Curing Performance Anxiety

Medically reviewed by Paige Henry, LMSW, J.D.
Updated October 23, 2024by BetterHelp Editorial Team

Do you get nervous before speaking in public? Or feel stressed when taking an exam? If so, you are not alone—many people experience fear and worry surrounding their ability to perform. These feelings are characteristic of a common challenge known as performance anxiety. 

While there generally isn’t a cure for performance anxiety, there are several steps you can take that may mitigate your risks of a symptomatic experience and help enhance your quality of life. Below, we’re exploring what performance anxiety is, possible contributing factors and symptoms, as well as how this condition is related to other forms of anxiety disorders. We’ll also discuss care methods to help you perform at your best. 

What is performance anxiety?

Performance anxiety generally refers to fear, worry, and nervousness surrounding meeting expectations. These feelings may arise when speaking or performing in front of others, playing a sport, becoming intimate with a partner, or participating in a group project. Although most people experience some level of nervousness or apprehension in these situations, for those with performance anxiety, these feelings are significantly more intense.

Performance anxiety can produce serious mental and physical symptoms that may impact an individual’s career, social life, and relationships. In severe cases, these symptoms may signal the existence of performance-type social anxiety disorder, a form of social phobia related specifically to presenting in front of others.

Performance anxiety is thought to affect 15-30% of the population.

Performance anxiety is typically related to an elevated fear of failure, judgment, or embarrassment. Someone with performance anxiety may experience symptoms while presenting at work, acting in a play, or studying for a quiz. It can manifest in many various ways across different individuals’ experiences, but common symptoms include increased heart rate, rapid breathing, sweating, worry, and panic.

Types of performance anxiety

While performance anxiety can often lead to negative outcomes and stressful situations, there are various forms. All types of performance anxiety can involve anxious feelings that can affect a person’s self-confidence and overall well-being in the same way. However, they may involve different situations or specific tasks. 

Sexual

Sexual performance anxiety is a form of performance anxiety that occurs in intimate settings, leading to intense fear or worry about one’s ability to perform sexually. This condition can manifest through physical symptoms such as sweating, a racing heart, and difficulty maintaining an erection or achieving orgasm. It can also cause psychological effects like feelings of inadequacy, stress, and reduced self-esteem. Sexual performance anxiety can hinder one's ability to enjoy intimate relationships and connect with partners, potentially affecting overall relationship satisfaction and personal well-being. 

Stage fright

Stage fright, or performance anxiety in the context of public speaking or performing arts, involves intense fear of performing in front of an audience. Individuals may experience symptoms such as trembling hands, a tight throat, sweating, a racing heart, and even memory lapses. This type of anxiety can hinder one's ability to express creativity or communicate effectively in public settings.

Tests 

Test anxiety is excessive worry about performing poorly on an exam. It can hinder a person's ability to focus and remember information during the test. Common symptoms include rapid heartbeat, nausea, cold hands, and excessive sweating, which often leads to poor academic performance.

Sports 

Sports performance anxiety affects athletes' mental and physical state before or during competition, which can lead to decreased athletic performance. Symptoms include excessive nervousness, fear of failure, and physical signs like muscle tension, which can prevent athletes from performing at their best.

Interviews

Interview anxiety refers to the stress and fear experienced before or during job interviews. It can manifest as symptoms such as stuttering, sweating, and having difficulty articulating thoughts. This type of anxiety can affect an individual's chances of making a good impression or getting a job offer.

Getty/Luis Alvarez
The pressure to succeed can impact your emotions

Living with an existing anxiety disorder, particularly social anxiety disorder (SAD), is a primary risk factor for performance anxiety. Generalized anxiety disorder, panic disorder, and specific phobias can also cause an individual to suffer from similar symptoms of anxiety. Still, individuals can experience performance anxiety without living with SAD or other anxiety disorders. Because performance anxiety often stems from a fear of being judged or humiliated, contributing factors may include a negative self-image, prior perceived failures, or inexperience. 

General symptoms of performance anxiety include: 

  • Nervousness and worry before a performance or presentation
  • Sweating
  • Trembling
  • Rapid heart rate
  • Gastrointestinal distress
  • Dry mouth
  • Avoidance of situations in which an individual may be perceived negatively
Getty/AnnaStills

Can I cure performance anxiety?

As with many mental health-related concerns, there is not a universal cure for performance anxiety. However, several techniques can significantly reduce its effects and help you gain a better sense of control over certain symptoms.

For those who live with social anxiety disorder, psychotherapy is a common method of care. A mental health professional can help you process the negative thoughts and emotions that may accompany performance anxiety and assist you in developing coping strategies that address your specific symptoms. 

A widely used therapy method for anxiety is cognitive behavioral therapy (CBT), which helps individuals identify and replace negative thought patterns that may be causing their symptoms. For example, a cognitive behavioral therapist may help you recognize that people aren’t actively judging you as frequently as you believe they are, which may help address thoughts of self-doubt. 

Medication can help alleviate symptoms of performance-type social anxiety disorder in some cases. Common anti-anxiety medications for performance anxiety include beta-blockers like propranolol, which may help widen the blood vessels and improve blood flow. Beta-blockers are particularly helpful for managing the physical effects of performance anxiety, such as a racing heart and rapid pulse. Always consult with a healthcare provider before starting or stopping any medication, or when looking for medical advice. 

If you believe you’re living with an anxiety disorder, consider consulting with a healthcare provider who can help you determine whether further testing and treatment is necessary. It's also important to consider that physical causes may influence physical symptoms, as a holistic approach that addresses physical and psychological factors may be beneficial.

Managing performance anxiety

Though there may not be a cure for performance anxiety, there are several techniques that can reduce its physical, emotional, and cognitive effects. Some of the following strategies are preventative in nature while others can be used during a performance or presentation.   

Preparation

One of the most important things you can do to alleviate the fear of not meeting expectations is to ensure you’re setting yourself up for success. For example, consider a situation where you’re giving a speech at a conference. As you prepare, having a thorough understanding of the message you’re conveying can be key. 

Repeatedly practicing what you say can help you feel more comfortable with the material and commit it to memory. In addition to understanding the content of your speech, you could also work through its logistics, including how you’ll arrive at the venue, where you’ll be before speaking, and what the environment will look like. 

Preparedness is considered a key measure by many public speakers for managing performance anxiety. Studies have found that preparation can also help reduce symptoms of anxiety experienced by students in online educational settings and musicians during jazz and classical performances.  

Sleep

Getting enough rest, particularly the night before a presentation or performance, may help you avoid excess stress and improve your cognitive functioning. Try to create a restful sleep environment by keeping your room quiet, cool, and dark. It can also help to avoid looking at your phone for an hour before bed. 

Additionally, a nighttime routine can provide consistency in your sleep schedule and help signal to your body that it's time to sleep. Your bedtime routine can include journaling, meditating, drinking herbal tea, tending to your hygiene, or other activities that help you wind down.

Yoga

Physical activity has proven benefits when it comes to addressing anxiety, and yoga may be especially helpful for performance anxiety. In a study of the impacts of yoga on performance anxiety, researchers concluded that regular sessions could have a preventative effect. Consider joining a class at your local studio or watching instructional videos online. 

Visualization

Imagining how a successful speech, presentation, or game will proceed can help you perform better in the moment. Visualization is a technique that is widely used by public figures who operate at a high level. Before a performance, try to picture how the scenario will unfold in detail. 

For instance, if you’re about to play a tennis match, you might visualize how the court will look, the way certain points will progress, and how you’ll feel when you win. Research shows that visualization can help with varied forms of performance anxiety; for example, it can alleviate anxiety related to public speaking and piano recitals

Affirmations

There is evidence of a link between positive self-talk and reduced performance anxiety. Affirmations, one form of self-talk, are statements you repeat to yourself that can help you build confidence and develop an optimistic mindset. For example, before a speech at a function, you may repeat phrases like “I am self-assured and capable as a public speaker” or “My message is important and deserves to be heard.”

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The pressure to succeed can impact your emotions

Reducing performance anxiety with online therapy

The results of an increasingly large number of studies suggest that online therapy can help individuals reduce symptoms of mental health challenges that may cause performance anxiety. For example, in a meta-analysis of 20 studies, including over 1,700 participants, researchers concluded that online therapy is as effective as in-person treatment when addressing social anxiety disorder. The review also noted the increased availability of online therapy compared to face-to-face counseling. 

Online therapy can be a discreet and effective forum for you to address performance anxiety. With an online therapy platform like BetterHelp, you can talk to a therapist remotely, which can be helpful if you experience anxiety when speaking in front of others. BetterHelp works with thousands of qualified providers with a wide range of specialties, so you'll have a good chance of connecting with someone who can address your specific concerns related to social anxiety or related challenges. Continue reading for reviews of BetterHelp therapists from those who have sought help for similar struggles.

"Therapy with Michele is the best thing that happened to me. Having her integrated approach to help with daily problems, anxiety and trauma-related struggles has been great for me. She is very good at reading a situation and her patient. I am very grateful to have been matched with so perfectly!"
— BetterHelp member’s review of their therapist
Takeaway
Performance anxiety can present serious challenges and may be a sign of a mental health condition. Although there is no cure for performance anxiety at present, it is possible to significantly reduce fear and nervousness surrounding meeting expectations. If you’re experiencing performance anxiety or related challenges, speaking with a licensed online therapist can be a helpful first step toward increased comfort in pressure situations. With the right guidance and support, you can continue to foster mental wellness and feel confident putting yourself out there.
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