Dear Alice,

Under times of heavy stress, high anxiety situations, and physically strenuous activity (especially running), I tend to gag and dry heave. When I am at rest, this never happens. I even gagged in class at my last mid-term because I was nervous about the test. This did not start until I was 18 years old and when I joined the military. I am 27 now.

I no longer wish to be this way. The military doctors said that I just have a sensitive gag reflex. Well, this is not normal; it's too sensitive. I would like to be a normal person and not gag in public when I get nervous or have to speak in front of large crowds. Do you have any idea what is wrong with me? My wife says that I need to have my tonsils taken out, but she is not a doctor. Gagging during sex is a big mood killer for her also, but the high excitement and physical activity just tightens my throat and I get choked out. Please help. What do I need to do?

Dear Reader,

Experiencing stress can be challenging at any time, but adding the feeling of having to gag can only make your discomfort that much worse. As people age, their bodies change, which might be explain why you are gagging and dry heaving now under stressful situations and when engaging in strenuous physical activity. Either way, it does seem that your quality of life would most likely improve if you could get to the bottom of this issue. 

Gagging and dry heaving can manifest itself for many reasons, including:

  • Panic attacks brought on by stressful situations, such as tests and public speaking.
  • Unpleasant odors, like sulfur from rotten eggs.
  • Intense physical activity, such as sex and exercise.
  • Sensitivity to certain foods and liquids to which you might be allergic.

Given that you have discussed this issue with military doctors, the problem is most likely not your tonsils, as your wife suggests or any other physical problem. From the description you have given concerning conditions under which the gagging presents, it seems as if stress could be the culprit. It is common for people to develop sensitivity to stress when they are in their late teens and reach a new level of independence. 

Stress can be both good (eustress) and bad (distress). For example, you could have the same reaction while in the throes of passion with your wife as you would while speaking in front of five hundred people at work. The key is not what you are doing, but whether or not the activity creates stress thus introducing endorphins into the equation. Both good and bad stress causes the release of endorphins into your bloodstream giving you the edge to confront an uncomfortable situation or the ability to fully enjoy a most pleasant one. 

It might be best to consult a mental health professional to discuss your situation. If you are a Columbia student on the Morningside campus, you can schedule an appointment with a therapist from Counseling and Psychological Services (CPS). If you are on the Medical Center campus, try reaching out to Mental Health Services. Hopefully, you can work together to address this nagging problem. Then, not only can you give a stellar speech at work without dry heaving, but you can come home and "celebrate" with your wife. 


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