Problems Swallowing: In My Throat or In My Head?

Reader’s Question

I am an 18-year-old male, and about a year ago I had what I believed to be food poisoning. I threw up early in the morning, skipped breakfast because I did not really feel like eating and went to school. That whole week, whenever I ate lunch at school, I felt sick to my stomach. I was on the way to getting over that until the Sunday we ate lunch at my grandmother’s, and all of a sudden I got a feeling in my throat like some rice was stuck in it, and I felt like I would throw up. That night I did not really eat much, and the following day at school I don’t think I ate much either. In the weeks that followed I found myself being unable to eat anything at school at all. This was because I initially thought that the food poisoning was caused by something I ate at school. I eventually removed that thought from my mind when I found out what causes food poisoning and how long it takes for you to throw up. But anyway, this continued for the remainder of the year. I eventually found myself almost shutting down when it came to eating. It was even hard for me to eat at home without feeling like throwing up.

2008 was probably the worst year of my life because these feelings got so bad that I would feel sick to my stomach when I was even walking up to school. The worst day, hands down, was when I had a group presentation. I was stressed out with this whole thing about not being able to eat and also had many projects due including this presentation. I woke up with the intention of eating breakfast, but because it felt as though I had to force myself to swallow, I didn’t. On the bus to school I felt trapped and sick to my stomach and was breathing heavily. It was creepy since nothing like that ever happened to me before. Anyway this whole being afraid to eat continued to the end of that semester, and I lost almost thirty pounds.

I really need help because I just can’t seem to get over this “fear” of eating away from home. I am starting university in a few weeks, and I don’t think I am going to be able to survive on snacks for 4 years. Any help will be greatly appreciated.

Psychologist’s Reply

Regardless of what might have prompted your first bout of nausea, and regardless of what genuine physical problems might be present, you appear to have some classic symptoms of anxiety. Anxiety can often be expressed in the form of “somatic” or body complaints, especially gastrointestinal problems. Anxiety problems also tend to escalate when the anxiety is not recognized for what it is or dealt with appropriately. Anxiety problems also rarely exist in a vacuum. Other “fears” and insecurities may be present, and sometimes there is what psychologists call a “secondary gain” of your anxiety symptoms. For example, if the real fear you have is of going off on your own and functioning independently, having these eating problems can serve as an all too convenient reason to avoid facing that fear and overcoming it.

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The really good news is that anxiety can be treated effectively and in relatively short order. Consult a physician and/or mental health professional to work with you on ridding yourself of your anxiety. Naturally, your therapist will want to be sure there are no significant medical complications to your problems, and a check-up from a gastroenterologist might be warranted. Such a visit might also help you calm your anxieties. But the biggest way to overcome the fears you’ve developed is to become familiar with the nature of anxiety and the distressing but certainly not dangerous symptoms anxiety can cause, and to learn effective strategies for overcoming the anxiety. In the end, you’ll be stronger, more confident, and much less stressed.

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