Can Stress Cause Nose Bleeds By Damaging Nasal Blood Vessels?

You may be familiar with nosebleeds as a result of dry air, allergies, injuries, or other irritations to the inside of the nose. But could stress be a potential cause of a bloody nose, and if so, how? Understanding why nosebleeds happen, how they may be connected to stress, and steps you can take to potentially prevent them may help you manage this symptom. If you’re looking for support in coping with stress, reaching out to an in-person or online therapist may be beneficial. 

What is a nosebleed?

According to the National Library of Medicine, a nosebleed—also known as epistaxis—is defined as “loss of blood from the tissue lining the nose. Bleeding most often occurs in one nostril only.” If your nose bleeds, you may also experience symptoms such as:

• Blood running from one or both nostrils
• An urge to swallow
• A sensation of runniness in the throat 
• An unpleasant taste in the mouth
• Nausea

If symptoms like nosebleeds are causing you stress or anxiety, you can get mental health support from an online therapist.

Types of nosebleeds

There are generally two known types of nosebleeds: anterior and posterior. Anterior nosebleeds normally flow from the front of your nose. They can be caused by scratching or dry air, and they’re the most common type of nosebleed. On the other hand, a posterior nosebleed typically comes from the back of your nasal cavity and might be caused by a bleeding disorder. This type of nosebleed is rarer and more serious, potentially requiring a doctor’s visit to identify any underlying conditions.

What causes nosebleeds?

• Dry climate
• High altitude
• Upper respiratory infections
• An object entering the nose
• Allergies
• Trauma to the nose or face
• Recreational drugs that are taken in through the nose
• Exposure to certain chemicals in daily life
• Use of certain nasal sprays
• Use of some blood-thinning medications
• Pregnancy
• A deviated septum

In rarer cases, nosebleeds may be caused by a more serious underlying condition. Some of these less common causes include hemophilia, nasal tumors or polyps, liver or kidney disease, or hereditary hemorrhagic telangiectasia (HHT). That’s why meeting with your doctor if you’re experiencing frequent or severe nosebleeds is recommended.

Can stress cause nosebleeds?

Understanding this mechanism can involve understanding the body’s stress response.

During a stressful event, the body typically releases cortisol, the stress hormone. Cortisol can constrict blood vessels, usually causing blood flow to redirect to the muscles to give them energy so you can fight or escape any potential threat. As a part of this full-body response, the blood vessels in your nose may also constrict. When this happens, they may be at increased risk of rupturing and causing a stress-related nosebleed. Other stress-related factors that might make a nosebleed more likely include:

• Increased blood pressure: Stress can also lead to elevated blood pressure, which may increase the likelihood of blood vessels bursting.
• Muscle tension: Chronic stress often causes muscle tension, including in the facial area, which may strain nasal blood vessels.
• Immune system suppression: Ongoing stress can weaken the immune system, making the nasal lining more susceptible to infections and irritations that could cause nosebleeds.
• Behavioral factors: Stress may lead to habits like nose picking or frequent blowing, which can irritate the nasal membranes. 

If you notice you have nosebleeds when you're feeling stressed or overwhelmed, it's possible that stress and anxiety could be part of the cause. If you experience nosebleeds frequently, however, it's usually best to seek medical attention, whether you believe they're stress-induced or not.

Therapy can be a helpful tool if you’re having trouble managing your stress levels. You may be able to receive care in person or online.

Risk factors that may make stress nosebleeds more likely

A person may be more prone to stress-related nosebleeds if they have certain, additional risk factors. For example, someone with chronic anxiety or an anxiety disorder may be at higher risk, since symptoms may cause their stress response to be engaged more often. People who are on certain medications, such as blood thinners, may also experience more stress nosebleeds. 

Finally, someone who already has high blood pressure (hypertension) may be more likely to have nosebleeds. If they do, the nosebleeds are likely to be more severe, potentially requiring medical attention.

How to stop a nosebleed safely

1. Sit up straight and lean slightly forward

This posture may help prevent the blood from going down your throat. If blood goes down your throat, you may choke or develop an upset stomach. 

2. Use your fingers to pinch your nose shut 

By pinching the soft, lower part of your nose, you may be able to put pressure on the blood vessels and stop the flow. Keep pinching your nostrils shut for at least five minutes. After five minutes, you can let go of your nose and check to see if the bleeding has stopped. If the blood continues to flow, try to pinch your nose again for 10 to 15 minutes.  

3. Relax and slowly breathe in and out through your mouth

Continue pinching your nose while slowly breathing in and out through your mouth to relax your body and mind. Panicking may increase blood pressure, which could make the nosebleed last longer, so finding ways to keep yourself calm may be helpful.

4. Take proper care of yourself after the nosebleed stops

Healthcare professionals usually advise patients to avoid picking or blowing their nose for a few days after a nosebleed to avoid restarting it. It can also be helpful to avoid bending over for long periods, engaging in vigorous physical activity, or eating spicy foods for a few days.

When to seek medical attention for a nosebleed

In many cases, blood flow slows from the nose after a few minutes. It’s often recommended that you visit the emergency room if your nosebleed doesn’t stop within about 20 minutes or if you're experiencing other symptoms too, such as dizziness, an intense headache, numbness, or nausea. If you experience frequent or severe nosebleeds, visiting an urgent care facility or making an appointment with your doctor may be advisable.

How to prevent nosebleeds

There are a few general practices that may help prevent nosebleeds or reduce their recurrence. First, it may help to:

• Keep nasal passages moist, such as by using a humidifier and wearing a scarf over your nose on cold days
• Avoid potential irritants, like smoke 
• Eat foods rich in iron and vitamins K and C to promote blood vessel health
• Avoid picking or vigorously blowing your nose 

Minimizing stress to help reduce nosebleeds

If your nosebleeds are more frequent when you’re stressed, taking steps to reduce or effectively manage your stress levels may also be helpful. You might consider strategies like the following:

• Get exercise regularly
• Eat nutrient-dense foods
• Avoid or limit caffeine and alcohol
• Quit smoking
• Meditate
• Journal
• Reach out to family and friends
• Connect with a mental health professional

Exploring talk therapy for help managing stress

If you’re having trouble managing your stress levels, it might be worth reaching out for professional help. Therapy may help you identify key causes of stress in your life, learn reframing techniques for negative thoughts, and develop healthy coping mechanisms.

While therapy may be helpful for managing stress, not everyone can regularly travel to and from in-person appointments. In situations like these, online therapy might be more convenient. This format allows you to attend sessions with a licensed professional virtually, from the comfort of your home or any location with an internet connection. Plus, online providers can often offer greater scheduling flexibility, and you may be able to schedule sessions outside of typical office hours.

The effectiveness of online therapy

Researchers have studied the effectiveness of online therapy for treating a variety of conditions, including stress, and findings indicate it can be effective in many cases. For example, one study suggests that “a relatively short ICBT is indicated to be effective in reducing stress-related symptoms.” ICBT stands for internet-based cognitive behavioral therapy. CBT is a common type of talk therapy that can generally be delivered in person or online.