Short of Breath – Is it Anxiety or Something Else?

Anxiety can cause breathlessness. Being short of breath causes stress. It can be worrisome to figure out what causes you to feel breathless. Let’s look at some common causes of shortness of breath. If your shortness of breath is severe or accompanied by other symptoms, such as chest pain, or comes on suddenly, get medical help right away.

Evaluate the shortness of breath

Shortness of breath can be caused by anxiety, infection, heart, lung, and many other conditions. Each case has distinctive qualities that help you to differentiate the cause of your breathlessness. It helps you to notice the symptoms you experience. Here are some questions to ask yourself:

  • Have I ever felt this way before?
  • What was I doing when I realized that I was short of breath?
  • How long have I been short of breath?
  • Do I have other symptoms such as panic, chest pain, fever, cough, or congestion?
  • Are there other factors that may be causing my shortness of breath?
  • Do I have habits such as smoking or medical problems contributing to my breathlessness?

Now that you have thought about the shortness of breath, you can begin to figure out the cause. Remember that self-evaluation is not a substitute for professional consultation with a health care expert. Let’s start by considering the impact anxiety has on the breath.

Anxiety and shortness of breath

Anxiety is a common cause of breathlessness. Many people with anxiety, PTSD, or panic disorder hyperventilate without being aware that they are doing so. Hyperventilation, and rapid breathing, can cause a lack of carbon dioxide oxide in the body. You may feel like you are gasping for breath. Hyperventilation can make you feel spacey, panicky, numb, or like you are not wholly present. You may feel like your heart is pounding. You may be sweaty. Breathe slowly into a paper bag for a couple of minutes to resolve hyperventilation symptoms.

The shortness of breath and chest pain caused by anxiety arises when thinking negative thoughts or experiencing a stressful situation. Chest pain may increase feelings of anxiety. Chest pain in the center of the chest may be steady or worse when inhaling. Coughing is rare. Congestion is not associated with anxiety-related shortness of breath.

Heart and blood vessel-related shortness of breath

People with anxiety and shortness of breath sometimes seek medical help because they feel like they have a heart attack. The pain of an actual heart attack is typically different from the chest pain that anxiety causes. Cardiac pain is usually a feeling of crushing or heaviness in the center of the chest. The pain may radiate to the jaw, back, or left arm. Heart-related shortness of breath may accompany sweating, coughing, nausea, or vomiting. The skin may be pale or bluish. Heart-related shortness of breath can come on slowly or quickly.

Blood clots in the lungs cause shortness of breath to arise suddenly. People may cough up pink mucus and experience severe chest pain. If you have symptoms of acute cardiovascular shortness of breath, get medical attention immediately.

Respiratory illnesses cause breathing trouble.

Shortness of breath is the central characteristic of many respiratory disorders, including asthma, lung cancer, COPD, and chronic bronchitis. Symptoms usually come slowly. Anxiety can be a significant factor when breathing is difficult. People with respiratory illnesses often have congestion, coughing, wheezing, and other chronic breathing problems. People with exercise-induced asthma may develop suddenly. Shortness of breath when they are active. Severe allergic reactions can cause hives and swelling of the throat. An anaphylactic allergic reaction is a medical emergency.

Infections and shortness of breath

Viral illnesses, including influenza, RSV, and COVID, are common causes of shortness of breath. Viruses or bacteria cause pneumonia. Symptoms may develop slowly or quickly. Shortness of breath is not usually the first sign of a viral illness. Fever, cough, congestion, and sometimes body aches may accompany respiratory illnesses. Pain may arise, especially when inhaling.

Here is a chart that can help you determine what is causing your shortness of breath:

Anxiety Cardiovascular Respiratory Conditions Infection
Onset Usually rapid, often related to stress or negative thoughts Typically slow, rarely sudden Rapid or slow Hours to days
Duration Short- minutes typically or Hours to years Minutes to years Days to weeks


Not usually, unless it is due to nervousness Often often yes
Congestion No Sometimes with a productive cough Often, wheezing may occur common
Pain Sometimes mid-chest Sometimes mid-chest with radiation to the back left arm or back. Crushing, heavy, squeezing, tight Chest tightness with discomfort when coughing sometimes occurs Sometimes chest pain with cough or with each breath when pneumonia is present. Influenza may cause widespread body aches.

Headache sometimes

Fever No occasionally No Often
Additional Information Often caused by hyperventilation. Sometimes brought on by exertion.


May have discoloration of the skin or sweating.


Nausea may occur.


Acute cardiac issues are a medical emergency. Call 911.

Sometimes brought on by exertion.


May have discoloration of the skin.


A severe allergic reaction may cause hives and severe shortness of breath.


Severe, acute shortness of breath is a medical emergency.


See a health care provider or call 911, depending on the symptoms.

Common causes include Influenza, RSV, and Covid. Pneumonia may develop.


Contact a medical professional.


Severe symptoms may warrant emergency treatment.

Key Takeaways

Shortness of breath has many causes. Often multiple factors cause shortness of breath. Shortness of breath caused by anxiety may feel terrible, but it is not dangerous. Please speak with your healthcare provider to determine the cause of shortness of breath and create a plan for preventing and treating it.

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