Psychosomatics and Cough: Can There Be a Nervous Cough?

A cough usually resolves on its own within 3–4 weeks, and in most cases it is caused by a cold or flu. But if there was no cold and the coughing drags on for weeks, many look for the cause in stress. Let us examine what is known about so-called nervous cough and how it is distinguished from respiratory tract diseases.

What Is Psychosomatic Cough

Cough is an innate protective reflex: a forced exhalation through the mouth that clears the airways of foreign substances. Its receptors are located throughout the respiratory tract — in the nose, sinuses, pharynx, larynx, trachea, bronchi, and pleura. The cough center is controlled by the cerebral cortex, so a cough can to some extent be suppressed and imitated, and it can occur in pathologies not related to the respiratory organs. In the classification by the location of the focus, neurogenic, or central, cough is distinguished separately — in psychosomatic and organic lesions of the nervous system.

Can There Be a Cough on a Nervous Basis

Yes, this variant is recognized: neurogenic cough is classified as a pathology of the nervous system, and simulated cough is also included in it. In 10–38% of cases the true cause of the cough cannot be identified, and then symptomatic treatment is used. Cough is a symptom, not an independent disease, so the cause is determined by a doctor.

How Nervous Cough Manifests and How It Differs from a Cold Cough

A cold and flu produce a cough that usually subsides within 3–4 weeks. By duration, acute cough (less than two weeks), prolonged (2–4 weeks), subacute (4–8 weeks), and chronic (more than two months) are distinguished. Chronic cough occurs in chronic bronchitis, asthma, allergy, COPD, gastroesophageal reflux, smoking, throat diseases, and with the use of certain medications. Timbre also says a lot: a cough can be barking, ringing and chesty, hoarse, muffled, and soundless, dry or wet. The character of the sound alone does not allow one to distinguish nervous cough from a disease — a doctor's assessment is needed.

Causes: Stress, Anxiety, and Neurological Factors

Neurogenic cough includes psychosomatic and organic lesions of the nervous system, for example in brain tumors, hysteria, Tourette syndrome, as well as the effect of certain psychoactive substances. Reflex cough is distinguished separately — from irritation of organs not related to breathing but innervated by the same nerves: the external auditory canal, tympanic membrane, esophagus, diaphragm, pericardium. Some medications can also cause cough, for example the groups of beta-blockers and ACE inhibitors.

• cough lasts longer than 3 weeks;
• cough without an apparent cause that cannot be found (10–38% of cases);
• cough is associated with the use of certain medications;
• cough in diseases not related to breathing.

How Lung Diseases and Other Causes of Cough Are Ruled Out

The doctor listens to the chest with a stethoscope, may take a sputum sample, order an X-ray, an allergy test, or a lung function test. Sometimes the patient is referred to a specialist in a hospital, but this is rare. Antibiotics for cough are usually not prescribed — only for a bacterial infection or risk of complications.

When to See a Doctor

One should see a doctor if the cough lasts more than 3 weeks, if a person loses weight without reason or has weakened immunity, for example due to chemotherapy or diabetes. Emergency help is needed if the cough is very severe or rapidly worsening, the person feels very unwell, there is chest pain, the glands in the neck are enlarged and painful, it is difficult to breathe, or blood has appeared in the sputum.

Coughing in itself is not a reason to call an ambulance. Call 103 or 112 if the cough is very severe or rapidly worsening, it is difficult to breathe, there is chest pain, or you are coughing up blood.

This article is for reference: it helps to orient yourself but does not replace a doctor's consultation, which will assess your situation as a whole.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer