Anxiety is one of the worst feelings you can have. It causes all kinds of symptoms, and can be caused by any everyday problem, even if you don’t really know what it is.

Sometimes, we live under stress without realizing it, so much so that we can’t even swallow saliva, which makes us wonder why our throats get tied .

This sensation, called a hysterical bolus, is common if you have an anxiety disorder, although sometimes it is difficult to relate this symptom to a psychological problem and is confused with a medical condition. Let’s take a closer look at how this feeling can occur and what you can do to combat it.

Why do we get a lump in our throat?

The sensation of having a lump in the throat is called a hysterical bolus or pharyngeal balloon and is one of the main symptoms of the manifestation of an anxiety disorder. It consists of the muscles of the throat contracting, despite there being no organic factor or cause for it, making it difficult to speak, swallow food or even swallow saliva.

The reason for the appearance of this sensation is that, when you are anxious, the body prepares itself for a possible danger or threat . In order to achieve the ability to escape or attack in the most efficient way, some physiological processes are inhibited, especially those related to the digestive system, with swallowing and digestion being the most affected.

Therefore, not only does the sensation of drowning occur, but also the mouth dries up because the production of saliva, used in the digestion process, is paralyzed.

Many people who have high levels of stress may experience a sensation similar to drowning or a blockage in the throat, even though there is no physical object or cause for it. Therefore, despite the sensation, which is very unpleasant, there is no real threat that the person will drown . In fact, if you try to drink water and try to stay calm, you will most likely manage to swallow it.

However, even if it is a feeling, it does not mean that it cannot get worse. If the person who is suffering from it starts to really believe that he or she is going to drown, the hysterical bolus will persist, as well as contributing to the person’s desperate behaviour to get rid of it.

Even if you have had this sensation before and you know, objectively speaking, that you will overcome it after a few minutes, the sensation of suffocation does produce some emotional reaction in the person , such as crying or loss of calm.

Many people can suffer from the pharyngeal balloon for multiple causes, but if the sensation persists over time, it is very necessary to resort to a professional. Not only to avoid or try to diminish its appearance, but to understand the anxiety problem that causes it.

Characteristics of this unpleasant sensation

As we were saying, the hysterical bolus basically manifests itself in the form of very annoying choking, popularly compared to a knot in the throat. However, the following two characteristics should be highlighted.

1. Appears in unexpected situations

Unlike panic attacks, a lump in the throat is a situation that can occur without any prior signal that it is going to happen. The hysterical lump appears when everything is going well, without warning.

This sensation appears because of all the anxiety you have been suffering, which, unconsciously, progressively orchestrates and triggers a series of physiological responses , drowning being one of them.

Because it occurs without attracting attention or even in a high-stress situation, it is more difficult to identify the cause that generates this feeling.

2. Makes it difficult to speak fluently

Although the sensation of drowning is indeed that, a sensation, it causes tension in the throat, which makes it difficult to speak comfortably .

It’s exactly the same as if you had a rope around your neck or someone was choking you, so you can’t talk normally.

What can be done?

On more than one occasion, especially when one does not know what to do or has not previously experienced this feeling, the person responds in a very alarmed way . This contributes to making the sensation of drowning worse, making the person even more nervous, entering a loop that only makes the negative sensation worse.

Thus, when faced with the notable sensation of not being able to breathe properly, one ends up going to the emergency room, where, after carrying out the appropriate tests, it is seen that there is no object obstructing the throat. It may be the case that some type of drug is prescribed to calm the feeling of discomfort, without considering that it is really a symptom caused by a psychological problem.

Not knowing or ignoring this sign, and therefore not delving into the possible anxiety disorder that should be behind it, is very detrimental to the person’s well-being . Not delving into what makes the person anxious can make their symptoms chronic. Anxiety, distress, stress and crying are warnings that something is not right in our life, and they should be paid attention to. Ignoring these warning signs will not make them go away or magically make the problem behind them go away.

The lump in the throat, as a symptom of anxiety, may be a sign that you need to go urgently to a professional to treat the problem causing it, which is certainly not an infection in the pharynx or a blockage in the neck. Taking medication that only ‘covers up’ the symptom instead of working on the cause will only lead to this unpleasant sensation in the future and, to top it all, to the development of some kind of addiction to the drugs used to treat this discomfort.

The hysterical bolus may be the first of many psychosomatic symptoms caused by anxiety. Others may follow, perhaps much worse, such as chest pain, which can be confused with a heart attack, depersonalization, facial paralysis, gastrointestinal pains, tics…

The lump in the throat is a symptom that, although simple, is disabling, especially because can appear at any time, without warning . It happens suddenly, like a summer storm. Since it is not possible to prevent it by your own means, the best option is to seek specialized help.

Bibliographic references:

  • Jones D., Prowse S. (2015). Globus pharyngeus: an update for general practice. The British Journal of General Practice. 65 (639): 554–5.
  • Kortequee S., Karkos P. D., Atkinson H., Sethi N., Sylvester D. C., Harar R. S., et al. (2013). Management of globus pharyngeus. International Journal of Otolaryngology. 2013: 946780.
  • Cybulska E. M. (1997). Globus hystericus–a somatic symptom of depression? The role of electroconvulsive therapy and antidepressants. Psychosomatic Medicine. 59 (1): 67–9.