Can anxiety cause phlegm? (+3 tips)

In this article, we will discuss whether anxiety causes phlegm formation. We will also discuss other diseases that may cause phlegm. You will also get to know some management tips to reduce phlegm in throat.

Can anxiety cause phlegm?

Yes, anxiety may cause phlegm. Phlegm and mucus formation are the common symptoms of chronic stress, including anxious behaviour, panic disorder, social anxiety disorder, and generalized anxiety disorder (1).

You may feel mucus and phlegm building up in your throat which may require frequent throat clearing. You may also feel that something is stuck in your throat that needs clearance, causing a persistent cough.

You should consult your doctor if anxiety and stress are causing phlegm in your throat. Although the intensity of anxiety-induced phlegm can be slight, moderate and severe symptoms may require clinical interventions.

What does research suggest?

According to a Cohort study (n=623), a positive correlation existed between productive cough and anxiety (adjusted odd ratio OR=1.8). Other conditions that caused cough with phlegm included allergic rhinitis (OR=1.9), asthma (OR=2.0), and gastroesophageal reflux (OR=4.4) (1).

In another study, it was observed that the intensity and severity of cough and phlegm due to chronic obstructive pulmonary disease (COPD) increased when the patient was depressed and anxious (2).

In one of the cross-sectional studies, 33% of the patients (n=57) with cough were identified as anxious, whereas 16% of the patients experienced depression. The patients also presented with phobic anxiety, somatisation, and obsession (3).

What are the symptoms of anxiety-induced phlegm?

The symptoms of anxiety-induced phlegm and throat clearing may include:

  • A feeling of something stuck in the throat that needs to be cleared.
  • Excess mucus that needs frequent clearance.
  • Constant cough due to the presence of mucus at the back of the throat.
  • Persistent mucus buildup in the throat and nose in the absence of cold and flu.
  • Throat soreness due to frequent coughing.

What other diseases cause phlegm production?

Apart from anxiety, other diseases and conditions may also cause phlegm and cough. A protracted cough and mucus formation may compromise your quality of life and may need clinical interventions to reduce the severity.

Flu and cold

Flu and cold, because of a viral infection, may cause the formation of phlegm. You may experience a persistent cough to clear the mucus and germs out of your body. In addition to mucus formation, you may also get a runny nose, body aches, sore throat, and sneeze frequently.

Upper airway cough syndrome

Upper airway cough syndrome, previously known as postnasal drip, is a common cause of phlegm and mucus formation in the throat. You may experience chronic cough to clear your throat and airway passage (4).

Asthma

In asthma, the bronchi become inflamed and more sensitive to the irritants. When a foreign particle enters the lung, it triggers the narrowing of the airways and increases the production of sticky material (phlegm) (5).

Bronchitis

One of the main symptoms of bronchitis is a dry cough. However, sometimes the cough may bring up white, clear, or yellow-grey mucus (phlegm). You also experience sore throat, low-grade fever and runny nose.

Gastroesophageal reflux disease (GERD)

It has been established through various clinical studies that GERD may cause productive cough with persistent phlegm production. In GERD, microvascular leakage and inflammatory cell infiltration occur in the airway, leading to mucus hypersecretion (6).

Smoker’s cough

A smoker’s cough is chronic and occurs in over 40% of the people who smoke daily. A smoker’s cough is often accompanied by phlegm and mucus and is rarely dry. It is characterised by wheezing sounds and white or clearless mucus.

What are other disease-like symptoms of anxiety?

Anxiety and stress may induce other disease-like symptoms, including:

  • Heart palpitations and chest pain,
  • Muscle weakness, numbness, and tingling sensations,
  • Body jolts,
  • Confusion and brain fog,
  • Trembling and shaking,
  • Difficulty in breathing, and
  • Back pain and chronic fatigue.

How to manage anxiety-induced phlegm?

Consult your doctor if you feel that anxiety is causing phlegm in your throat, and not some other disease. For the management of anxiety-induced phelgm, the foremost thing is that your should reduce your level of stress.

Reduce stress

You should avoid situations that cause you stress and depression. Take a break from regular stressful activities and relax at night before going to bed. Indulge in activities that comforts you and reduces your stress level.

Stay hydrated

You should stay hydrated and drink plenty of water. You can also drink luke warm water and tea to soothe the throat, reduce the phlegm from throat, and remove toxins from your body.

Antidepressants

Your doctor may prescribe you antidepressants to reduce anxiety and depression. However, you may expereience some side effects. Some common antidepressants and their possible side effects include (7, 8),

Antidepressant Side effect
Selective serotonin reuptake inhibitors (SSRIs)
Paroxetine Hypersexuality and urine retention
Fluvoxamine Gas, bloating, and indigestion
Fluoxetine Weight loss and night sweats
Sertraline Heartburn and tremors
Seronotnin and norepinehrine reuptake inhibtors (SNRIs)
Venlafaxine Nausea, dry mouth, and change in body odour
Duloxetine Dehydration and rashes
Monoamine oxidase inhibitors (MOIs)
Phenelzine Weakness, dark urine, and urine retention
Selegiline Constipation, dizzines, and high blood pressure
Trcycilic antidepressants
Amitryptiline Constipation, dizziness, and dry mouth
Amoxapine Rash, dry mouth, and chest pain
Imipramine Dry mouth, light headedness, and dark urine

Always take antidepressants after consulting your healthcare provider. Never take more than the prescribed dose. Follow the instructions of your doctor to ensure safe and effective use of antidepressant.

In my experience

In my experience, anxiety can cause phlegm and give a feeling of something stuck in your throat. As a pharmacist, I would suggest you reduce your stress levels and avoid triggers that may cause anxiety. You may take antidepressants as per your doctor’s advice and prescription.

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References

1.-

Lúdvíksdóttir D, Björnsson E, Janson C, Boman G. Habitual coughing and its associations with asthma, anxiety, and gastroesophageal reflux. Chest. 1996 May 1;109(5):1262-8. https://www.sciencedirect.com/science/article/abs/pii/S0012369215461732

2.-

Choate R, Pasquale CB, Parada NA, Prieto-Centurion V, Mularski RA, Yawn BP. The burden of cough and phlegm in people with COPD: a COPD patient-powered research network study. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation. 2020;7(1):49. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182382/

3.-

McGarvey LP, Carton C, Gamble LA, Heaney LG, Shepherd R, Ennis M, MacMahon J. Prevalence of psychomorbidity among patients with chronic cough. Cough. 2006 Dec;2:1-6. https://link.springer.com/article/10.1186/1745-9974-2-4

4.-

Donaldson AM. Upper Airway Cough Syndrome. Otolaryngologic Clinics of North America. 2023 Feb 1. https://pubmed.ncbi.nlm.nih.gov/36283869

5.-

Evans CM, Kim K, Tuvim MJ, Dickey BF. Mucus hypersecretion in asthma: causes and effects. Current opinion in pulmonary medicine. 2009 Jan;15(1):4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709596/

6.-

Morimoto C, Matsumoto H, Nagasaki T, Kanemitsu Y, Ishiyama Y, Sunadome H, Oguma T, Ito I, Murase K, Kawaguchi T, Tabara Y. Gastroesophageal reflux disease is a risk factor for sputum production in the general population: the Nagahama study. Respiratory Research. 2021 Dec;22:1-7. https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-020-01601

7.-

Marken PA, Munro JS. Selecting a selective serotonin reuptake inhibitor: clinically important distinguishing features. Primary care companion to the Journal of clinical psychiatry. 2000 Dec;2(6):205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181142/

8.-

Laban TS, Saadabadi A. Monoamine oxidase inhibitors (MAOI). InStatPearls [Internet] 2022 Jul 19. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539848/