The Effect That Anxiety Can Have On The Voice
Author: Anna Pasternak, Reg. CASLPO, Speech-Language Pathologist
Date: Wednesday, July 30, 2025
Table of Contents
When we feel anxious, the anxiety has an effect on our body causing physiological changes that can make us tense. This can impact the voice as some of this tension can also be carried around the chest and neck area. Often I have clients telling me they feel like they have a lump in their throat or they are out of breath when speaking, and this is most often the cause of tension due to anxiety. But the good news is these voice symptoms that appear can be managed with the proper tools and techniques.
The anxiety loop
We call this a loop because the mind and body are closely connected. When we feel anxious we may tense our muscles, breathe more shallowly, and our heart rate increases. All these changes our body is experiencing can directly have an effect on our voice. With added tension and poor breath control we lose our tools to be able to control how our voice sounds. The breath is the fundamental aspect for your voice, and once that is gone our voice may not sound like we would like it to.
Once our voice is affected we might sound like we are quivering when we are speaking, or like we are trying to speak through a lump in our throat. When our voice doesn’t come out like we would like, this can cause more anxiety to develop. So either it is that we are anxious and this affects our voice, and once our voice is affected this can make us even more anxious. It can become an endless cycle of feeling anxious unless something is done to help reduce it. Various strategies will be discussed later on.
Impact anxiety has on voice and why
The breath is one of the most affected things when we are anxious. We begin to breathe shallow and do not take proper breaths. Often we may try to speak on one breath for too long, making us feel like we are running out of air and causing the speech rate to increase so we can finish saying what we want on the one breath. When anxious some people may also breath-hold, and with no air being released this will have a negative impact on how the voice will be delivered.
When anxious, tension can be created in the laryngeal area, jaw, chest, neck and shoulders, which may have an impact on how the voice is used and perceived. This added tension can make the voice sound more strained or hoarse. Sometimes it may be described as a lump in the throat, and this is due to the larynx raising up when we are stressed and the surrounding muscles tightening, which will give us poor control over our voice and result in the voice sounding like there is a tightness or cracking in the voice. Increased tension equals poor control.
Vocal fatigue may set in as well, as there is consistent tension and no ease of the voice being used. Vocal fatigue can often be a result of talking for longer periods of time. But with increased tension and strain, vocal fatigue can result after even short periods of talking. Vocal fatigue is often described as a feeling of having a weak or strained feeling voice, and speaking feels difficult and heavy.
The voice can also become shaky. This is a result of the breath not coordinating well with the voice. As the breath may be shallow or uneven, this creates poor control for the voice. Sometimes improper breathing and tightness over time can also lead to the voice being lost due to improper use and misuse of the voice over time.
The voice may become inconsistent sounding, sometimes clients feel like it is ok, and the next moment feel strained. Anxiety can also lead to dysfluencies or stuttering where people might feel like they can’t get words out or they repeat the first sounds of words. This can be due to poor breath control and the tension caused by anxiety.
And of course, the feeling of having a lump in the throat can be due to the larynx elevating. This creates a tightness feeling in the throat, and the vocal folds feel constricted. With this, sometimes people find it very hard to get the voice out, or if they do it feels very strained.
When anxious, the mouth can also become dry, due to saliva production decreasing. This can cause us to not articulate words smoothly, and the voice may sound hoarse.
Pitch also may change when we are anxious. As our vocal folds constrict, this can have an impact on our pitch and result in sounding higher than usual. With poor breath as well, pitch may become difficult to control.
When we are anxious, it can also affect our cognitive processing. We may draw blanks more often, or can’t find our words. It may become difficult to retrieve our words and speak more fluently, causing us to use more filler words such as ‘umm,’ ‘uhh,’ and ‘like.’ This can result in our speech and words sounding uncertain or like we are unfamiliar with the topic. It may also become difficult to organize our thoughts clearly, causing others to have difficulty understanding our point and having to try to consistently rehearse what we are saying.
In summary, when we are anxious our voice gets affected by improper breathing for speech, laryngeal elevation, muscle tension, and cognitive processing. This may cause our voice to be strained, fatigued, hoarse, shaky, inconsistent, have pitch changes, or have the feeling of something stuck in our throat. It can also cause dry mouth and speech disruptions. There are some strategies that can help with this.
Strategies to ease anxiety and impact on voice
Breathing exercises
Working on breathing is one of the most important areas to target when wanting to ease the impact that anxiety has on the voice. The breath not only affects how the voice is produced, but deep breathing can also calm the mind, hopefully resulting in us feeling less anxious. When anxious we tend to breathe more from the chest and the breath therefore is shallow. Deep diaphragmatic breathing should be practiced to ease anxiety and ensure proper support for voice use. Doing this when feeling anxious is a first step to try to calm our nerves. Slow controlled inhales and exhales and being in the moment can help ease the chaos that is going on in our head at the time. If this is a persistent problem, receiving proper training to learn how to breathe when speaking from a speech-language pathologist can also be extremely beneficial. A speech-language pathologist can identify whether you are breathing correctly, and if not, how to change it through demonstrations, feedback, and various exercises.
Muscle tension release
Doing various stretches for the neck and shoulders can help ease the tension that may be impacting the voice. Stretching these areas can help the muscles relax and let go of the tension that is being held.
Vocal warm-ups and cool-downs
It is important to warm up the voice before speaking, just like when we exercise and go to the gym. Those initial stretches will prevent the voice from feeling shocked if suddenly having to be used for a longer period and will help reduce tension and prevent strain. Stretching the voice after longer periods of talking or when feeling strained will also prevent the voice from getting worse over time. Some stretches include humming, pitch glides, blowing bubbles, and lip and tongue trills.
Vocal hygiene
It is important to follow good vocal hygiene habits to ensure optimal voice, especially if the voice is being misused due to created tension. Make sure to drink plenty of water and reduce caffeine and alcohol as these can have a dehydrating effect. Remember not to whisper, throat clear, or yell when not needed. Using a signal like a whistle, a microphone when having to speak louder in bigger rooms, and taking vocal breaks are all things we can do to avoid the effects this might have on our voice.
Stress reduction
Finding ways to relax yourself — whether it be meditation, yoga, or anything that helps ground you and allow you to be in the moment — is important. Also allowing ourselves to limit negative self-talk that may be popping into our heads is important to try to limit stress. Try reading out some daily positive affirmations instead to help support positive thinking, such as “I can speak clearly and calmly.”
Support
Finding a therapist that may support you if you are experiencing anxiety can be very beneficial. A speech-language pathologist can help by teaching appropriate breathing and voice exercises, as well as working on reducing tension. A psychotherapist or psychologist can work more deeply with the psychological portion to help identify and reduce anxiety. Working with either one or sometimes both simultaneously can be very beneficial to work on the problem as a whole.
In all, the mind and voice are deeply connected. When your mental state is off, your voice may reflect that. If you feel like anxiety is interfering with your ability to speak confidently or perform vocally, you're not alone.
With the right techniques, strategies, and support — you can regain control and use your voice with clarity and confidence.
To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.
