In short
Yes, anxiety can cause shortness of breath. The stress response speeds up breathing and shifts it high into the chest, and over-breathing then causes dizziness, tingling and the feeling that you can’t get a full breath. It passes, and slow belly breathing helps. Because breathlessness can also come from the heart or lungs, get new or unexplained breathlessness checked, and call 000 for severe symptoms.
On this page
Can anxiety cause shortness of breath?
Yes. Anxiety and panic attacks are recognised causes of shortness of breath, alongside lung problems, heart problems, infections, allergic reactions and anaemia.1 Shortness of breath is one of the common physical symptoms of anxiety.2
Why anxiety makes you feel breathless
Breathing is controlled automatically by the brain. When you feel stressed or anxious, your breathing rate and pattern change as part of the fight-or-flight response.3
- Breathing moves into the upper chest. An anxious person takes small, shallow breaths, using the shoulders in place of the diaphragm3
- You over-breathe. Breathing faster than your body needs, known as hyperventilation, lowers the carbon dioxide in your blood and disturbs the balance of gases3,4
- That causes more symptoms. Light-headedness, dizziness, tingling in the hands and arms, and a tight feeling in the chest4
- The symptoms cause more anxiety. Feeling that you can’t breathe is alarming, so you breathe harder, and the cycle continues3
The odd thing is that you are getting plenty of air. The trouble is too much breathing, not too little.
Want to talk it through?
Talk it through with an Australian doctor online. No referral needed.
What it feels like
- You can’t seem to get a deep, satisfying breath
- You sigh or yawn a lot, trying to “catch” one
- Your chest feels tight
- You are very aware of each breath
Lung specialists call this group of patterns dysfunctional breathing. It includes hyperventilation and frequent deep sighing with an irregular rhythm, and it can occur with or without a lung condition.5
Anxiety or something else?
You can’t be certain from symptoms alone, which is why new breathlessness should be checked. These are general pointers, not rules.
| More typical of anxiety | More typical of a heart or lung problem |
|---|---|
| Comes with a fast heartbeat, sweating, shaking, nausea, dizziness and a sense of dread1 | Comes on with physical effort, or when you lie flat1 |
| Can start at rest, even while watching television4 | Comes with chest pain, swollen feet or ankles, or palpitations1 |
| Tingling in the hands and arms4 | Wheezing, cough, fever or coughing up blood1 |
| Settles within minutes to half an hour4 | Is getting steadily worse over days or weeks1 |
Anxiety and physical illness can also occur together. People with asthma, for instance, can have both.
How to ease anxious breathing
- Sit down, lean forward slightly and stay as calm as you can1
- Slow down, don’t gulp. Taking bigger breaths adds to the over-breathing. Aim for slower and gentler
- Breathe through your nose, in for a count of three and out for a count of three or more6
- Use your belly. Put one hand on your chest and one on your stomach. The lower hand should move more3
- Give it a few minutes. The carbon dioxide level corrects itself as your breathing settles
Does breathing training work?
The evidence is promising but thin. A Cochrane review looking for trials of breathing exercises for hyperventilation found only one small study, which reported fewer and milder attacks but gave too little detail to draw conclusions.7
More broadly, a meta-analysis of 20 trials found breathing exercises reduced anxiety, with a small-to-medium effect.8 And in a trial for panic disorder, people who trained with a device that showed their carbon dioxide level improved, while those left untreated did not, and the gains lasted. The authors called the evidence preliminary.9
If anxiety is behind the breathlessness, treating the anxiety matters most. See how to calm anxiety and anxiety symptoms.
When to call 000
Call triple zero (000) and ask for an ambulance if someone is short of breath and:1
- They can’t speak, or can only say a few words at a time
- They have pain in the chest, arm or jaw
- Their skin is pale and sweaty, or their lips are blue
- They are drowsy or confused
When to see a doctor
- You have breathlessness that is new or unexplained, even if you suspect anxiety
- You get short of breath with less effort than before1
- It is worse when you lie down, or your ankles are swollen1
- You have a wheeze, a cough or a fever with it1
- Anxiety or panic attacks are happening often
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- healthdirect. Shortness of breath (dyspnoea).
- healthdirect. Anxiety.
- Better Health Channel (Victorian Government). Breathing to reduce stress.
- Better Health Channel (Victorian Government). Panic attack.
- Boulding R, Stacey R, Niven R, et al. Dysfunctional breathing: a review of the literature and proposal for classification. Eur Respir Rev. 2016;25(141):287-94.
- healthdirect. Relaxation techniques for stress relief.
- Jones M, Harvey A, Marston L, et al. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults. Cochrane Database Syst Rev. 2013;2013(5):CD009041.
- Fincham GW, Strauss C, Montero-Marin J, et al. Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Sci Rep. 2023;13(1):432.
- Meuret AE, Wilhelm FH, Ritz T, et al. Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder. J Psychiatr Res. 2008;42(7):560-8.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.