Speech Anxiety and Shortness of Breath: Understanding the Causes and Solutions

Feeling nervous, shaky, short of breath, or out of air as soon as you start speaking can be attributed to both non-pathological and pathological factors. This condition may be linked to personality traits, anxiety disorders, neurasthenia, or even pulmonary fibrosis. If you frequently experience these symptoms, it is highly recommended to visit an internal medicine specialist at a hospital for proper diagnosis and treatment.

Non-Pathological Causes

Some individuals may experience these symptoms due to an introverted personality or lack of social interaction. Those who are naturally shy or have limited exposure to social environments may feel anxious or fearful when speaking in front of others. This can lead to physical reactions such as trembling, shortness of breath, and a sense of panic. In such cases, gradually increasing social interaction and practicing communication skills can help ease these symptoms over time.

Pathological Causes

1. Anxiety Disorders

Anxiety disorders, especially social anxiety disorder, are commonly associated with this issue. These conditions can be influenced by genetic factors or psychological stress. When anxiety is present, the body may release abnormal levels of neurotransmitters, triggering feelings of panic and physical symptoms like shaking and shortness of breath when speaking. Doctors may recommend medications such as paroxetine or sertraline to help manage the condition. Additionally, engaging in relaxing activities like reading or listening to music can help reduce anxiety levels.

2. Neurasthenia

Neurasthenia, or nervous exhaustion, often results from long-term stress or emotional strain. This condition can affect the nervous system's ability to regulate bodily functions, causing symptoms like trembling and breathlessness during speech. Patients are advised to take adequate rest and consider taking nerve-nourishing supplements like methylcobalamin or vitamin B12 under a doctor's supervision.

3. Pulmonary Fibrosis

Pulmonary fibrosis is a serious lung condition that can be caused by long-term smoking or the use of certain medications such as cyclophosphamide or amiodarone. As the lung tissue becomes scarred and less flexible, oxygen exchange is impaired, making it difficult to breathe normally—especially during speech. This often leads to rapid breathing, trembling, and a feeling of breathlessness. Treatment options may include medications like nintedanib or pirfenidone, which are designed to slow disease progression and alleviate symptoms.