How to Overcome Swallowing Anxiety

Phagophobia is the fear of swallowing. People with phagophobia are highly reluctant to swallow food, beverages, and pills.

What causes this condition, and how can you overcome it? This article answers these and other related questions.

Phagophobia, Pseudodysphagia, and Other Swallowing Conditions

Most people take swallowing for granted. They ingest foods or beverages, chew them if necessary, their tongue moves the substance to the back of the mouth, and it begins its journey down the esophagus. However, swallowing involves a complex choreography of nerves and muscles working together to enable what’s typically an automatic process.

Several conditions can disrupt swallowing or make a person reluctant to swallow. In addition to phagophobia, problems like pseudodysphagia (the fear of choking) and various physical dysfunctions can also cause swallowing difficulties.

This article covers phagophobia specifically, including its symptoms, causes, and treatments. If you have problems swallowing, it’s helpful to remember that there are many potential causes.

Symptoms of Swallowing Anxiety

The fear of swallowing is a recognized phobia in the Diagnostic and Statistical Manual of Mental Disorders (DSM). So, if you experience it, you aren’t alone.

Phagophobia can cause several symptoms and behaviors, including:

• Anxiety as mealtimes approach
• Rapid heart rate and breathing before and during meals
• Sweating
• Eating tiny bites of food and following them with large quantities of fluids
• Extreme concern before each swallowing episode
• Reluctance to eat or drink in front of others
• Panic attacks
• Adopting a liquid diet to avoid solid foods
• Unintended and unwanted weight loss

What Causes Swallowing Anxiety and How Do Doctors Diagnose It?

Experts aren’t sure what causes swallowing anxiety. However, they suspect multiple factors may be involved, including:

• Anxiety disorders, particularly if they cause tension or tightness in the throat
• Seeing someone’s embarrassment after they choke or struggle to swallow in public
• Fear of specific foods (like those that can be dangerous if undercooked or spoiled)
• Previous choking experiences

If you have persistent concerns about swallowing, your doctor will talk with you about how frequently you experience them and how long the condition has persisted. They’ll also try to rule out potential causes, such as gastroesophageal reflux disease (GERD), dry mouth, and globus sensation (the feeling that you have a lump in your throat).

In addition, they may try to determine if you have another mental health condition, like social anxiety disorder (SAD), an eating disorder, panic disorder, and others.

Treatments for Swallowing Anxiety

Swallowing anxiety is a treatable condition. Your doctor may recommend one or more of these treatments:

• Cognitive behavioral therapy (CBT). This treatment involves conversations with a therapist that help you identify negative thought patterns. The goal is to identify and overcome them by substituting healthy thought patterns.
• Exposure therapy. This treatment is a process where a therapist guides you through intentionally engaging your fear, gradually increasing your exposure to decrease the stress it causes.
• Eye movement desensitization and reprocessing (EMDR). In this treatment, you learn to use sensory stimuli like hand tapping or eye movements to minimize your anxiety when swallowing.
• Hypnotherapy. This treatment involves a therapist helping you achieve a trance-like state that enables you to identify, understand, and overcome the root causes of your condition.
• Medication. Your doctor may prescribe specific medications to help reduce your symptoms as you get other treatments.

Talk with Your Baptist Health Doctor About Swallowing Anxiety

While it’s not typically physically dangerous, swallowing anxiety can have a pronounced negative impact on your quality of life. Fortunately, there are effective treatments.

If you experience stress and anxiety about swallowing foods and beverages, talk with your primary care doctor. They can work with you to diagnose and treat your condition.

Our online provider directory can help you find a physician if you don’t have one.