Hey, recently i realised almost everyday and almost every hour i will be feeling nauseas ( the feeling of wanting to gag). I am not sure if it is due to gastric issue however, i have seen a doctor and i was prescribed acid reflux medication. I ate the medicine a few times however the nauseas or globus sensation did not go away. For your information, the globus sensation have been with me for around 9 years but my condition got worst in a way where now the nauseous sensation has become more obvious. I also realised that when i am nervous/anxious i will feel nauseous and the globus sensation at the back of my throat can be felt as well. I am not sure is it because of the fear of puking or gagging in public made my anxiety worst (and worsen the nausea sensation) or is it just my gastric problem. Sometimes, when this nauseas sensation comes up i will keep thinking that “oh no, i feel like i am going to vomit” and makes my anxiety worst. Therefore, i need help or advice because i am not sure if it is my anxiety that is causing this nauseas feeling or it is from my gastric. Additionally, this nauseas sensation will be triggered whenever i am in a crowded public transport or area. Thanks for reading through. 
see a psychiatrist or psychologist via polyclinic referral. not a professional but u have anxiety issues thats linked to certain things like crowded public places. i do get anxious until i geel like puking or giddy when my anxiety is triggered by something
Hi @nehznay,
Thank you for sharing what you’ve been going through—it sounds like you’ve been managing a lot, and I can imagine how frustrating and overwhelming it must feel to deal with persistent nausea and anxiety. The fact that you’re seeking advice shows how much you care about improving your situation, and that’s a strength worth recognising.
This cycle of nausea and anxiety is clearly causing significant distress. When physical symptoms like the globus sensation and nausea become tied to anxiety, it can feel like you’re stuck in a loop where one triggers the other. It’s completely valid to feel unsure whether this is more about your anxiety or a gastric issue. The truth is, it might be a combination of both—anxiety can often amplify physical sensations, and those sensations, in turn, can make you feel more anxious.
You mentioned that crowded spaces trigger these sensations, and I wonder if you recall when this first started or if there are certain situations that feel more manageable. Also, did you get a second opinion from another doctor or specialist? Sometimes identifying even small patterns can help us understand what’s happening and how to approach it.
It’s worth looking into it since your condition did not improve and if your gagging caused difficulty swallowing food or liquids. Have you also experienced pain or significant discomfort with swallowing?
Let us know your thoughts and if there’s anything else that you have explored. 
Hey, thanks for replying. I do not have any issues with swallowing neither do i feel any discomfort when swallowing. I realise i won’t feel nauseous sometimes if i have my mind occupied with work/ when i am very focused on doing something. However, sometimes the nauseous sensation is extremely bad that it affects me and i cannot focus on my task. I realised if i am on a crowded bus and i feel anxious and nauseous, calling someone and talking to them can help.
That’s good to hear! If there is anything else that we can help with, feel free to write about it. 
Previously i tried a few ways to cope with anxiety but none of them helped me much. For example, deep breathing, distract myself by listening to music or use my phone to watch movie when i am on a long journey ride. I am not sure if there are any other ways i can try to cope with anxiety.
Would you be willing to share more about your anxiety? Like what do you get anxious about? And what goes through your mind?
I think usually my anxiety comes when i am stressed/ keep thinking about school work and when there’s too many people surrounding me. I’m not sure if i am afraid of humans ( this sounds crazy ) but even simple things such as ordering food i would feel embarrassed or scared to do so. (i think im afraid that people would judge). About what goes through my mind, i think im just worried people would judge or look at me and because i am scared of vomiting and then whenever the nauseas sensation hits with my anxiety, it just makes everything worst. So i think in my mind i also keep thinking that “ohh no i am going to vomit, i can’t do that here, what if everyone looks at me.”
Hi @Nehznay,
Thank you for opening up more about what’s been going through your mind—I want to acknowledge how hard that must feel, especially when it feels like the nausea and fear of judgement are feeding into each other.
What you’ve described makes so much sense. When we experience anxiety, our minds tend to focus excessively on hypothetical scenarios, such as worrying about vomiting or being judged, which can intensify physical sensations like nausea. It’s not crazy to feel that way; it’s a very human response to fear and stress.
It also sounds like you’re carrying the extra weight of self-consciousness, where even small actions, like ordering food, feel overwhelming. That fear of being judged can be so hard to shake because it’s tied to how much we care about how others see us.
- Do you recall when this first started to happen? Knowing when you first began feeling this way might help uncover patterns or triggers.
- Have there been moments where these feelings were less intense or didn’t happen? Sometimes understanding those moments can help us find ways to create more of them.
It’s also worth remembering that you’re not alone in feeling this way. Many people struggle with similar fears, and it’s not a reflection of who you are—it’s something that can be managed with time and support.
If it feels manageable, we could explore small steps to ease some of this anxiety, like practicing grounding techniques when you feel overwhelmed or breaking bigger tasks (like ordering food) into smaller, less stressful steps. For example, instead of thinking about the whole experience, focus on just one part, like walking to the counter, and remind yourself that most people are focused on their own day.
You’re already doing something really powerful by reflecting on what’s happening and seeking ways to manage it. That’s an incredible strength and shows your determination to feel better. Take things at your own pace and let me know how you’re feeling about this—I’m here to support you. 
Hey there! Hope you are feeling slightly better!
Just sharing my experience that I used to have stomach flu or gastric very easily when I am very stressed and anxious so maybe you can see a doctor to get a proper diagnosis.
Hey, thank you for your response. I think i had this globus sensation back when i was 11 years old. Back then i was really afraid of it because i also constantly felt like vomiting whenever there’s like a “lump” sensation stuck at my throat. However, i am not very sure when i started to feel afraid to order food on my own, but i think i slowly realised it when i was around 13? Usually if i am out with my parents, my parents would order food for me (even till now). If i am out with my friends, i have no issue with ordering food (but i feel slightly more comfortable if i am accompanied by someone when i order food). Basically i only feel nervous/anxious if i am alone and having to order food myself especially in crowded hawkers/kopitiam. I am also not sure but maybe it’s the sense of security?
Hi @Nehznay,
Thank you for sharing more about your experience—it sounds like you’ve been dealing with these feelings for a long time, and I really appreciate how open you’ve been about it. It makes a lot of sense why these situations feel overwhelming for you, especially since the globus sensation and fear of vomiting add an extra layer of discomfort.
It seems like you feel more secure when someone is with you, whether it’s your parents or friends, and that sense of support makes things feel a bit easier. On the other hand, being alone in busy places like crowded hawkers or kopitiam feels much harder, which is completely valid. You’ve recognised that it might be connected to a sense of security, and that’s a very insightful observation.
I want to reassure you that what you’re feeling doesn’t mean there’s something wrong with you. Our minds and bodies often associate certain places or situations with stress, and over time, that can build up into patterns of avoidance. These patterns are your way of protecting yourself, even though they might feel frustrating or limiting right now.
If you feel ready, here are a couple of things we could explore together:
- Do you remember any situations, apart from ordering food, where you’ve felt similarly anxious when alone in public?
- You mentioned feeling more comfortable with someone accompanying you—what do you think makes their presence reassuring?
Even with this anxiety, you’ve shown remarkable self-awareness and reflection, like recognising the connection to your sense of security. These strengths will be invaluable as you work toward feeling more confident in these situations. The fact that you can order food when accompanied shows that this is something you’re capable of—you just might need to take smaller steps when doing it alone.
If it feels manageable, perhaps you could start practicing in smaller, less crowded spaces to build your confidence. For example, ordering food at quieter times or in less busy areas might feel less overwhelming. Would you feel comfortable exploring this?
You’re already doing an amazing job by sharing and reflecting on your experiences. It’s okay to take things one step at a time, and I’m here to support you through this. Let me know how you’re feeling about this, and we can explore more together. You’ve got this.
Hey, thanks for further clarifying. I also feel anxious when i have to do presentations in school, or even just talking to my lecturers can make me feel nervous. I also realised that sometimes when i talk to people whom i think are good looking, or well dressed and even people who have higher educational qualifications than me, it makes me feel inferior and thus i feel nervous talking to them (it could even be my cousins as well). I also have issues with dining outside in public area, most of the time i would feel nervous because i don’t feel comfortable/safe in that environment, and this really affected me a lot as well because i don’t even dare to eat with my friends because i am worried i would feel anxious and it leads to nausea. About what makes me feel reassured when i have people around me (especially family members) is because i know there’s someone here for me and if anything happens (like when i feel nauseous) i feel more comfortable telling them. Sometimes when i tell someone i am nervous or feel nauseous, i actually feel slightly better after saying it. I don’t want them to feel alarmed if i were to really vomit or gag, especially my dad because he cares about me and worry about me a lot so sometimes if he suddenly over reacts (in a very concerning way), i will also get affected and it makes me feel more scared in a sense. Ohh and adding on, i actually realised that when i take public transport (eg bus or mrt) i will feel nauseous but once i get out and start walking, somehow i feel better. Im not sure why but i noticed quite a few times already, when i can’t take the nausea when im on the bus, i will quickly alight and walk home instead (i feel slightly better). I don’t know if it’s because i can’t stay inside a particular space for too long because being in the bus or mrt makes me feel like i am being trapped and i am worried bad things would happen inside ( for example, gagging or vomiting).
Hi @Nehznay,
Thank you for sharing details so openly—I can see how much reflection you’ve put into understanding what triggers your anxiety and how it impacts you. It’s incredibly insightful to notice patterns like feeling better when you’re walking or how your loved ones helps you feel safer. These observations are great steps toward managing anxiety more effectively. Let’s hold space for how much effort you’re already putting into this—it’s not easy, but you’re doing it.
It sounds like situations that feel unpredictable or where you perceive others judging you amplify your sense of vulnerability. Whether it’s presenting at school, eating out, or using public transport, these moments seem to create a heightened sense of “what if?”—what if people judge, what if something bad happens, what if I can’t escape? These thoughts, while understandable, sound like they’re adding to the sense of being trapped or overwhelmed. Do you recall a recent moment when these thoughts felt the most intense? How did you respond, and what helped, even slightly?
Here are some thoughts and small steps to consider but only if feel that you are comfortable…
Safe Practices for Specific Situations
- Social Interactions:
- Practice Gradual Exposure: Start with brief, planned conversations with people you trust and slowly expand to others. This could be a peer or teacher you find approachable.
- Affirm Internal Validation: Before interactions, remind yourself of your strengths or achievements that make you unique. This can counteract feelings of inferiority.
- Public Transport and Dining:
- Carrying a Comfort Object: Bring something small (e.g., a stress ball or a piece of soft fabric) to ground yourself when anxiety builds.
- Break the Journey: Plan short stops along routes to help manage the feeling of being trapped. The act of stepping out briefly can provide relief.
- Mindful Eating: At home, practice eating in different environments, like near a window or a slightly public space, to ease into the idea of dining outside gradually.
- Presentations and Lectures:
- Visualization Practice: Before a presentation, take 10 minutes to close your eyes and picture yourself calmly and confidently delivering your points. This can help reduce anticipatory anxiety.
- Controlled Breathing Techniques: Practice “box breathing” (inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and pause for 4 seconds) before and during moments of heightened anxiety.
What stands out most about you is your self-awareness and ability to articulate your experiences with remarkable clarity. These strengths will serve you well in finding ways to manage anxiety. Additionally, your ability to find healthy ways—like sharing your feelings with loved ones—shows a natural capacity for self-care.
You don’t need to tackle everything at once. Perhaps you could start by identifying one situation where you feel the most anxiety and trying one small strategy there. For example, if public transport feels overwhelming, could you try taking a shorter ride and rewarding yourself after?
Remember, progress isn’t about perfection but about persistence. You’re not alone in this journey, and I’m here to explore this further with you whenever you’re ready. Let me know what feels like the next step for you.
Hii, so sorry for the very late reply as i have been busy with school. However i also wanted to add on that recently i reflected deeper and i think the nauseous sensation usually isn’t that bad when i am at home but when i am outside, my nauseous sensation can go from bad to worse. However, i realised if i occupy my mind with something and distract myself, i wont think of puking, but when i am not focused or occupied by anything, for example i am just sitting down, walking around the shopping mall or being in a public transport commuting, i feel nauseous. I also realise if i suddenly think about things that made me nervous, sad or scared, the nauseous sensation could also worsen and makes me have the urge of wanting to gag really badly. Until now i seriously have no idea if it’s a mental issue or it’s just something else, since i also realised if i am distracted, i don’t feel nauseous. Honestly, every now and then sometimes bitting my lips can help me counter the nauseous sensation because it hurts and it is like a way to distract me. However, i know this is not a long term solution and i should not do that but i seriously have no idea how else i can help myself because nothing seems to help with my nauseous sensation, only if i am in a place where i feel safe and comfortable. However, i can’t forever be trapped at home and not go outside, but every now and then its daunting even before i want to step out of house because i will be thinking “Would anything bad happen? Would i vomit in public? Would the sensation be really strong till i cannot take it?” All these thoughts are always in my mind and it affects my mood and the willingness of wanting to go outside.
Hi @nehznay,
It’s clear that you’ve been carrying a lot of emotional weight with the nausea and the fear it brings. I can hear that it’s creating a lot of stress and frustration for you, and I can understand why it feels overwhelming to face these experiences when they seem to spiral and make you feel like you’re trapped.
The fact that you’re reaching out and reflecting on what’s been happening shows real strength and self-awareness. It’s not easy to confront something that’s so unsettling and has such a strong grip on your thoughts.
From what you’ve shared, it sounds like the nausea you experience is linked to anxiety and certain triggers. Have you noticed any particular thoughts or worries that seem to make the nausea worse? You mentioned worrying about what might happen when you go outside—about the possibility of vomiting in public or feeling overwhelmed. These thoughts could be fuelling the anxiety, which in turn exacerbates the physical symptoms of nausea.
The coping strategies you’ve tried, like distracting yourself or biting your lips, are understandable, but they may only provide temporary relief, and as you mentioned, they’re not long-term solutions. Have you tried other calming techniques that might help you regulate your anxiety before it becomes overwhelming, like deep breathing or focusing on your senses?
It’s also okay to be kind to yourself and recognise that this struggle doesn’t make you weak. How would it feel to acknowledge that taking small steps, even if they seem insignificant, are victories in themselves? Maybe you could try setting little goals, like stepping outside for a short walk, and gradually build up your comfort level with public spaces. You don’t have to face this all at once.
Finally, you mentioned feeling more comfortable when you’re at home, and that’s perfectly valid. What would it look like for you to start extending that sense of safety to other spaces in small, manageable ways?
It’s acceptable to not possess all the answers at present, and to seek assistance when you’re prepared. You don’t have to face this alone, and taking small steps towards understanding and managing your anxiety is already progress.