The Great Encyclopedia of Psychological Dysphagia discusses dysphagia, a swallowing disorder that affects anyone, causing discomfort from mild to severe. Dysphagia is categorized into two types: oropharyngeal dysphagia (affecting the mouth and throat) and esophageal dysphagia (affecting the esophagus). Though usually tied to physical causes like stroke or neurological diseases, psychological dysphagia, or psychogenic dysphagia, is often overlooked.
Psychological dysphagia involves trouble swallowing with no physical issues. It’s classified as functional dysphagia, where there are no structural problems, but symptoms persist due to other kinds of mental health issues like anxiety, depression, or phobias.
Anxiety disorders, similar to generalized anxiety disorder (GAD) or panic disorder, are common psychological causes of dysphagia. People with these conditions may be highly aware of their bodily sensations, leading to difficulty swallowing, such as the sensation of a lump in the throat (globus pharyngeus). For example, someone with a panic attack while eating may develop a fear of swallowing, worrying it could happen again.
Depression can also slow down mental and physical processes, including swallowing, making it feel difficult and reducing appetite, further worsening depressive symptoms.
Phagophobia, the fear of swallowing, is often linked to traumatic experiences like choking. Individuals with this phobia may avoid solid foods, opting for liquids due to the anxiety surrounding swallowing, which can lead to malnutrition and weight loss.
Another manifestation is conversion disorder, where emotional stress is converted into physical symptoms. In psychological dysphagia, the mind transforms emotional distress into swallowing difficulties despite no physical cause.
Lastly, health anxiety (hypochondriasis) involves worrying excessively about health, leading individuals to misinterpret normal sensations, like those in the throat, as signs of a serious condition.
Diagnosing psychological dysphagia requires ruling out physical causes through tests like barium swallow and endoscopy. Once physical causes are excluded, psychological assessments help uncover underlying mental health issues.
Treatment includes cognitive behavioral therapy (CBT), exposure therapy, relaxation techniques, and sometimes medication. CBT helps patients rethink their beliefs about swallowing, while exposure therapy introduces different food textures gradually to reduce anxiety.
Relaxation techniques such as deep breathing or mindfulness also help ease swallowing anxiety. In some cases, medications such as antidepressants or anxiolytics may be prescribed if necessary. Consult with your doctor.
Working with a speech and language pathologist can be helpful for individuals with psychological dysphagia, especially if there are concerns about swallowing mechanics. Therapy may focus on:
– Swallowing Exercises: Exercises designed to strengthen the muscles responsible for swallowing and enhance coordination.
– Building Confidence: Helping the individual develop confidence in their ability to swallow, particularly in social situations where anxiety may be heightened.
Psychological dysphagia is challenging, but with proper treatment and support, individuals can regain confidence in their ability to swallow.
References:
- American Psychological Association (for mental health and psychological dysphagia)
- National Institute of Neurological Disorders and Stroke (for general dysphagia knowledge)
- The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (for phobias and anxiety disorders)