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How does stress affect speech

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two women discussing anxiety and slurred speech

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According to the National Alliance on Mental Illness (NAMI), anxiety disorders affect roughly 19 percent of people in the United States. Anxiety disorders often cause a wide variety of chronic symptoms, such as fatigue, headaches, gastrointestinal issues, and more. For some people, anxiety can even affect the way they speak, leading to speech that is faster, slower, or possibly even slurred.

In this article, we’ll discuss whether anxiety can cause slurred speech, how anxiety can affect your speech, and how to get help if anxiety is negatively impacting your daily life.

Can anxiety make your speech slurred?

Dysarthria is a motor speech disorder, often caused by brain changes or damage, that occurs due to muscle weakness in the face, lips, tongue, throat, or around the lungs. When people develop slurred speech, such as after a stroke, it’s usually due to the development of dysarthria.

In some people, anxiety can lead to symptoms that mimic those found in motor speech disorders, such as slurred speech. However, slurred speech that’s caused by anxiety isn’t the same as slurred speech caused by dysarthria. In fact, it’s rare for anxiety to cause slurred speech at all.

“In speech therapy, I have seen short-term memory deficits and difficulty with concentration with anxiety, as well as accelerated rate of speech,” said Jennifer Daniels, MA, CCC-SLP, a speech language pathologist in Columbus, Ohio. “But not slurred speech, per se.”

So, in what ways could anxiety potentially lead to slurred speech? As it turns out, anxiety can have a negative impact on both the cognitive element of producing speech, as well as the physical act of speaking.

When you become anxious, increased tension in the muscles of the jaw or face can have an impact on your speech.

“Muscle tension can cause speech to sound different, as you are not able to manipulate sounds in the same way as normal,” explained Daniels. “Your pharynx and oral cavity have to move in certain ways for sounds to resonate properly.”

An increase in muscle tension may make it more difficult for the mouth and tongue to produce words in a clear, concise manner. In some cases, there’s the potential that speech may begin to sound “slurred” because of this.

Anxiety is also a common cause of racing thoughts and faster speech, both of which can make communication more difficult. People who are anxious may feel like they can’t keep up with their thoughts and may speak much faster as a result, which can cause stuttering or slurring.

Communication difficulties due to anxiety may become even more apparent among people with other underlying speech impairments, as well.

“Sometimes, when there are other underlying conditions that have impacted speech, anxiety can increase the severity of those symptoms,” explained Daniels. “For example, in post-stroke patients who become more anxious, the speech impairments that are present may become more severe.”

In some cases, certain underlying anxiety conditions may impact speech more than others, such as somatic OCD or social anxiety. These conditions can both cause a hyperawareness of speech, which in turn may lead to speech impairments, such as slurring.

In addition, panic attacks can sometimes cause a variety of concerning symptoms, many of which can feel more extreme than “standard” anxiety symptoms. Since panic attacks tend to come on more suddenly, changes to the speech that occur with anxiety, such as slurring, may become more severe during a panic attack.

But while anxiety may be a potential cause of slurred speech, it isn’t necessarily one that Daniels has seen much in practice. “Generally, most motor speech impairments, such as slurred speech and trouble articulating words, are secondary to neurological impairments, such as nerve damage and brain damage,” she clarified.

Can anxiety affect your speech in other ways?

While slurred speech may not be an extremely common symptom of anxiety, anxiety can still impact speech in other ways:

  • When you become anxious, your mouth may become dry and your voice may become shaky, both of which can make it hard to get words out.
  • You may experience decreased concentration, which can cause you to stumble over or forget words.
  • You may also notice that your speech becomes slower or that you stutter more often, both of which can be mistaken for “slurred” speech.

In one study from 2011, researchers evaluated the impact of anxiety on communicative performance in study participants. Twenty-four participants were asked to speak about an anxious moment in their lives, and their speech patterns were analyzed. According to the researchers, participants with high anxiety demonstrated changes in both voice control and articulation.

Ultimately, the way anxiety affects speech depends on the person. Since everyone experiences anxiety differently, some people may experience no changes in speech, while others may experience changes in the way they talk, sound, or communicate overall.

Tips for getting your speech back to normal

If you’re someone whose speech is greatly impacted by your anxiety, there are some practices that can help restore your typical speech pattern. Try these tips the next time you’re anxious and notice your speech becoming more difficult:

  • Take a deep breath. Although it can be difficult to calm down in a moment of anxiety, deep breathing has been shown to help slow down the sympathetic nervous system and reduce the anxious response. Before you start talking, try to take a few deep breaths to slow yourself down.
  • Slow down your speech. It can be hard to slow down the way you speak when your mind is racing with anxious thoughts, but intentionally slowing down your speech can be a great mindful exercise. When speaking, pronouncing your words clearly and concisely can also help slow down your speech.
  • Keep your sentences short. Sometimes anxiety can make it difficult to use your regular vocabulary, so it can help to keep your sentences short and to the point. If you’re having trouble recalling certain words or concepts, try not to panic — this is a completely normal symptom of anxiety.
  • Don’t force anxiety away. When you’re anxious, it can be tempting to want to fight the feeling and make it go away as quickly as possible. However, this can often make anxiety worse. One of the best things you can do when anxious is to allow the feeling to pass naturally as much as possible.

How is anxiety diagnosed?

Anxiety is a natural response to stress. For some people, anxiety can become chronic, excessive, and disruptive. If you’re struggling with anxiety that’s negatively impacting your daily life, schedule a visit with your doctor.

Many of the symptoms of anxiety can be caused by other health conditions, so your doctor will likely use diagnostic testing to help eliminate any other causes of your symptoms first. Once your doctor can rule out other health concerns, you’ll be referred to a mental health professional, such as a psychologist or psychiatrist, for an official diagnosis.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), you may have an anxiety disorder if you have:

  • excessive anxiety for at least 6 months, on most days
  • symptoms of restlessness, fatigue, trouble concentrating, irritability, muscle tension, and sleep disturbances for at least 6 months, on most days
  • difficulty controlling your worry or anxiety
  • anxiety that causes significant clinical distress or impairment in your everyday life
  • anxiety that isn’t caused by any other mental or physical illnesses

A mental health professional will diagnose you depending on the exact symptoms you’re experiencing. Some of the most commonly diagnosed anxiety-related conditions include:

  • generalized anxiety disorder (GAD)
  • obsessive-compulsive disorder (OCD)
  • specific phobias

How is anxiety treated?

Anxiety disorders are generally treated with a combination of psychotherapy, medication, and lifestyle changes.

Psychotherapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy that’s been shown to be effective at treating both depression and anxiety. CBT works by helping you change your thoughts, behaviors, and feelings towards anxiety. Psychotherapy, especially CBT, can be used in conjunction with medication to help treat anxiety disorders.

Medication

Medications for anxiety include long-acting medications, such as selective serotonin reuptake inhibitors (SSRIs), and short-acting medications, such as benzodiazepines. SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been shown to be most effective for anxiety and are commonly combined with therapy for treatment.

Lifestyle

In addition to psychotherapy and medication, lifestyle changes can help create positive habits and reduce stress in people with anxiety disorders. Exercise can help promote the release of feel-good hormones in the brain. Relaxation activities, like meditation or yoga, can also help reduce stress — mentally and physically.

Other causes for slurred speech

In addition to anxiety, slurred speech can also be caused by:

  • severe fatigue
  • migraine
  • neurological conditions, such as Parkinson’s disease
  • stroke or other brain injuries
  • certain medications, such as sedatives
  • excess alcohol consumption

Although anxiety can cause your speech to sound somewhat slurred, you should still pay close attention to other developing symptoms.

“If you are experiencing slurred speech that comes on suddenly or with other symptoms that can be consistent with a stroke,” said Daniels, “it’s very important to seek immediate help.”

Symptoms of stroke include:

  • paralysis
  • numbness or weakness in the arm, face, and leg, especially on one side of the body
  • trouble speaking or understanding speech
  • confusion
  • vision problems, such as trouble seeing in one or both eyes with vision blackened or blurred, or double vision
  • trouble walking
  • loss of balance or coordination
  • dizziness
  • severe, sudden headache with an unknown cause

Finding care for anxiety

If you’re concerned that your anxiety is negatively affecting your life, it may be time to seek professional help. Here are some tips for how to find a mental health specialist in your area:

  • Reach out to your doctor. Your primary care doctor can provide you with a referral for mental health professionals in your area.
  • Use the SAMHSA database. You can find other mental health professionals in your area through the Substance Abuse and Mental Health Services Administration (SAMHSA) database.
  • Consider doing online therapy. You can sign up for an online therapy service if you’d prefer to do therapy from the comfort of your own home.

What’s the outlook for people who have slurred speech from anxiety?

While slurred speech that is caused by anxiety is rare, it can happen. More often than not, this condition is neither permanent nor dangerous. In fact, as with most anxiety symptoms, these speech changes will resolve as soon as the anxiety dissipates.

However, if you’re someone who frequently experiences slurred speech when you’re anxious, you may benefit from professional help. With the right mental health treatment options, you can get your anxiety under control and reduce your symptoms in the long run.

If you have developed speech issues that don’t go away or get worse over time, make sure to schedule a visit with your doctor as soon as possible, as there may be another underlying condition impacting your speech.

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