Fear of choking

[FreddyP]

Hi I'm hoping some can help I've recently had to come off AD I've been on for 27 years and I have been changed to sertraline which I've been taking for just over a week for severe anxiety the thing is it's obviously had a bad impact on my mental health but the biggest issue seems to be I've developed a fear of choking (always had this slightly) to the point where I'm getting distressed before I eat or take medication, I've resorted to soft foods and soups but am terrified this will get worse or is it that my fears are heightened until the new meds kick in? Any advice would be much appreciated I'm getting desperate and I feel gp is dismissing me 😪

Can anyone please help with this?

Hi @FreddyP, sorry you're struggling with this. How have you been getting on since your original post? You must be about 3 weeks in to taking the Sertraline now?

How are you coping with the anxiety around choking? Is there anything that has helped in the past with this?

@rainbowninja hi I've usually been able to manage it myself in the past or taken 4mg of diazepam to help if necessary but most of the time I was OK and didn't think about it but since starting the sertraline everything has heightened anxiety wise and I also think it's given me loss of appetite, I have spoken to others who this happened to but not through fear of choking, I'm not really helping myself as I'm dwelling on the eating issue, thanks for asking

Do you have any CBT or other techniques you’ve used in the past to help with anxiety?

Hi @FreddyP,

That's ok, sounds like a big change for you after having been on your previous medication for a long time so hopefully it's just a case of your body adjusting but I can see how the increased anxiety would be distressing in the meantime.

How are doing with food? Are you limited in what you can eat?

@Wolfiefan unfortunately although I've have had CBT years ago for agoraphobia and GAD I never felt much benefit from it at the time but I've self referred myself to give it another go I think if I could get past the fear of eating I would be able to move forward better

@rainbowninja I've avoided any solid food now for about 5 days I was eating porridge for breakfast and a banana but kept being aware of it going down and then felt it was stuck in my chest so I've now resorted to meal replacement shakes and soups as the thought of the food getting stuck terrifies me , I tried a couple of maize crisps last night that were practically melted before I swallowed then but was still convinced it was stuck and got very anxious 😪

It started with me thinking tablets were getting stuck in my throat and has spiralled from there the last couple of weeks

You must speak to your GP urgently. You can’t keep avoiding solid food. CBT can help but so can other strategies. You need urgent help with this. Good luck.

Oh bless you, that does sound awful, it's great that you've referred yourself for CBT. It's always worth another go. There's lots of self help resources on getselfhelp.co.uk as well in the meantime.

Is it worth speaking to your GP to say that anxiety has increased?

And slowly trying to reintroduce solids even if it's letting a crisp melt in your mouth sounds like a good way to go.

@Wolfiefan thank you I've spoken with him today but he's not very helpful I'm afraid he thinks it's increased anxiety due to the medication but if it continues for another week he will refer to ENT, I'm not really getting much help his answer last week was if you stop eating and drinking go to A&E

@rainbowninja thank you I'm not sleeping well ATM but I'm going to try best tomorrow to try little bits of maybe porridge or mashed potato just I feel so dreadful when I wake up I keep putting it off another day but I know deep down exposure is the key, thank you and @Wolfiefan for listening to me

@rainbowninja thank you I'm not sleeping well ATM but I'm going to try best tomorrow to try little bits of maybe porridge or mashed potato just I feel so dreadful when I wake up I keep putting it off another day but I know deep down exposure is the key, thank you and @Wolfiefan for listening to me

Can’t see ENT being the answer TBH. If it’s anxiety stopping you then that’s what he needs to address.
I don’t know if you need other medication to deal with the anxiety for now or to switch off the setraline.
Anxiety is shit! How about a well dunked biscuit or a homemade smoothie?

I have a fear of choking which is heightened when I am anxious. If anything like a tablet feels stuck in my throat I always eat banana or bread. You can get chewable or soluble versions of most common tablets though. It sounds like you have a really bad case of anxiety about this and I worry about you not having any solid food as this is not good for your digestion.

@Swirlywoo yes this is how it used to be with me but since changing medication ( I'm 3 weeks in today) this fear has got intense and I'm using avoidance to cope, I'm praying once they kick in it will settle and another side effect can be loss of appetite I'm just praying it all settles in the next week, awful isn't it fear of choking 😢

@Wolfiefan I agree I thought he would offer some kind of therapy to help but I don't think mental health is his forte my family doctor of 30 years has recently left the practice but was very patient and reassuring regarding mental health. You're right it's the pits it's hindered me all of my adult life and now because they decided I had to change my medication after 27 years I've been through hell for 4 months weaning off and starting these. Good idea about the smoothies thanks 😊

You poor thing. I have every sympathy. I last had a spell of it a while back with fruit eaten in the evening. I think I was too tired to think normally about it. Also I often wake up at night thinking I have choked due to a postnasal drip, and I have trained myself to know that I am not. I think changing the way I think about it has helped me a bit, so CBT might help, but I can guarantee that at the first sign of fresh anxiety it will return. I hope your new tablets start helping soon.

@Swirlywoo thank you so much!

@FreddyP it's no problem at all, I am a long time anxiety sufferer myself and I know how distressing this type of intrusive thought can be. I think GP's underestimate how unsettling medication changes can be as well so you have my sympathy.

Hope you're doing ok today.

@rainbowninja that's the bit I'm struggling with all the negativity surrounding eating and leaving the house, trying so hard to push myself made it to the shop today on my own and tried a small sausage with mashed potato and a jaffa cake today but was very anxious, thank you for your kind words it's much appreciated x

@FreddyP that sounds like progress? Well done for getting out and trying with the sausage and mash xx

I totally hear you. Agree with @Wolfiefan that this isn’t an ent issue, it’s almost certainly anxiety putting negative thoughts in to your head. I’m a great source of amusement apparently as I have to chew my disgusting tasting painkillers rather than swallow them whole (have done for years), but I have some medications where it’s 100% not allowed and it takes me AGES to swallow the damn things.

I’ve been trying to figure out where this has come from as I haven’t had any “near misses”, I haven’t actually choked or even witnessed anyone choking so I don’t know why my anxiety suddenly decided this would be a great thing to torture me with. With food, I try and apply logic. I remind myself that we are engineered to swallow food/liquid as that’s what’s needed to survive. The consequences of not doing so are worse than my imagined choking on it. Our bodies are perfectly engineered to swallow sensible food, they have to be. I remember confiding in my intensive nurse friend about it and she was (kindly, not mocking) fascinated and said it’s almost impossible and you couldn’t do it if you tried and incidents in adults are incredibly rare.

So, I think fwiw, we both need to re-wire our brains, and in your case as you’ve stopped eating because of it you need a little help with that, not ent but mh. Where you get that from with the way things are at the moment, I don’t know- hopefully someone else does.

@rainbowninja thank you and @Phoenix76 you have certainly amused me with your story, agreed its certainly a mh problem I've just got this bloody idea in my head which started with feeling of tablets being stuck in my throat and that I would suffocate somehow 🙄 my doctor isn't really interested in this problem I'm having but its good to know you can relate and I'm now making small progress peice of toast and a packet of crisps last night and a small portion of fish chips and curry this evening which took me about an hour to eat lol

@FreddyP what I have to do is remind myself we have 2 tubes. One is for breathing (our protected by madness tube 😂) and one is for swallowing things. When we swallow food, a protective flap lifts up and “protects” our air tube, it’s not something we can control it’s designed by nature (more powerful than us) specifically to stop us from choking. The food cannot (unless you & I become one of the VERY rare few) go into our breathing tube. The sensation we both feel of “getting caught, choking warning” is our anxiety seizing everything up so we can feel the bastard travelling down our food pipe (as it’s meant to, all normal) but of course anxiety is persuading us we’re choking (we’re not, we’re actually fine). If we were actually choking we would be in no doubt of the fact. Interestingly, I find the sensation 100;times worse if I’m hungry and according to my “research” that’s because we’re so bloody hungry our stomachs are producing extra acid which .... guess what.... makes it feel like we’re going to choke! I hate feeling like it, I watch people eat with gusto in envy but I’ve been working on it, by understanding how the body works, I have been able to gulp down a McDonald’s quarter pounder enjoying every mouthful and I’m still here to eat the next one because my body knows what to do even if my anxiety tells me it would be a death sentence.