Dysphagia, Anxiety, and Living Inside a Choking Fear

I’m writing this while I’m still in it.

I’m still struggling to eat normally. I’m still hyper-aware of my swallowing. I’m still scared of choking, even though clinicians have told me there’s no obstruction and that my airway is safe. I want to explain what this actually feels like, because when people say “it’s just anxiety,” that phrase doesn’t capture the reality of living inside it.

How this started

This began with a real scare. A hair caught at the back of my throat and triggered a sudden gag reflex that felt like choking. It passed quickly, but my body didn’t forget it. From that moment, my nervous system went into full alarm mode.

Since then, swallowing hasn’t felt automatic.

What dysphagia feels like for me right now

My swallowing still works, but it doesn’t feel reliable. When I’m calmer, I can eat solid food — I’ve eaten pizza, chocolate, and other foods — but when anxiety rises, swallowing feels delayed and unsafe.

Saliva is the hardest part. Fluids go down more easily, but saliva feels thick, pooled, or like it isn’t going down properly. My throat often feels tight, tingly, numb, or tickly. Sometimes the sensation feels like it moves, which feeds the fear that something is still stuck, even though I’ve been told there’s no obstruction.

Eating depends entirely on my anxiety level. That fluctuation is one of the most unsettling parts. One moment I can manage food, the next I’m terrified to try. It makes me doubt myself constantly.

The fear loop

The fear doesn’t stay rational. When anxiety spikes, my body clamps down. I start monitoring every swallow and every breath. I notice tiny, normal pauses in breathing and interpret them as danger. At its worst, the fear convinces me that I might die.

I cry. I shake. I feel overwhelmed by my own body.

I drool more when anxious — something I’ve experienced for years — but now it feels frightening instead of familiar. I replay the original moment in my head over and over, telling myself that if I’d breathed differently, something terrible could have happened. That thought is hard to escape.

Medical reassurance versus lived fear

I’ve spoken to clinicians and had someone come out to check me over. I was told there was no obstruction and that this was anxiety-related. I believe that on a logical level.

Emotionally, the fear hasn’t fully let go.

That’s one of the hardest things about anxiety-related dysphagia. Reassurance helps, but it doesn’t instantly calm a nervous system that’s been shocked. My body still reacts as if it’s under threat, even when I know I’m safe.

How I’m coping with food

Right now, I’m surviving on soup, yogurt, rice pudding, and other soft foods. That isn’t failure — it’s strategy. Hunger makes my anxiety worse, so eating what feels safest is how I’m coping.

I eat slowly, upright, in small bites, and only when my anxiety is lower. I don’t force myself to eat when panic is high, because forcing swallowing makes everything worse.

I remind myself that missing meals briefly isn’t dangerous. Dehydration would matter — but I can drink.

What I’m learning as I go

I’m learning that dangerous swallowing problems don’t switch on and off with anxiety. If calming down helps even a little, it isn’t an obstruction.

I’m learning that choking doesn’t happen quietly or gradually. It doesn’t wait. It doesn’t negotiate.

I’m learning that throat sensations can persist long after the original trigger is gone, especially when nerves are sensitised by fear, crying, and muscle tension.

Most importantly, I’m learning that my body hasn’t failed me. It reacted to a scare, and now it’s struggling to stand down.

Why I’m writing this now

I’m writing this because I’m still in the middle of it. Anxiety-related dysphagia feels incredibly real and incredibly frightening. It can make you feel like you can’t trust your own body.

Being told “it’s just anxiety” without explanation can feel invalidating. This isn’t imagined. It’s a physical experience driven by a nervous system stuck in alarm mode.

I don’t know exactly when this will fully settle. But I do know it already fluctuates, and that tells me it can improve. I’ve had moments where eating feels easier. I’ve had moments where fear loosens its grip.

I’m holding onto those moments.

If you’re reading this and recognising yourself

If your swallowing difficulty worsens with anxiety and eases when you’re calmer, you’re not broken. You’re not weak. You’re not about to choke.

Get checked if you need reassurance — that matters. But know that anxiety can hijack swallowing in ways that feel terrifying without being dangerous. I'm still trying to believe this.

I’m still learning to trust my body again.

And for now, that’s enough.