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How Anxiety Can Cause Dry Mouth

How Anxiety Can Cause Dry Mouth Image

When we get anxious, stressed, or frightened, it’s normal for our mouths to feel dry. 

The link between dry mouth and anxiety is why your throat always seems to dry up when you speak in front of lots of people or chat to an intimidating boss. 

Anxiety disorders can also cause dry mouth – unlike day-to-day nervousness, anxiety can produce persistent feelings of dry mouth, which can impact everyday activities like eating and speaking, making your anxiety even worse.

Keep reading to find out exactly what clinical anxiety and dry mouth are, as well as the relationship between anxiety and dry mouth, and what you can do to treat it.

 

What is anxiety?


Anxiety is clinically defined as “feelings of worry strong to interfere with daily activities” [1].  It’s normally classed as a disorder when these feelings persist over a period of time, rather than occurring occasionally in response to stressful situations [2].     

Anxiety disorders are the most common mental health condition in Australia, affecting 14.4% of the population, with depression and substance abuse disorders coming in at 6.2% and 5.1% respectively.  Common anxiety disorders include social phobia, generalised anxiety disorder, panic disorder, and PTSD [3].    

There isn’t a single clear cause of anxiety disorders.  Although they’re technically classed as genetic diseases, with a heritability of 30–67%, environmental circumstances also contribute to their creation [3].  These can include [4]:

·  Physical or emotional abuse or neglect

·  Sexual violence

· Chronic illness

· Traumatic injuries

· Deaths of significant others

· Separation and divorce

· Financial difficulties

Symptoms of Anxiety

So how does anxiety normally present itself in day-to-day life? 

While individual experiences of anxiety vary, people with generalised anxiety disorder, which is one of the most common anxiety disorders, may be affected by symptoms like [5]:

· Feeling nervous, anxious or on edge

· Not being able to stop or control your worry

· Worrying a lot about different things

· Difficulty relaxing

· Being restless

· Becoming easily irritated or annoyed

· Feeling a sense of impending doom, as though something bad is going to happen

Panic disorder is another common anxiety disorder.  People with panic disorder may experience panic attacks, which are classified as “the rapid onset of intense fear (typically peaking within about 10 minutes)” [5].

Panic attacks can cause [5, 6]:

· Heart palpitations

· Dry mouth

· Sweating

· Trembling or shaking

· Feelings of being smothered or being unable to breath

· Feelings of choking

· Chest pain or discomfort

· Nausea

· Feeling dizzy, light-headed, or faint

· Chills or heat sensations

· Numbness or tingling

· Feelings of unreality or being detached from your body

· Fear of losing control

 

What is dry mouth?

Dry mouth occurs when your salivary glands don’t produce enough fluid to keep the inside of your mouth moist.

Saliva is essential for everyday tasks like speaking, eating, and swallowing, so many people with dry mouth experience reduced quality of life.  If not managed properly, dry mouth can also lead to a variety of different oral health conditions, like bad breath, gum disease, and tooth decay [7].    

 

How does anxiety cause dry mouth?

To understand how anxiety causes dry mouth, we first need to break down dry mouth into two categories [8]:

· The physical reduction of salivary flow rates, known as ‘hyposalivation’

· The subjective feeling of having a dry mouth, known as ‘xerostomia’

Not every person with hyposalivation actually feels as though their mouth is dry, and not every person with xerostomia necessarily has a reduced salivary flow rate.

A 2017 study found that there was a correlation between depression, anxiety and stress, and hyposalivation and xerostomia [6].

· 50% of survey participants with both hyposalivation and xerostomia had severe and very severe stress scores

· 30% of survey participants with just hyposalivation had severe and very severe stress scores

· 61.1% of survey participants with just xerostomia had severe and very severe stress scores

· 4.4% of the control group (who had neither xerostomia or hyposalivation) had severe and very severe stress scores

An earlier study from 2000 produced similar results, indicating that depression, stress and anxiety can all have detrimental effects on both salivary flow and the feeling of having a dry mouth [9].

A 2016 study also found a correlation between depression, anxiety, bipolar disorder and schizophrenia, and xerostomia.  Fifty-one percent of surveyed anxiety patients were found to have moderate or severe xerostomia, compared to mild xerostomia in 27% of healthy participants [10]. 

Anxiety causes hyposalivation through complex interactions between the salivary nuclei in your brainstem and your salivary glands [11].  Your salivary gland cells are also associated with your parasympathetic and sympathetic nerves, which help you relax and initiate your fight/flight response respectively [11].  Anxiety can cause responses in both nervous systems, affecting your saliva [11]. 

If that was a bit confusing, don’t worry – the bottom line is that anxiety can cause dry mouth.

 

Dry Mouth and Antidepressants

Anxiety can also cause dry mouth indirectly through the use of antidepressant drugs.

One study concluded that 96% of the 23 surveyed antidepressants caused xerostomia, with dry mouth being a ‘very common’ side effect for 18 of the 23 drugs [12].

A 2014 study yielded similar results, finding that 46% of participants using antidepressants had xerostomia, with 66.6–80% having a reduced salivary flow [13].    

Many antidepressants are anticholinergics, which means they block acetylcholine, a chemical messenger from your brain to other parts of your body.  While this effect helps antidepressants treat anxiety, it can also have the unintentional effect of blocking acetylcholine delivery to receptors that control salivary flow and viscosity [14].  

Consequently, you may find that taking certain antidepressants makes your mouth produce less saliva or saliva that is thicker and stickier [14].     

 

How to Treat Anxiety-Induced Dry Mouth

The easiest way to treat anxiety-induced dry mouth is to address the cause: your anxiety disorder. 

There are a number of anxiety management techniques you can try at home, but, if you’re concerned about your anxiety, you should consult a mental health professional.  You can go directly to a psychiatrist or psychologist for treatment, or visit a GP for a referral.  Getting an assessment from a GP means your treatment may be covered by Medicare

If you’re already managing your anxiety, you can try natural dry mouth remedies.  Our favourite treatments include eliminating certain foods and drinks, improving your oral care, and drinking more water.

Unfortunately, these techniques aren’t always effective for managing severe or chronic dry mouth.  If your dry mouth is making life uncomfortable, dry mouth sprays can be an easy, affordable treatment option.

One of Australia’s best dry mouth sprays is Osmist, an Australian-made spray with active natural ingredients like grapeseed oil, papaya enzymes, and peppermint oil.  It’s easy to use, too – just spray two quick pumps directly into your mouth, and enjoy up to three hours of relief from dry mouth.

Packaged in a convenient 50-millilitre bottle, Osmist sprays can be stored in your handbag or pocket for easy, discreet access.  It’s the perfect way to help manage your dry mouth, especially if you’re taking antidepressant medication.

Conclusion

Dry mouth and anxiety are two health conditions that often go hand-in-hand.  For some people, dry mouth is caused by the anxiety itself, while, for other people, dry mouth is actually caused by the medication they’re using to treat their anxiety.

In both cases, dry mouth can be a debilitating condition that can seriously impact quality of life, and may not necessarily be manageable using normal dry mouth treatments.  If you’re suffering from dry mouth and anxiety, try:

· Treating your anxiety

· Managing your dry mouth with natural remedies

· Using Osmist Dry Mouth Spray to manage your dry mouth

 

If you have anxiety, depression, or another mental health condition, or experience suicidal thoughts, you can contact beyondblue on 1300 22 4636, or Lifeline on 13 11 14.

Medical information on Osmist.com.au is merely information and is not the advice of a medical practitioner. This information is general advice and was accurate at the time of publication. For more information about oral care and your individual needs, seek the advice of a qualified medical professional.

 

References

[1] Schuyler, D. (2016) Anxiety. The Primary Care Companion for CNS Disorders. 18(5). DOI: 10.4088/PCC.16f02039

[2] Dean, E. (2016) Anxiety. Nursing Standard. 30(46), 15–15. DOI: 10.7748/ns.30.46.15.s17 

[3] Ströhle, A., Genischen, J. & Domschke, K. (2018) The Diagnosis and Treatment of Anxiety Disorders. Deutsches Ärzteblatt International. 115(37), 611–620. DOI: 10.3238/arztebl.2018.0611

[4] Klauke, B., Deckert, J., Reif, A., Pauli, P. & Domschke, K. (2010) Life events in panic disorder-an update on “candidate stressors.” Depression and Anxiety. 27, 716–730. DOI: 10.1002/da.20667 

[5] Locke, A. B., Kirst, N. & Schultz, C. G. (2015) Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician. 91(9), 617–624.

[6] Gholami, N., Sabzvari, B. H., Razzaghi, A. & Salah, S. (2017) Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia. Journal of Dental Research, Dental Clinics, Dental Prospects. 11(4), 247–252. DOI: 10.15171/joddd.2017.043

[7] Han, P., Suarez-Durall, P. & Mulligan, R. (2015) Dry mouth: A critical topic for older adult patients. Journal of Prosthodontic Research. 59(1), 6–19. DOI: 10.1016/j.jpor.2014.11.001 

[8] Borahan, M. O., Pekiner, F. N. & Atalay, T. (2012) Evaluation of Effects of The Psychological Factors on Saliva. Journal of Marmara University Institute of Health Sciences. 2(1), S8–S14.

[9] Bergdahl, M. & Bergdahl, J. (2000) Low Unstimulated Salivary Flow and Subjective Oral Dryness: Association with Medication, Anxiety, Depression, and Stress. Journal of Dental Research. 79(9), 1652–1658. DOI: 10.1177/00220345000790090301 

[10] Veerabhadrappa, S. K., Chandrappa, P. R., Patil, S., Roodmal, S. Y., Kumarswamy, A. & Chappi, M. K. (2016) Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study. Journal of Clinical and Diagnostic Research. 10(9), ZC24–ZC27. DOI: 10.7860/JCDR/2016/19020.8437

[11] Proctor, G. B. (2015) The physiology of salivary secretion. Periodontology 2000, 70(1), 11–25. DOI: 10.1111/prd.12116 

[12] Cockburn, N., Pradhan, A., Taing, M. W., Kisely, S. & Ford, P. J. (2017) Oral health impacts of medications used to treat mental illness. Journal of Affective Disorders. 223, 184–193. DOI: 10.1016/j.jad.2017.07.037 

[13] Kumar, N. N., Panchaksharappa, M. G. & Annigeri, R. G. (2014) Modified schirmer test–A screening tool for xerostomia among subjects on antidepressants. Archives of Oral Biology. 59(8), 829–834. DOI: 10.1016/j.archoralbio.2014.05.008 

[14] De Almeida, P. D. V., Grégio, A. M. T., Brancher, J. A., Ignácio, S. A., Machado, M. Â. N., de Lima, A. A. S. & Azevedo, L. R. (2008) Effects of antidepressants and benzodiazepines on stimulated salivary flow rate and biochemistry composition of the saliva. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 106(1), 58–65. DOI: 10.1016/j.tripleo.2007.11.008 

 

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