for cough without a known physical source or that persist despite treatment include:
- idiopathic cough, or unexplained cough
- cough hypersensitivity syndrome
- laryngeal hypersensitivity
While underlying mental health symptoms may be contributing factors in some of these types of chronic cough, an unexplained cough can occur in people without psychological symptoms.
Treatment
Since research is lacking in somatic cough syndrome, there’s no sufficient evidence regarding which types of treatments are most effective.
Some approaches that may be beneficial include:
- receiving mental health support
- hypnosis
- suggestion therapy
- appropriate medications
Approaches to reduce anxiety may also help. These can include:
- meditation
- yoga
- eating a balanced diet
- exercise
There are a number of steps you can take at home to provide relief for a persistent cough. These include the following:
- Try drinking warm, soothing liquids, like warm lemon and ginger tea, or another tea that can ease a cough.
- A spoonful of honey may soothe the throat and reduce coughing.
- Stay hydrated and avoid dehydrating foods and drinks, like alcohol, salty foods, and sugary drinks.
- Humidify the air. If you don’t own a humidifier, place a shallow bowl of water near a heat source to let the water slowly evaporate into the room.
- Take time to rest. Your body needs time to recover and recharge. Get at least 8 to 10 hours sleep at night, and avoid strenuous exercise for a few days.
Next steps
If you’re experiencing a persistent cough, it’s important to seek the opinion of a healthcare professional. Together, you can discuss whether anxiety or another reason is triggering your cough.
If you find that anxiety is the probable cause of your cough, it might help to engage in stress-reducing activities, such as meditation or yoga.
You might also consider making an appointment with a counselor or psychiatrist to discuss other options for managing your anxiety.
