Why Do I Feel Nervous, Short of Breath, and Shaky When Speaking?

Non-Pathological Causes

Personality Traits: Some individuals may naturally be more introverted or have had limited social interaction throughout their lives. This can lead to feelings of fear or nervousness in social situations. As a result, they may experience physical symptoms like shortness of breath, trembling, or gasping when speaking. To help manage this, it is recommended to gradually increase social interactions and work on building confidence through consistent communication with others.

Pathological Causes

1. Anxiety Disorders

Social Anxiety and Its Effects: Anxiety disorders, particularly social anxiety, are often linked to genetic and psychological factors. When someone suffers from anxiety, imbalances in neurotransmitters can cause intense nervousness, especially in public speaking or social settings. This can lead to symptoms such as trembling, shortness of breath, and a feeling of being out of control while speaking. Treatment options include medications like paroxetine or sertraline under medical supervision. Additionally, engaging in relaxing activities like reading or listening to calming music can help reduce anxiety levels.

2. Neurological Fatigue

Impact of Chronic Stress: Prolonged mental strain or excessive psychological pressure can lead to a condition known as neurasthenia or neurological fatigue. This can disrupt normal nerve function, especially during speech, resulting in physical reactions like trembling, rapid breathing, or breathlessness. For those experiencing these symptoms, it is important to allow time for rest and recovery. Doctors may recommend supplements like methylcobalamin or vitamin B12 to support nerve health and improve symptoms.

3. Pulmonary Fibrosis

Respiratory Complications: Pulmonary fibrosis can be caused by long-term smoking or the use of certain medications such as cyclophosphamide or amiodarone. This condition damages lung tissue and impairs oxygen exchange. As a result, speaking—which requires regular breathing—can become difficult and lead to symptoms like shortness of breath, shaking, or feeling out of air. To manage this condition, doctors may prescribe medications like nintedanib or pirfenidone to slow disease progression and ease breathing difficulties.