Anxiety Symptoms- Lump in the Throat?

Anxiety symptoms can be confusing to navigate, we often hear of the common ones that signal we may be experiencing some anxiety. For example, shortness of breath, elevated heart rate, tunnel vision feeling, clammy hands etc. Picture this though, one of the least commonly spoken symptoms… ever had to have a difficult conversation with someone, a meeting with your boss, someone causing conflict and not knowing how to respond. Public speaking even. You feel like you can’t get the words out, there feels like there is this big lump in your throat and you just can’t get the words out. Sound familiar?

There is a name for this and we will explain why this happens mentally and physiologically below in more detail.

What happens when we experience anxiety?

In the medical definition of anxiety, anxiety is a psychological, physiological and behavioural state induced by a threat to one well being or survival, either current and actually existing or through the potential for there to be a perceived threat[1].

Anxiety shifts us very quickly into the sympathetic nervous system state, otherwise known as ‘fight or flight’ as it is commonly termed in modern times.

Anxiety is often characterised by:

• Higher blood pressure.
• Increased heart rate.
• Tension in the chest.
• Erratic focus, inability to center thoughts.
• Holding your breath.
• Change in posture, more defensive state.
• Trembling.
• Fidgety and restless.
• Sweating.
• Difficulty controlling worry, feeling it becoming consuming.
• Poor sleep.
• Gastrointestinal problems.

We don’t all experience the same symptoms of anxiety

Sometimes it can be difficult to feel like you have to tick off a list to understand that you may actually be experiencing anxiety. We don’t all experience the same symptoms as the next person.

Another aspect of this is that we shouldn’t feel like something is ‘not normal’ with us because we experience these symptoms, they are innate. The probability of your sheer existence alone in this world is staggering to think about… On average, only half of the cycles a woman has had been estimated to be viable, on top of that, survival estimates of sperm and ovum are around 1.4 and 0.7 days respectively. Combine with that, sperm has a probability of just 5% of surviving more than 4.4 days and a 1% probability of surviving more than 6.8 days.

Why is this important? Because for you to be here now even with those odds, your ancestors needed to have these innate fight or flight mechanisms to continue the human species as a whole. It’s a strength, not a flaw! To be aware of your environment and work out potential threats is so ingrained in our survival as a species, we cannot help this. Not everyone may experience it to the same extent, but they do have it pre-wired ready to go. In the instance of anxiety and chronic anxiety, it just means that you are always ready to go.

One of the least common symptoms we show

It's actually probably one of the most common that we show, we often just write it off as nervous and not anxiety per se. However, if we pay close enough attention, we likely all have come across this one in particular; the old ‘lump in the throat’.

You have gone to do a talk, take on a difficult conversation or perhaps pre-empting a phone call that brings back memories or conflict and you feel like there is a blockage right in the middle of your throat. You try not to tear up, and struggle to get the words out? This phenomenon is published in the literature and it’s known by the name of, ‘Globus pharyngeus’[3]. In literature, this is described as an anxiety linked experience that is felt when attempting to hold back strong emotions or feelings. The reason this gets tight in this moment is that the natural human fight or flight response engages and tenses the muscles for quick reactions. Unfortunately, even though our throat isn’t doing the running action or fighting action, it is still packed with muscles. This also extends to our diaphragm, intercostal muscles and any accessory breathing muscles too that control our breathing.

How to steady your breathing during a moment of Anxiety

If you are one who feels this sensation often and wanting to better understand ways to help combat it, there are some great options available:

Self-Calming method to try:

• Bringing awareness to the breath, if there is a lot of shallow breathing. Try to picture yourself breathing out as if you are blowing out a candle.

• Place your hand on your stomach and take a belly-deep breath in and relax the shoulders and pay attention to the movement of your hand going up and down as you inhale and exhale slowly.

• Focus on this breathing pattern and your hand moving up and down until the feeling in your throat or situation calms for you some more.

Pay attention to where you position your tongue when you feel this comes over you, do you push it to the roof of your mouth? If so, try to bring your attention to your tongue and move it more freely in your mouth, bringing it down to a relaxed position. Once here, move around the outside of your teeth with your mouth closed 10 times in one direction and 10 times the other direction.

The UK’s national health service also suggests that attempting to yawn while inhaling and sighing while exhaling can help relax the tongue and larynx[4].

Professional methods available:

If after trying some of these calming techniques you still feel that this issue keeps arising, it may be a great idea to work with a professional on getting to the bottom of why this may keep coming up for you. Some excellent therapy methods are available:

• CBT (Cognitive behavioural therapy) [5]
• DBT (Dialectal behavioural therapy) [6]
• ACT (Acceptance and Commitment Therapy) [7]
• EMDR (Eye movement desensitisation and reprocessing) [8]

Always consult with a healthcare professional before making any changes to your current lifestyle.

Take home?

Anxiety should never feel like a taboo subject, it's an innate strength. We, unfortunately, get exposed to more and more stressors in our environment than we have in the past. Our body responds to stress without a gauge assessment of how threatening it may be, it just is threatening and we need to respond accordingly and think back later.

Pay attention to your body’s signals, and make sure that you are making a conscious effort to both recognise stressors and on the other hand, prioritise downtime to activate and step into your parasympathetic nervous system. The parasympathetic is our rest and digest state and is important for recovery, growth and pleasure.

References

1. Steimer T. (2002). The biology of fear- and anxiety-related behaviors. Dialogues in clinical neuroscience, 4(3), 231–249. https://doi.org/10.31887/DCNS.2002.4.3/tsteimer
2. Ferreira-Poblete A. The probability of conception on different days of the cycle with respect to ovulation: an overview. Adv Contracept. 1997 Jun-Sep;13(2-3):83-95. doi: 10.1023/a:1006527232605. PMID: 9288325.
3. https://www.medicalnewstoday.com/articles/318633
4. https://www.hey.nhs.uk/patient-leaflet/globus-sensation/#:~:text=Globus%20can%20often%20be%20experienced,back%20strong%20feelings%20or%20emotions.&text=Laryngopharyngeal%20reflux%2C%20also%20referred%20to,pipe%20and%20into%20the%20throat.
5. https://www.hey.nhs.uk/patient-leaflet/globus-sensation/
6. Chand SP, Kuckel DP, Huecker MR. Cognitive Behavior Therapy. . In: StatPearls . Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470241/
7. Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa. : Township)), 3(9), 62–68.
8. Zhang, C. Q., Leeming, E., Smith, P., Chung, P. K., Hagger, M. S., & Hayes, S. C. (2018). Acceptance and Commitment Therapy for Health Behavior Change: A Contextually-Driven Approach. Frontiers in psychology, 8, 2350. https://doi.org/10.3389/fpsyg.2017.02350
9. Novo Navarro P, Landin-Romero R, Guardiola-Wanden-Berghe R, Moreno-Alcázar A, Valiente-Gómez A, Lupo W, García F, Fernández I, Pérez V, Amann BL. 25 years of Eye Movement Desensitization and Reprocessing (EMDR): The EMDR therapy protocol, hypotheses of its mechanism of action and a systematic review of its efficacy in the treatment of post-traumatic stress disorder. Rev Psiquiatr Salud Ment (Engl Ed). 2018 Apr-Jun;11(2):101-114. English, Spanish. doi: 10.1016/j.rpsm.2015.12.002. Epub 2016 Feb 11. PMID: 26877093.