Hypersalivation, Excessive Saliva, Drooling And Anxiety

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated September 1, 2021

hypersalivation excessive saliva anxiety symptoms

Hypersalivation, excessive saliva, Sialorrhea (excessive drooling), and squirting saliva can be symptoms of anxiety disorder, including anxiety and panic attacks, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder.

While anxiety is often associated with dry mouth (xerostomia), anxiety can also be a contributing factor for excessive saliva, drooling, and squirting.

This article explains the relationship between anxiety and hypersalivation.

Common Hypersalivation Symptom Descriptions:

This anxiety-related symptom is often described as:

  • You have much more saliva than normal.
  • Some people refer to this symptom as increased saliva and excessive saliva.
  • Some people also unintentionally squirt saliva out of their mouths when they open their mouths.
  • You have so much excess saliva that you have to spit to clear it.
  • You have so much excess saliva that you notice yourself drooling uncharacteristically.
  • Frequent swallowing due to excessive saliva.

Hypersalivation can come and go rarely, occur frequently, or persist 24/7 day after day. For example, you have excessive saliva once in a while and not often, have it off and on, or have it all the time and every day.

Hypersalivation can precede, accompany, or follow an escalation of other anxiety sensations and symptoms or occur by itself.

It can also precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" and for no apparent reason.

Excessive saliva can range in intensity from slight, to moderate, to severe. It can also come in waves where it’s strong one moment and seems to have eased off the next.

This symptom can change from day to day, moment to moment, or remain as a constant background to your struggle with anxiety disorder.

All of the above combinations and variations are common.

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.

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Causes:

Medical Advisory

We recommend all new, changing, persistent, and returning symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms, including excessive saliva, drooling, and squirting.

If you've done that and your doctor has attributed your symptoms solely to anxiety or stress, you can be confident there isn't a medical or medication cause.

If your excessive saliva has been attributed to anxiety, here are a few of the ways anxiety can contribute to this symptom:

1. The stress response

Anxious behavior activates the stress response, causing many body-wide changes that give the body an emergency “boost” of energy and resources when we believe we could be in danger.

This survival reaction is often referred to as the fight or flight response, the emergency response, the fight, flight, or freeze response (some people freeze when they are afraid like a “deer caught in headlights”), or the fight, flight, freeze, or faint response (since some people faint when they are afraid).[1][2]

Visit our “Stress Response” article for more information about the many changes caused by the stress response.

Some of these changes include:

  • Increases blood sugar so that we have an instant boost of energy.
  • Stimulates the nervous system.
  • Increases activity in the fear center of the brain (amygdala and others) and decreases activity in the rationalization areas of the brain (cortex and others). This change in brain function occurs to immediately react to danger rather than remain in danger as we figure things out.
  • Heightens most of the body’s senses.
  • Shunts blood to parts of the body more vital to survival, such as the brain, arms, legs, and vital organs, and away from parts of the body less vital for survival, such as the stomach, digestive system, and skin. Due to this shunting action, digestion is suppressed. However, the stomach increases the production of hydrochloric acid.
  • Salivary glands are suppressed, reducing saliva.[3]

The higher the degree of stress response, the more dramatic the changes.

Since stress responses push the body beyond its balance point, stress responses stress the body. As such, anxiety stresses the body.

While acute anxiety can cause dry mouth due to salivary gland suppression, chronic anxiety (hyperstimulation) can cause excessive saliva. Here’s how:

2. Hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly from the many stress response changes.

However, when stress responses occur too frequently, such as from overly apprehensive behavior, the body can’t complete recovery.

Incomplete recovery can leave the body in a state of semi-stress response readiness, which we call “stress-response hyperstimulation” since stress hormones are stimulants.

Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation.”[4][5]

Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.

Hyperstimulation (chronic stress) can cause chronic stress response changes, adversely affecting many body functions, such as digestion.

For instance, chronic stress can cause stomach and digestive problems, such as nausea and GERD. Stomach and digestive problems can increase saliva production, causing excessive saliva.

Hyperstimulation can also cause Homeostatic Dysregulation,[6] which can also cause periods of irregular saliva production.

Even though dry mouth (xerostomia) is a common symptom of anxiety (acute stress), hypersalivation is a common symptom of hyperstimulation (chronic stress).

As the degree of hypersalivation increases, so often does hypersalivation, sialorrhea (excessive drooling), squirting, and spitting.

When I (Jim Folk) was struggling with anxiety disorder, I experienced both dry mouth and excessive saliva symptoms at different times. Many of our members and therapy clients have, as well.

Excessive salivation is a common symptom of hyperstimulation.

Regarding involuntarily squirting saliva out of your mouth when you open it, sometimes the ducts that secrete saliva do so at a higher pressure than normal and can squirt saliva rather than just secret it.

This is a common phenomenon for many people regardless of if they have an anxiety disorder. Higher reflexes in these salivary ducts can cause squirting (these more reactive ducts are often referred to as “squirters”).

While excessive saliva can be annoying and sometimes embarrassing, it isn’t harmful.

3. Behavior

Anxiety, especially chronic anxiety, often causes a dramatic increase in nervous energy. Heightened nervous energy can cause some anxious people to clench their jaws or chew gum. Both clenching and chewing gum can create excess saliva.

Furthermore, the control of saliva production can be influenced by the health of the mouth (ulcers, dental problems, tonsillitis, etc.) and the objects that are in the mouth (food, drink, candies, other objects).

The brain also has a major influence on our salivary glands (smells, cravings, thoughts of food, thoughts in general). For example, even just the thought of eating a delicious meal can get our mouths watering (increased production of saliva).

As such, focusing on mouth and salivation problems can create excessive salivation.

4. Other Factors

Other factors can cause anxiety-like symptoms, aggravate existing anxiety symptoms, and contribute to hyperstimulation and its symptoms, including:

Medication

Side effects of prescription and over-the-counter (OTC) medications can mimic, cause, and aggravate anxiety symptoms.

Talk with your doctor and pharmacist if you are unsure if your medication is playing a role in your symptoms, including hypersalivation.

Visit our Medication article for more information.

Recreational Drugs

Many recreational drugs can cause and aggravate anxiety symptoms.

Many recreational drugs can also profoundly affect the nervous system, which can aggravate existing anxiety symptoms since anxiety also affects the nervous system.

Visit our Recreational Drugs article for more information.

Stimulants

Stimulants bring about their stimulating effect by causing the secretion of stress hormones and other chemicals into the bloodstream, stimulating the body.

Increasing the body’s stimulation can cause and aggravate existing anxiety symptoms.

Visit our Stimulants article for more information.

Sleep Deprivation

Going without adequate sleep can affect the body in many ways, such as:

  • Prevents the body from sufficiently refreshing itself
  • Stresses the nervous system
  • Impairs brain function
  • Increases blood pressure
  • Increases blood sugar
  • Increases moodiness
  • Increases cortisol secretion to compensate for feeling tired (cortisol is a powerful stress hormone)

These effects can cause and aggravate anxiety symptoms.

Visit our Sleep Deprivation article for more information.

Fatigue

Fatigue can cause many anxiety-like symptoms and aggravate existing anxiety symptoms, such as difficulty thinking, foggy head, lightheadedness, dizziness, unsteadiness, pain, heart palpitations, trembling, memory loss, muscle weakness, and shortness of breath, to name a few.

Visit our Fatigue article for more information

Hyper and Hypoventilation

Over breathing (hyperventilation) and under breathing (hypoventilation) can also cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Hyper And Hypoventilation article for more information.

Low Blood Sugar

Even if blood sugar is low within the normal range, it can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Low Blood Sugar article for more information.

Nutritional Deficiency

Nutritional deficiencies, such as low vitamin B and D, to name two, can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Nutritional Deficiencies article for more information.

Dehydration

Dehydration can also cause anxiety-like symptoms and aggravate existing anxiety symptoms, such as concentration problems, lightheadedness, dizziness, fatigue, headache, involuntary panic attacks, muscle twitching, and heart palpitations.

Visit our Dehydration article for more information.

Hormone Changes

Hormones affect the body in many ways and can affect each other. A change in hormones can cause many anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Hormone Changes article for more information.

Pain

Pain stresses the body. As such, pain, especially chronic pain, can stress the body sufficiently to cause hyperstimulation and aggravate pre-existing hyperstimulation.

If you are anxious, hyperstimulated, and symptomatic, pain, especially chronic pain, can aggravate all of them.

Visit our Pain article for more information.

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Treatment:

When anxiety symptoms are caused or aggravated by other factors, addressing those factors can reduce and eliminate them, including excessive saliva.

When this symptom is caused by hyperstimulation (chronic stress), we need to eliminate hyperstimulation before this symptom subsides.

Faithfully practicing the physiological recovery strategies we explain in Chapter 4, addressing the underlying factors of your anxiety so that your body CAN recover (continuing to trigger stress responses because of unidentified and unresolved underlying factors can prevent recovery), and giving your body ample time to recover will allow it to calm down and stabilize over time.

As the body recovers from hyperstimulation, it stops exhibiting involuntary stress-caused symptoms, including this symptom.

Eventually, symptoms of chronic stress completely disappear as the body regains its normal, non-hyperstimulated health.

However, eliminating hyperstimulation can take much longer than most people think. It’s common for symptoms of hyperstimulation to linger as long as the body is hyperstimulated.

But as with all symptoms of hyperstimulation, this symptom will subside when the body’s stress is returned to a normal level and the body has sufficient time to recover and stabilize.

Because this symptom is just a symptom of chronic stress (hyperstimulation), it’s harmless and needn’t be a cause for concern.

Lingering stress-caused sensations and symptoms are simply an indication that:

  1. You continue to trigger stress responses (from stressful circumstances or from anxious behavior motivated by unidentified and unresolved underlying factors).
  2. The body’s stress level hasn’t been sufficiently reduced.
  3. The body hasn’t completed its recovery work.

Lingering anxiety symptoms ONLY remain because of the above reasons. They AREN’T an indication of a more serious medical problem.

Anxiety symptoms will subside when hyperstimulation has been eliminated and the body has had sufficient time to recover and stabilize.

Since worrying, fretting, and becoming emotionally upset about stress-caused sensations and symptoms stress the body, these behaviors aren’t helpful to recovery and symptom elimination.

Passively accepting your symptoms in the short-term — allowing them to persist without reacting to, resisting, worrying about, or fighting them — while faithfully practicing your recovery strategies will bring about their cessation in time. Acceptance, practice, and patience are key to recovery.

Keep in mind that it can take a long time for the body to recover from hyperstimulation's adverse effects. Despite the lack of apparent progress, we have to persevere with our recovery efforts and remain patient as the body recovers.

We also have to do our recovery work FIRST before the body can recover. It’s the cumulative effects of our recovery work that produces results down the road. And, the body’s stimulation has to diminish FIRST before symptoms can subside.

Nevertheless, faithfully practicing your recovery strategies, passively accepting your symptoms, containing your anxious behavior, and being patient will bring results.

When we do the right work, the body has no choice but to recover.

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Therapy

Unidentified and unaddressed underlying factors that cause issues with anxiety and stress are the number one reason why anxiety disorder and its symptoms persist.

Dealing with your anxiety issues (Level Two recovery) is the most important work overall if you desire lasting success.

If you have difficulty containing, becoming unafraid of your symptoms, eliminating your symptoms, overcoming your anxiety issues, or have what seems like out-of-control worry, consider connecting with one of our recommended anxiety disorder therapists.

All of our recommended therapists have personally experienced anxiety disorder and have overcome it. Their personal experience with anxiety disorder combined with their Master's Degree and above professional training makes them a good choice for achieving lasting success over anxiety disorder, its symptoms, and worry.

Working with an experienced anxiety disorder therapist is the best way to attain Level Two recovery success. In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.[7][8][9]

FAQ

Can excessive saliva cause anxiety?

Anxiety is caused by apprehensive behavior. Therefore, excessive saliva doesn’t cause anxiety.

However, if you are worried about having excessive saliva, that worry can cause anxiety since worry is an example of apprehensive behavior.

How can I stop worrying about drooling in public?

You can eliminate excessive saliva that creates drooling by eliminating hyperstimulation.

You can eliminate issues with worry by working with an experienced anxiety disorder therapist.

Are there any fast ways of eliminating excessive saliva?

If your excessive saliva is caused by clenching your teeth, sucking on candy, or chewing gum, you can stop excessive saliva by stopping these activities.

If your excessive saliva is caused by hyperstimulation, no, there isn’t a fast way to eliminate hyperstimulation or its symptoms, such as excessive saliva.

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Prevalence

How common is this symptom? In an online poll we conducted, 53 percent of respondents said they experienced hypersalivation because of their struggle with anxiety.

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The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including hypersalivation, excessive saliva, drooling, spitting, and squirting anxiety symptoms.

References

  1. Berczi, Istvan. “Walter Cannon's ‘Fight or Flight Response’ - ‘Acute Stress Response.’” Walter Cannon's "Fight or Flight Response" - "Acute Stress Response", 2017.

  2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.

  3. Gholami, Neda, et al. "Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia." Journal of Dental Research, Dental Clinics, and Dental Prospects, 13 Dec 2017.

  4. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018.

  5. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

  6. Marks, David. "Dyshomeostasis, obesity, addiction and chronic stress." Health Psychology Open, Jan 2016.

  7. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.

  8. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

  9. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.