Dry cough anxiety

Anxiety and Cough: Is There a Link?

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.

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.

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

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.

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.

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.

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.

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.

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.

Anxiety Cough Symptoms, Chronic Cough and Nervous Cough Symptoms

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.

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.

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.

How to get rid of a cough and when to run to the doctor

Coughing can be a concern at any time of the year. Together with the general practitioner, we understand the possible causes and consider treatment options.

The respiratory tract of our body is covered with a thin layer of cells with cilia. They are constantly moving and remove all the mucus and dirt from the lungs and bronchi to the outside. But if the amount of irritants or mucus is too high, as well as when a foreign body enters, the second one comes to the rescue of the first defense mechanism - cough.

Andrey Besedin, PhD, general practitioner, family doctor at GMS Clinic.

Coughing is a protective reflex of our airways. It is needed to shake off all the excess that gets there. Coughing effectively rids the body of almost any irritant that can enter the respiratory tract.

Why there is a cough

A cough can start due to any object or substance that has entered the respiratory tract: food fragments, perfume vapors or aerosol. Sometimes it's caused by allergies, and sometimes it's stress.

Most often, coughing is provoked by viruses or bacteria and their metabolic products. In this case, the cough is called infectious, and its manifestations will differ depending on the pathogen:

Manifestations of infectious cough:

Coronavirus infection. The cough is most often dry, debilitating, in addition to this, there are other symptoms: shortness of breath, weakness, fever, headache.
Pneumonia. Symptoms depend on the type of infection, but often the disease begins with a cough that grows and turns into a persistent wet cough. The amount of sputum increases, chest pain, fever, weakness may appear. There is a general deterioration in the condition.
Bronchitis. The cough is wet, after expectoration it becomes easier. With deep breathing, sounds are sometimes heard in the chest - they are caused by the fact that sputum accumulates in the bronchi.
Whooping cough. The cough in this disease is debilitating, paroxysmal, prolonged, it interferes with sleep. It is difficult to find a position to alleviate the condition. From constant coughing, the intercostal muscles hurt, and hemorrhage in the eye may occur. Over time, the frequency of seizures decreases, but this condition sometimes lasts for several months.

Cough can be a sign not only of an infectious disease, but also of other conditions and diseases.

More common than others are:

Allergy and asthma. In most cases, coughing fits occur after contact with an irritant in the air.
Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic airflow limitation in the airways. The main symptoms of COPD are cough with phlegm and shortness of breath.
Heartburn or gastroesophageal reflux disease (GERD). The movement of the acidic contents of the stomach up the esophagus causes irritation of the mucous membrane of the throat and vocal cords, which contributes to coughing and itching.
Nervous disorder. In a stressful situation, especially in children, a nervous cough is possible as a variant of a nervous breakdown like a tic.
Foreign body or tumor.
Smoking.
Tuberculosis.

Understanding the cause of a cough

To understand the cause of a cough, you need to answer a few questions:

When does the cough start? At night in a dream, after physical exertion or after eating?
Has there been contact with ARVI patients in the last few days?
Are there any gastrointestinal diseases or symptoms of stomach upset?
Is there sputum, what does it look like?
Did the cough develop during birch blossoms or after contact with other allergens?
Is the cough accompanied by other symptoms? Is there a temperature, chills, weakness, is there weight loss?
Has there been a lot of stress recently?
Is the office or apartment well ventilated, is there a humidifier?
How long does the cough last? Is it decreasing or increasing?

If you characterize a cough, it will be approximately clear where to look for the cause and how urgently you need to see a doctor. Any kind of cough that lasts more than a few days, interferes with sleep, is accompanied by a high fever, or produces a pronounced colored discharge is an occasion to see a doctor. You need to go to the appointment especially quickly if, due to coughing, it is difficult to inhale and exhale when there is not enough breathing.

How to get rid of a cough

You need to go to the doctor and not self-medicate, but this is not always possible to do right away. If you can’t get an appointment right away, there are ways to alleviate the condition using proven methods.

Clean air

If you fantasize, the best option is to live on the shores of the warm Mediterranean Sea, not stress, eat well and tasty and not get sick. But this is not always possible, so you need to take care of respiratory hygiene. The first and most important thing is to moisturize the mucous membranes. We forget to humidify the air where we are constantly. Offices often have a central air filtration system that is not efficient enough. In this case, walks in the forest or square help.

Dry dusty air irritates the mucous membranes and intensifies coughing. Therefore, you can put a humidifier at home or put a damp towel on the battery, in addition, you should do wet cleaning more often and do not forget to open windows for ventilation.

Natural remedies

Evidence-based medicine treats herbal infusions with caution. Herbs can cause allergies, and the concentration of the beneficial substance in them is unknown, it is difficult to measure it for normal dosing of the drug.

Lollipops

The easiest way to moisturize the mucous membranes is to use any lozenges for resorption. It is not necessary to buy medical ones from a pharmacy, you can take any delicious ones in the store. This stimulates saliva flow and slightly moistens the oropharynx.

Drinking plenty of fluids

It moisturizes the mucous membranes and thins the sputum, and it becomes easier for the body to get rid of it. If there is not enough fluid in the body, then the sputum thickens, coughs up worse, can become a breeding ground for bacteria and cause complications.

Salt solution

Salt solution should be instilled into the nose when coughing, which appeared due to irritation of the posterior pharyngeal wall with discharge from the nose. You can buy saline solution at a pharmacy or make it at home: dissolve a quarter teaspoon of soda and half a teaspoon of salt in a glass of water (250 ml).

Inhalation with saline

They moisturize the respiratory tract well and help to remove sputum, but in recent decades, world medicine has increasingly warned against inhalation without a preliminary examination by a doctor.

Medicines

For the treatment of coughs, there are many drugs that are freely sold in pharmacies. But you can take them only after consulting a doctor. With ordinary SARS, moisturizing the mucous membranes and drinking plenty of water work no worse than drugs, and buying inappropriate drugs can worsen the condition.

For example, if you take antitussives to get rid of a boring cough, then sputum can accumulate in the bronchi and cause bacterial complications.

The doctor may prescribe medication if he sees the need. Most often it is:

Antitussives. They are prescribed for a dry, debilitating cough, when the cough interferes with sleep, such as whooping cough.
Expectorants. They are prescribed for sputum that does not cough up on its own. Children under the age of four should not take these medicines without a doctor's permission.
Nasal drops. If the cause of the cough is a runny nose and mucus flowing into the oropharynx, then they can help. But drops from the common cold should not be used for more than 3-5 days due to the danger of addiction.
Medicinal inhalations. In this case, bronchodilators or hormonal drugs are added to saline to reduce inflammation and relieve spasm.
Attacks of respiratory failure (bronchial obstruction) in children are relieved by inhalation drugs, but this is discussed at a face-to-face appointment with parents. There is no need to create a home first aid kit based on articles from the Internet. After all, there is no identical course of even a common cold, and understanding how to reduce bronchial obstruction in a particular patient is not always possible right away, even at the reception.

How to recognize a chronic cough

If the cough lasts more than three weeks, you need to beware. Only a doctor can help determine the cause of a cough, its type and choose the right treatment.

The diagnosis of "Chronic cough" is made based on the results of a discussion with a doctor; it is impossible to determine this on your own. Sometimes it happens that a person comes to an appointment and says that he has a chronic cough. It turns out that for the first three weeks he was recovering from an acute respiratory viral infection, then for two weeks there was an exacerbation of GERD (gastroesophageal reflux disease), which provoked a cough. And another whole month fell in the early spring and the spraying of some birch or alder. In this case, we are not talking about chronic cough. And it happens that a patient has chronic obstructive pulmonary disease, and he coughs precisely because of it.

What to do if the cough interferes

First of all, you need to sit or stand up and try to inhale through your nose. If the inhalation and exhalation with the help of the nose is successful, then everything is fine for now. If you can’t take a breath, then you need to wake up someone close, try to scream or say something. If it works out, then breathing is preserved - already not bad. If you can’t scream and breathe, then you need to urgently call an ambulance.

If at night the cough interferes so that it is impossible to sleep, you need to find out if an ambulance and hospitalization are required.

While the ambulance is on its way, you need to:

open window for fresh cool air;
turn on hot water in the bathroom and breathe over the steam;
calm down.

How heart disease and cough are related

If the heart ceases to cope with its work and slowly pumps out blood, then pressure rises in the lungs, fluid accumulates, and this causes a reflex cough. This condition is characterized by bouts of dry cough. In severe cases, blood-streaked sputum may appear. That is, coughing is associated with the formation of heart failure, there is excess pressure in the pulmonary circulation. Fortunately, this doesn't happen often.

How to treat cough during pregnancy

In pregnant women, coughing may be associated with increased pressure on the lungs or heartburn in the later period, but there may be more serious reasons.

Any cough in pregnant women, even a slight one, is a reason to visit a doctor. There can be many reasons for coughing, and pregnancy is a period of increased attention to health.

Peculiarities of cough in children

You should not buy expectorant and expectorant drugs for children on your own, they can worsen the condition and cause complications.

In most cases, young children have an irregular cough that occurs against the background of swelling of the nose. If the child does not have a high fever and shortness of breath, then most likely the cause of the cough is a nasopharyngeal drip. In this case, the mucus flows down the back wall from the nose and irritates the vocal cords. But at home, this cannot be determined accurately.

Cough is not a disease, but one of the signs that something is wrong in the body. Most often, a cough goes away on its own and without consequences, but each situation is individual, and it is important to consult a doctor in time in search of reasons. Especially if there are other alarming symptoms besides coughing.

Why a cough should be treated as soon as possible

Most parents, especially mothers, become worried when a child coughs and must take immediate action.

Among all the symptoms of colds, coughing is the most worrying for mothers.

Their fear is justified, if the cough is not treated in time, the course of the disease may worsen! Up to 12% of children* may develop cough-related complications such as bronchitis and pneumonia. *

The mother is the first to recognize the problem when the cough starts and the first to help the child. If a mother takes action at the first sign of a cough, then the likelihood of complications and worsening of the course of her child's illness is reduced.

When a cough develops, measures should be taken as soon as possible.

So, we can reduce its severity, frequency and intensity. The potential for complications is also reduced because excess sputum from a productive/wet cough is more efficiently cleared from the airways and does not promote bacterial growth.

REDUCTION OF COUGH SYMPTOMS
Improvement in various types of coughs with drugs in a convenient form for children and adults
The minimum risk of complications
less risk of infection on other respiratory tract departments
Reducing treatment time
Reducing the intensity and treatment time of cough
Calm Cashes not interfere

Viral respiratory infections are the most common cause of cough. Preventive measures and cough hygiene can help stop the spread of infection, and herbal medicines can help fight coughs ⁶ .

Herbal preparations have been shown to be as effective as synthetic drugs in relieving some medical problems, including coughs.

Dry cough can be relieved with remedies such as marshmallow roots, mallow flowers, psyllium herb. They help reduce irritation and inflammation of the upper respiratory mucosa and reduce the cough reflex ^3.6 .

If coughing starts sputum secretion , then this is a wet/productive cough. In this case, expectorants are suitable, which help thin the sputum and improve its expectoration and thus clear the airways ^3.6 . One of the most recognized groups of expectorant natural remedies for its effectiveness is those containing primrose, thyme, and ivy.

According to the mechanism of action, dry extract of ivy leaves can be attributed to drugs with a complex pharmacological effect ³ .

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