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How to Manage Public Speaking Anxiety

Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology.

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

Luis Alvarez / Getty Images

Speech Anxiety and SAD

How to prepare for a speech.

Public speaking anxiety, also known as glossophobia , is one of the most commonly reported social fears.

While some people may feel nervous about giving a speech or presentation if you have social anxiety disorder (SAD) , public speaking anxiety may take over your life.

Public speaking anxiety may also be called speech anxiety or performance anxiety and is a type of social anxiety disorder (SAD). Social anxiety disorder, also sometimes referred to as social phobia, is one of the most common types of mental health conditions.

Public Speaking Anxiety Symptoms

Symptoms of public speaking anxiety are the same as those that occur for social anxiety disorder, but they only happen in the context of speaking in public.

If you live with public speaking anxiety, you may worry weeks or months in advance of a speech or presentation, and you probably have severe physical symptoms of anxiety during a speech, such as:

• Pounding heart
• Quivering voice
• Shortness of breath
• Upset stomach

Causes of Public Speaking Anxiety

These symptoms are a result of the fight or flight response —a rush of adrenaline that prepares you for danger. When there is no real physical threat, it can feel as though you have lost control of your body. This makes it very hard to do well during public speaking and may cause you to avoid situations in which you may have to speak in public.

How Is Public Speaking Anxiety Is Diagnosed

Public speaking anxiety may be diagnosed as SAD if it significantly interferes with your life. This fear of public speaking anxiety can cause problems such as:

• Changing courses at college to avoid a required oral presentation
• Changing jobs or careers
• Turning down promotions because of public speaking obligations
• Failing to give a speech when it would be appropriate (e.g., best man at a wedding)

If you have intense anxiety symptoms while speaking in public and your ability to live your life the way that you would like is affected by it, you may have SAD.

Public Speaking Anxiety Treatment

Fortunately, effective treatments for public speaking anxiety are avaible. Such treatment may involve medication, therapy, or a combination of the two.

Short-term therapy such as systematic desensitization and cognitive-behavioral therapy (CBT) can be helpful to learn how to manage anxiety symptoms and anxious thoughts that trigger them.

Ask your doctor for a referral to a therapist who can offer this type of therapy; in particular, it will be helpful if the therapist has experience in treating social anxiety and/or public speaking anxiety.

Research has also found that virtual reality (VR) therapy can also be an effective way to treat public speaking anxiety. One analysis found that students treated with VR therapy were able to experience positive benefits in as little as a week with between one and 12 sessions of VR therapy. The research also found that VR sessions were effective while being less invasive than in-person treatment sessions.

Get Help Now

We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

If you live with public speaking anxiety that is causing you significant distress, ask your doctor about medication that can help. Short-term medications known as beta-blockers (e.g., propranolol) can be taken prior to a speech or presentation to block the symptoms of anxiety.

Other medications may also be prescribed for longer-term treatment of SAD, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). When used in conjunction with therapy, you may find the medication helps to reduce your phobia of public speaking.

In addition to traditional treatment, there are several strategies that you can use to cope with speech anxiety and become better at public speaking in general . Public speaking is like any activity—better preparation equals better performance. Being better prepared will boost your confidence and make it easier to concentrate on delivering your message.

Even if you have SAD, with proper treatment and time invested in preparation, you can deliver a successful speech or presentation.

Pre-Performance Planning

Taking some steps to plan before you give a speech can help you better control feelings of anxiety. Before you give a speech or public performance:

• Choose a topic that interests you . If you are able, choose a topic that you are excited about. If you are not able to choose the topic, try using an approach to the topic that you find interesting. For example, you could tell a personal story that relates to the topic as a way to introduce your speech. This will ensure that you are engaged in your topic and motivated to research and prepare. When you present, others will feel your enthusiasm and be interested in what you have to say.
• Become familiar with the venue . Ideally, visit the conference room, classroom, auditorium, or banquet hall where you will be presenting before you give your speech. If possible, try practicing at least once in the environment that you will be speaking in. Being familiar with the venue and knowing where needed audio-visual components are ahead of time will mean one less thing to worry about at the time of your speech.
• Ask for accommodations . Accommodations are changes to your work environment that help you to manage your anxiety. This might mean asking for a podium, having a pitcher of ice water handy, bringing in audiovisual equipment, or even choosing to stay seated if appropriate. If you have been diagnosed with an anxiety disorder such as social anxiety disorder (SAD), you may be eligible for these through the Americans with Disabilities Act (ADA).
• Don’t script it . Have you ever sat through a speech where someone read from a prepared script word for word? You probably don’t recall much of what was said. Instead, prepare a list of key points on paper or notecards that you can refer to.
• Develop a routine . Put together a routine for managing anxiety on the day of a speech or presentation. This routine should help to put you in the proper frame of mind and allow you to maintain a relaxed state. An example might be exercising or practicing meditation on the morning of a speech.

Practice and Visualization

Even people who are comfortable speaking in public rehearse their speeches many times to get them right. Practicing your speech 10, 20, or even 30 times will give you confidence in your ability to deliver.

If your talk has a time limit, time yourself during practice runs and adjust your content as needed to fit within the time that you have. Lots of practice will help boost your self-confidence .

• Prepare for difficult questions . Before your presentation, try to anticipate hard questions and critical comments that might arise, and prepare responses ahead of time. Deal with a difficult audience member by paying them a compliment or finding something that you can agree on. Say something like, “Thanks for that important question” or “I really appreciate your comment.” Convey that you are open-minded and relaxed. If you don’t know how to answer the question, say you will look into it.
• Get some perspective . During a practice run, speak in front of a mirror or record yourself on a smartphone. Make note of how you appear and identify any nervous habits to avoid. This step is best done after you have received therapy or medication to manage your anxiety.
• Imagine yourself succeeding . Did you know your brain can’t tell the difference between an imagined activity and a real one? That is why elite athletes use visualization to improve athletic performance. As you practice your speech (remember 10, 20, or even 30 times!), imagine yourself wowing the audience with your amazing oratorical skills. Over time, what you imagine will be translated into what you are capable of.
• Learn to accept some anxiety . Even professional performers experience a bit of nervous excitement before a performance—in fact, most believe that a little anxiety actually makes you a better speaker. Learn to accept that you will always be a little anxious about giving a speech, but that it is normal and common to feel this way.

Setting Goals

Instead of trying to just scrape by, make it a personal goal to become an excellent public speaker. With proper treatment and lots of practice, you can become good at speaking in public. You might even end up enjoying it!

Put things into perspective. If you find that public speaking isn’t one of your strengths, remember that it is only one aspect of your life. We all have strengths in different areas. Instead, make it a goal simply to be more comfortable in front of an audience, so that public speaking anxiety doesn’t prevent you from achieving other goals in life.

A Word From Verywell

In the end, preparing well for a speech or presentation gives you confidence that you have done everything possible to succeed. Give yourself the tools and the ability to succeed, and be sure to include strategies for managing anxiety. These public-speaking tips should be used to complement traditional treatment methods for SAD, such as therapy and medication.

Crome E, Baillie A. Mild to severe social fears: Ranking types of feared social situations using item response theory . J Anxiety Disord . 2014;28(5):471-479. doi:10.1016/j.janxdis.2014.05.002

Pull CB. Current status of knowledge on public-speaking anxiety . Curr Opin Psychiatry. 2012;25(1):32-8. doi:10.1097/YCO.0b013e32834e06dc

Goldstein DS. Adrenal responses to stress . Cell Mol Neurobiol. 2010;30(8):1433-40. doi:10.1007/s10571-010-9606-9

Anderson PL, Zimand E, Hodges LF, Rothbaum BO. Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure . Depress Anxiety. 2005;22(3):156-8. doi:10.1002/da.20090

Hinojo-Lucena FJ, Aznar-Díaz I, Cáceres-Reche MP, Trujillo-Torres JM, Romero-Rodríguez JM. Virtual reality treatment for public speaking anxiety in students. advancements and results in personalized medicine .  J Pers Med . 2020;10(1):14. doi:10.3390/jpm10010014

Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis . J Psychopharmacol (Oxford). 2016;30(2):128-39. doi:10.1177/0269881115612236

By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology.

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Social anxiety medication & public speaking anxiety medication

This is not medical advice - talk to a psychiatrist

I am not a psychiatrist or a medical doctor. This is not medical advice and is not a recommendation. 

What are medications that some people use for public speaking and social anxiety?

Because public speaking anxiety is a type of social anxiety, this article covers both. 

Key Take Away A psychiatrist will assess your specific situation and will develop a treatment plan based on your needs.

For public speaking phobia, there are the "take as needed" meds, for example, a combination of Alprazolam and Propranolol. You can take these 30-minutes before the fearful event (you have to plan a little in advance). These meds don't have the more serious potential side-effects of the "take everyday" meds. You may also want to discuss the "take everyday" meds with a psychiatrist, and discuss your specific needs.

Public speaking and social anxiety medications discussed in the presentation

There are two types of public speaking and social anxiety medications. The first type is taken "every day.” The second type is taken "as needed."

1. Take "every day" medications

• Selective serotonin reuptake inhibitors (SSRIs)
• Monoamine oxidase inhibitors (MAOIs)
• Antidepressants

2. Take "as needed" medications

• Beta blockers
• Benzodiazepines ("benzos")

1. "Take every day" medications

Ssri examples (brand and generic names) :.

• Paxil (Paroxetine) • Zoloft (Sertraline) • Effexor (Venlafaxine) • Celexa (Citalopram) • Luvox (Fluvoxamine) • Prozac (Fluoxetine)

MAOI Examples (brand and generic names) :

• Marplan (Isocarboxazid) • Nardil (Phenelzine) • Emsam (Selegiline) - also available as a skin (transdermal) patch • Parnate (Tranylcypromine)

Antidepressant Examples (brand and generic names) :

• Tofranil (imipramine) • Norpramin, Pertofrane and others (desipramine) • Aventyl or Pamelor (nortriptyline) • Elavil (amitriptyline) • Sinequan or Adapin (doxepin) • Anafranil (clomipramine) • Desyrel (trazodone)

Be aware that the “every day” medications (SSRIs, MAOIs, and antidepressants) take several weeks to kick in so you won't see the effect immediately. They also have side effects. So learn about the side effects and talk to your doctor or psychiatrist about what to expect.

Check out these authoritative sites for researching medications and side-effects:

• National Institute of Health (NIH) Medline Plus
• Mayo Clinic

Plan to work with your doctor over a period of weeks (or months) to find the right dose for you. Medications interact with each individual differently. Finding the right dose takes some experimentation including increasing or decreasing the dose, and checking in with your doctor to discuss how the medication is affecting you at a specific dose and adjusting the dose as needed.

It's important to not go off of these medications "cold turkey" otherwise you can expect painful withdrawal symptoms. Your doctor will give you a graduated "weaning off" schedule that you'll want to follow carefully.

If you want to avoid the potential side effects of the take "every day" medications, the "take as needed" medications may be a better option. Let's take a look at these now.

2. "Take as needed" medications

A. beta blocker examples (brand and generic names) :.

• Inderal (Propanolol) • Tenormin (Atenolol)

b. Benzo Examples (brand and generic names):

• Klonopin (Clonazepam) • Xanax (Alprazolam) • Valium (Diazepam) • Ativan (Lorazepam) • Centrax (Prazepam) • Dalmane (Flurazepam) • Halcion (Triazolam) • Librium (Chlordiazepoxide) • Paxipam (Halazepam) • Restoril (Temazepam) • Serax (Oxazepam) • Tranxene (Clorazepate)

For public speaking phobia, the advantages of the "take as needed" drugs are:  (1) you can plan for the fearful event at a specific day/time, and (2) they don't have the more serious potential side-effects of the "take everyday" drugs.

The "take as needed" drugs can be taken 30 minutes before a fearful situation like a public speaking event, job interview, date or other fearful situation. If you have persistent anxiety, the take "as needed" drugs may not be a good alternative for you. But if your anxiety is primarily in response to a specific type of event and you know when it will happen, the take "as needed" meds may be a good option.

There are two types of take "as needed" meds: Beta blockers and benzodiazepines ("benzos”). Let’s start with beta blockers.

a. Beta blockers

Why use beta blockers.

• Reduces anxiety symptoms like rapid heart rate • When you have high levels of anxiety, your brain interprets your bodily symptoms as dangerous. This causes more anxiety which increases the symptoms. It’s a self-perpetuating cycle • A beta blocker can “put a monkey wrench” in the cycle by reducing the symptoms • Make sure to combine with new self-talk. Fearful self-talk can overpower the effect of the beta blocker

Side effects

If you have low blood pressure, a beta blocker will bring your blood pressure down further and can make you feel dizzy and sluggish.

b. Benzodiazepines

Why use benzos.

A benzo is like a glass of wine. But be aware that benzos are addictive and habit-forming. You need bigger and bigger doses to have the same effect. So be careful with these. They are highly monitored because of their addictive nature and because they have been over-prescribed. Some primary care physicians doctors don't want to prescribe them and you may need to see a psychiatrist (psychiatrists typically see their patients once a month to monitor meds).

Beta blocker + benzo 30-minutes before anxious event

If you take a beta-blocker and benzo 30-minutes before an event, they can help you manage the anxiety. Combine with the right self-talk and proper exposure techniques, and these can be effective tools in managing your anxiety. Feel free to comment or ask questions in the discussion below.

Another type of med

d-cycloserine is another type of med that is being studied. It may be able to enhance desensitization during exposures. The idea is that it deepens your learning. So if you have good exposures, it can help you learn that the situation is safe. (The down-side is that if you have bad exposures, it will enhance that learning as well.) Read more about d-cycloserine .

Anxiety chat: Best free places to chat online

Tips for overcoming public speaking anxiety: daily exercises, how to get over public speaking anxiety: filtering, how much anxiety is normal [public speaking example].

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Can This Drug Cure Performance Anxiety?

Beta-blockers, used primarily as a treatment for heart disease, may help calm the nerves of anxious orators.

When we think about performance-enhancing drugs, our minds immediately turn to famous athletes using banned substances to build muscles and heal faster. Lance Armstrong, Mark McGwire, Marion Jones—the list of athletes whose legacies are tainted by alleged (or, in some cases, admitted) drug use seems to grow longer every year.

But athletes aren’t the only ones ingesting pharmaceuticals to do their work better.

For people whose jobs require public speaking or presentations, a class of drugs called beta-blockers can be a powerful tool to calm the nerves and reduce the jitters that detract from performance.

Beta-blockers were discovered by Scottish pharmacologist James Black in 1962 as a treatment for heart disease. The chemicals work by inhibiting the body’s response to adrenaline, lowering blood pressure and reducing the risk of heart attack. By the 1970s, doctors had begun using them to reduce performance anxiety, particularly in musicians. However, that remains a secondary use; beta-blockers are still used primarily to improve people’s circulatory systems. For his work, Black won the Nobel Prize, and upon his death in 2010, The New York Times credited him with “extending the lives of millions of people.”

I began hearing about their usefulness in public speaking from writer friends who found themselves anxious on book tours. “All of my bad things that usually happened when I’d speak—the sweating, the fast breathing—didn’t happen,” one best-selling author told me after trying the pills. “I don’t know if it’s psychosomatic or not, but the pills just tamp down all of the physical sensations.”

Another friend looks at beta-blockers as an insurance policy. He doesn’t think of himself as a nervous speaker, but occasionally he’ll suffer feelings of panic at the podium. “Beta-blockers just subtract the possibility that your body is going to rebel against you,” he says. “The medicine helps immeasurably, and I’ve become an evangelist for it. It’s improved my career by making me a more confident public speaker.”

So when I began working on a book about how people get psyched up to perform better at work, I decided to give beta-blockers a try.

On a winter evening, I’m sitting in the crowded waiting room of a medical office. I’m here to see a certified nurse specialist, to try to get a prescription for propranolol , the generic beta-blocker my friends have been using.

In her office, the nurse taps on an iPad, asking for my biographical information—name, address, employer, insurance.

She asks about my emotional well-being and professional life. I tell her that I spend most days writing and editing, but that my job does require occasional public speaking. In my last job, my employer asked me to make periodic appearances on television; although these opportunities have waned since I changed jobs, I still go on camera every once in a while. When I do, I experience the classic markers of performance anxiety : the dry mouth, the tight throat, and the rapid heartbeat. When my kids have seen me on TV, they’ve teased me about compulsive blinking. I tell the nurse about my friends who take beta-blockers before speeches. “They say it takes the physical signs of nervousness off the table, and it’s made a big difference in their careers,” I say.

The nurse nods approvingly. She’s had patients who’ve had great results with propranolol. In fact, she suddenly scowls and looks annoyed. Earlier that morning, she’d seen a patient who was distressed because she’d become extremely nervous during a job interview. In retrospect, the nurse says she wishes she’d recommended propranolol, and she makes a note to call the patient after I leave to discuss it. After a few more minutes of conversation, she electronically sends the prescription to CVS, where I pay a $7 co-pay for 30 tablets of propranolol, renewable three times.

A few weeks later, I’m scheduled to fly to California to moderate a panel discussion in front of an audience of 75 people. It’s a chance to try out my new pills, and I’m excited—but I inadvertently leave the bottle in my car at the airport. At the conference, I’m well prepared and not particularly nervous; I lead the discussion drug-free without a hitch.

While I wait for more chances to try the drug, a friend texts me in a panic. He’s recently taken a new job, and the next morning he has to make a one-on-one presentation to his firm’s CEO. He cuts to the chase. “You know those pills you were telling me about for performance anxiety? Can I grab some from you before I get on the plane?”

I say no, fearing it would be illegal to share them. He pressures me. I come up with a compromise. “Okay, I’ll drop some pills off late tonight,” I tell him. Then I drive to CVS, buy a bottle of vitamin B12, and leave five tablets in an envelope taped to his door. I text him careful instructions: Take one pill 90 minutes before the presentation, and another 15 minutes beforehand if he still feels nervous.

Later, he texts me from the plane: “What is this medication called?” “Propranolol,” I lie. He googles it and starts reading online reviews. “Wow, people really rave about this stuff,” he says.

After the meeting, I text him: “How did it go?” “Really well,” he replies. “Those pills are magic.”

My friend’s experience illustrates how hard it is to know how well these drugs really work: Because we want them to work, the odds of a placebo effect is high—and because the pills’ effect is signified by the absence of something, it’s difficult to know if the pills really kept you from feeling nervous. It’s similar to the flu vaccine: If you get the shot, and you don’t get the flu that year, can you say for certain that the immunization prevented the illness?

Placebo or not, I notice an effect when I start trying them. Although I don’t have any other public speaking opportunities in the weeks after I obtain the prescription, I take the pills a few times before important interviews at work. I tend not to get nervous during interviews ... except, occasionally and unpredictably, I’ll start sweating. I remain sweat-free while on beta-blockers, with no rapid heartbeat or shallow breathing—though it’s hard to say how much to credit the drug for that.

The beta-blockers have a more noticeable effect in an unlikely setting: a two-day, 20-man annual golf tournament I play in with friends each year. I’m the worst golfer in the group, but on the first day, I play poorly even by my low standards. The next morning, on the driving range, I pop a propranolol. On the first tee, I’m unusually calm. (There’s a reason the PGA bans players from taking beta-blockers.) I still post the day’s poorest score, but I play far better than I usually do. The lack of nervousness is especially noticeable on tee shots and important putts—and with my handicap giving me strokes against my opponents, I keep my match competitive until the 16th hole. By then the drugs have worn off, and as I stand over a putt, I feel the familiar jitteriness—one I hadn’t felt that morning. Nonetheless, even my opponents notice the difference. “Dan played out of his mind today,” one announced over drinks at the clubhouse after the round.

I can only hope the pills work that well at my next public speaking opportunity.

This article is adapted from McGinn’s recent book, Psyched Up: How the Science of Mental Preparation Can Help You Succeed .

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Presentation Anxiety: How to Overcome Stage Fright (Complete Guide)

Tyler Ellis

Glossophobia, the fear of public speaking, is thought to affect as much as 75% of the population. For both students and professionals alike, this phobia tends to take the form of presentation anxiety. So, how can we overcome stage fright and presentation anxiety once and for all?

While avoiding presentations may bring some short-term relief to your anxiety, this will worsen your stage fright in the long-run. To overcome presentation anxiety long-term, presentation tools and gradual practice are the most effective solutions.

Maybe, right now, you’re extremely anxious about a presentation coming up. Maybe the only thought racing through your mind is how in the world am I going to get out of giving this presentation?

No worries. This guide is going to cover everything – and I mean everything – you’ll need to know. Make sure not to skip the section on “alternative ways of presenting,” I think you’ll find those really useful!

No need to stress; let’s get right into this.

What Causes Presentation Anxiety?

First things first… why do we feel presentation anxiety in the first place?

Sure, we might expect our heart to pound and breathing to accelerate as we walk along the edge of a cliff – but during a presentation? What part of talking about George Washington Carver inventing peanut butter should cause our hands to tremble and our voice to stutter?

Well, as it turns out, presentation anxiety is caused by ancient mechanisms in our brain responsible for our survival. For anxious people, our brain perceives being the center of attention in large group to be a threat. This triggers the “fight or flight” response, causing us to panic as we try and escape our uncomfortable setting.

Obviously, we are in no real danger while giving a class presentation or work presentation. Many years of evolution, however, have trained us to avoid stage fright with a passion. In ancient times, being surround by a (potentially angry) mob could have fatal consequences; as could being humiliated, rejected, or otherwise cast out from the tribe.

For many of us – especially those of us prone to social anxiety – such fears have stuck with us since caveman times. It’s important we remember these fears are harmless. Just being aware of their nature can help with this process. Despite what your brain and body may be telling you, these feelings of anxiety are not dangerous; they are going to pass.

Feel free to check out this article for a better understanding of the evolutionary psychology behind anxiety .

How to Get Out of a Presentation

I recommend against avoidance in most cases, as it only reinforces our anxiety in the long-run.

However, I know what it’s like to be a student with presentation anxiety.

I know how hard it is juggling academics, a social life, relationships, and newly blossoming anxieties all at once. I know that it can get so bad the most logical option feels like dropping out of school altogether. I don’t want you to feel like you have to do that.

So, if you’re really just not ready to overcome your stage fright:

• Intentionally Choose Classes That Don’t Require Presentations
• Tell the Teacher or Professor About What You’re Going Through
• Ask the Teacher or Professor for Alternative Assignments
• For Group Presentations, Ask Someone Else to Take the Lead
• Present Your Assignment in an Alternative Format Using Presentation Tools and Software (more on this in a bit)

If this seems a bit vague, it’s only because I’ve actually dedicated an entire article to this topic already. Check out this piece on how to get out of giving a presentation in class for more help with this.

Like I said, ultimately, avoidance is a poor strategy. However, I believe it’s just as detrimental to be “forced” into facing our fears before we are mentally prepared to do so. Having been there myself, I want you to be able to rest easy knowing that you do have some options here.

For this guide, however, I want to focus more on how to actually overcome presentation anxiety and stage fright.

My secret is – believe it or not – I get incredibly nervous before public speaking, no matter how big the crowd or the audience and, um, despite the fact that I laugh and joke all the time I get incredibly nervous, if not anxious, actually, before going into rooms full of people when I'm wearing a suit... And now that I've confessed that, I'll probably be even more worried that people are looking at me.

Prince Harry - Duke of Sussex, Member of the British Royal Family

How to Stop a Panic Attack While Presenting in Class

When I first started having panic attacks, I had no idea what they were or why they were happening. Prior to my first panic attack, I had never had an issue with public speaking or presentation anxiety at all. In fact, I had voluntarily participated in several clubs and activities that required public speaking.

Yet, when my first few panic attacks started (I was around 16 at the time), they would occur in any random situation. Wherever they occurred, I'd quickly develop a phobia associated with that location or situation. One such random panic attack occurred – you guessed it – during a class presentation.

While this experience was terrifying, embarrassing, and extremely uncomfortable, I had – fortunately – managed to keep it together enough for most people not to notice. For the many class presentations that would follow, however, I had to develop some tricks to stop panic attacks while presenting in class.

Here’s what worked for me:

• Volunteer to go first. This may seem strange, but I always felt it easier to volunteer first and get it out of the way. Oftentimes, it’s easier to deal with presentation anxiety when we don’t feel cornered. By choosing to do it yourself, you maintain some control of the situation and get the jump on things before anticipation anxiety kicks in .
• Remember you are not going to die. This is just a panic attack, and it’s going to pass. It may be uncomfortable, but it will be over within a few moments.
• Take control of your breathing. 478 breathing is a simple technique that works. Simply breathe in for 4 seconds through the nose, hold for 7 seconds, exhale for 8 seconds through the mouth.
• Find a focus object. Choose a point, or several points, to focus on in the room. This could be a ceiling tile, a lightbulb, a pile of books, anything. Whenever your thoughts start to wander or spiral out of control, recenter your thoughts on that focus object.
• Try and remember the other times you’ve given a class presentation with anxiety. Chances are, this isn’t your first time. Remember those past successes and visualize this presentation as one where you overcome stage fright as well. If your mind is drawn to a time when it didn’t go so well, at least remind yourself that it passed and you survived it; just as you’ll survive this one.
• If you have a friend in the class, look to them from time to time. Flash them a smile or a wink, and try not to laugh out loud while you’re up there. This may seem silly, but I’d rather stifle a laugh than grapple a panic attack.
• Remember that no one’s really paying attention. Just as you were sitting at your desk nervously thinking about your own turn to present, most people are doing the exact same now. And even if they’re not anxious, they’re probably zoned out or drifting off; it’s quite difficult to keep an involuntary crowd’s attention. Trust me, they’re probably not thinking about you much.

These are just a few ways to stop a panic attack while presenting in class. Of course, just about any method for stopping panic attacks can work well here, so feel free to explore our site a bit to learn some other methods.

There are only two types of speakers in the world:

1. The nervous

Mark Twain - American humorist, novelist, and travel writer

Alternative Ways of Presenting to Help Overcome Stage Fright

If you take nothing else from this article, I believe that this is the section that can help anxious students and professionals with stage fright the most. When I was dealing with presentation anxiety myself, most of these options didn’t even exist. If you’re anxious about standing in front of class and presenting, any of these could be fantastic alternatives to presenting.

Basically, any of these presentation software tools can help you to quickly create a visually stunning presentation; all without having to speak in front of the class. They utilize audio, video, and/or animation to create informative videos that get the point across even more effectively than conventional presentations.

For the most part, all a teacher or boss really cares about is that you: 

• Put hard work and dedication into your assignment
• Learned something throughout the process
• Are able to communicate what you learned to educate your peers

Telling the teacher “Sorry, I just can’t present today,” won’t meet any of these points, and is likely to land you a failed grade.

Instead, ask your teacher if you can use one of these presentation tools to create an even more engaging and informative presentation. This way, it’ll seem like you’ve put in the most effort in the class, rather than the least; all without having to speak in front of the class.

Here are the automated presentation tools I currently use myself and recommend:

I go into much greater detail on these tools here: automated presentation software . Before buying anything, I strongly suggest giving that article a read. Otherwise, Toonly and Doodly are my top picks.

What is the Best Presentation Anxiety Medication for Stage Fright?

Giving a presentation in high school or college can be extremely stressful for many people. If standing in front of the class feels like an impossible task, you may be wondering about presentation anxiety medication. So… what are the best drugs for presentation anxiety?

Since I’m not a doctor, I can only offer you a friendly opinion here.

In general, I think it’s a good idea to steer clear of anti-anxiety medication whenever it isn’t absolutely necessary. If your doctor prescribes you presentation anxiety medication, so be it. In the long-run, however, this can often create cycles of reliance and dependence that are best avoided.

But what about taking an over-the-counter supplement for anxiety before a presentation?

I have personally found one supplement to help me relax and communicate more confidently. This is my favorite supplement for stage fright, as it has helped me tremendously in situations where I would normally feel a bit socially anxious. I’ve used this supplement for presentations, job interviews, and even first dates.

My favorite supplement for presentation anxiety symptoms is phenibut. It just helps me feel significantly calmer while simultaneously boosting my sociability and confidence. This supplement is extremely affordable and legally sold online in most countries. If you want to learn a bit more about it, I have an article going into greater depth about phenibut here.

I do urge responsibility when using phenibut, as you don’t want to become reliant on it. But if it makes the difference between shirking your presentation vs. delivering a great one, I highly recommend it.

Let our advance worrying become advance thinking and planning

Winston Churchill - Former Prime Minister of the UK, Famous Orator

Tips for How to Present a Project Effectively

Few things help to eliminate anticipation anxiety like truly preparing for the situation. If your fears are rooted in delivering a poor or ineffective presentation, take some time to prepare.

Here are some tips for how to present a project effectively:

How to Overcome Stage Fright and Presentation Anxiety

There are many strategies we can take when dealing with our presentation anxiety or stage fright. Here are three of the most common strategies:

• Complete Avoidance – Post-college, public speaking occasions like presentations are pretty few and far between. As an adult, it isn’t too difficult to avoid presentations, although not overcoming stage fright can be a hinderance in many career fields.
• Reluctant and Occasional – Here’s where most people in the world probably fall. Most of us aren’t 100% comfortable with presenting, yet we suck it up and get it done when we have to. This isn’t a bad place to be, although it's uncomfortable occasionally.
• Conquering Presentation Anxiety – Some brave souls will choose to completely crush their fear of public speaking, overcoming stage fright and glossophobia entirely. This path is not for the faint of heart, as it isn’t easy; however, it has the largest payoff in the end with regard to career and confidence.

We’ve already discussed strategies for the first two earlier in this guide. Let’s now focus on the third.

How can we overcome presentation anxiety and glossophobia?

Well, whenever we want to eliminate a fear or phobia long-term, the best way to do so is through exposure therapy. We do have a full article on how to extinguish fears through exposure therapy if you’re curious to really understand this process.

For now, I’ll fill you in on the basics:

By gradually stepping outside of our comfort zone and exposing ourselves to our fears, we can eliminate those fears over time. The key here is that we are stepping a bit outside our comfort zone, but not immersing ourselves so fully to induce panic. In other words: challenge yourself at a fair pace.  

So how do we apply this to overcome presentation anxiety and stage fright?

My suggestion would be to identify the smallest voluntary step you can take outside of your comfort zone without panicking. Perhaps presenting may induce a panic attack, but are you at least able to read aloud from your seat? Perhaps reading aloud is difficult, but could you at least volunteer an answer from time to time?

This process will be as unique as a fingerprint for each person, as we all have different comfort zones and stressors. Try and find where your comfort zone ends and take small steps just outside of it. With repeated practice, you’ll notice your comfort zone expanding as you become more confident with the activity.

In general, here are some opportunities you may find useful for stepping outside of your comfort zone:

• Start raising your hand more often to ask or answer questions
• Volunteer to read aloud or answer a problem on the board whenever you’re feeling confident
• Create a presentation using presentation software (recommendations above), but see if you can actually get through it without relying on the audio. If you get too nervous, you can use it
• Rather than trying to get out of a presentation, ask your groupmates if you could take a lesser role with speaking; perhaps you could do more of the research to make up for it
• Seek out your local Toastmasters group to practice public speaking away from the pressures of your own social circles
• Try and attend small open mic nights and similar opportunities to gain experience with public speaking

Fun Fact: I successfully avoided presentations for the majority of my high school and college career. Afterward, I wound up working several jobs that forced me to confront this fear. First came a sales job, and next came a job that required me to speak in front of 150-200 people multiple times per day.

Turns out, I liked money more than I disliked public speaking.

List of Famous People with Public Speaking Anxiety

Sometimes a bit of solidarity goes a long way. Here’s a list of famous/successful people who have long been known to have suffered from public speaking anxiety:

• Winston Churchill
• Mahatma Gandhi
• Abraham Lincoln
• Prince Harry
• Warren Buffet
• Mark Zuckerberg
• Sigmund Freud
• Arnold Schwarzenegger
• Tiger Woods
• Rowan Atkinson
• Jackie Chan
• Thomas Jefferson
• Margaret Thatcher
• Princess Diana
• Eleanor Roosevelt
• Sir Richard Branson

As you can see… we’ve got some big names up there. And this is just a very small list of successful people who have been open about their public speaking anxiety – to say nothing of the silent majority!

Never forget, you’re far from alone in experiencing this – you can absolutely overcome presentation anxiety, stage fright, and glossophobia if you wish to!

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About the Author

Years of personal experience with anxiety disorders and panic attacks have led me to devise some pretty creative ways to keep my anxiety in check. In the past, anxiety and panic attacks felt like something I'd have to live with forever. Nowadays, panic attacks are a distant memory for me, and I'm free to pursue passions like writing and traveling the world. Hopefully, the information on this website can help you achieve the same. I do all the writing here myself, so don't hesitate to reach out with questions!

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Don’t Let Anxiety Sabotage Your Next Presentation

• Riaz Meghji

Stop focusing on yourself and start focusing on your audience.

If you want to beat speaking anxiety, you need to stop focusing on yourself and point your focus outward. This shift isn’t something that can happen instantaneously. It takes time, patience, and practice. Here’s how to get started.

• Be a giver, not a taker. Takers tend to have more anxiety. They want and need validation from their listeners.
• Givers, on the other hand, are all about service. They do work beforehand to connect with stakeholders and use the information they receive to address the needs of their audience. As a result, their presentation becomes less about them and more about helping the other people in the room.
• If you want to turn your presentation into an act of service, you need to talk to the people in the room — well before your presentation begins.
• Choose about three to five influential leaders, and meet with them before to learn their concerns and goals surrounding the topic you’re presenting on.
• Then, incorporate your findings into you presentation. This will help you shift your focus outwards, from yourself to the audience, and as a result, ease some of your nerves.

Where your work meets your life. See more from Ascend here .

How many times have you had an important message to share, only to be sabotaged by anxiety right before you speak?

• RM Riaz Meghji is a human connection keynote speaker, author of Every Conversation Counts: The 5 Habits of Human Connection That Build Extraordinary Relationships and creator of The Magnetic Presenter speaker coaching program. He is also an accomplished broadcaster with 17 years of television hosting experience. Riaz has hosted for Citytv’s Breakfast Television, MTV Canada, TEDxVancouver, CTV News, and the Toronto International Film Festival.  

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Public Speaking Anxiety Medication

January 11, 2024 by Arlin Cuncic, M.A.

Performance Anxiety Medication

Public speaking can be one of the most daunting situations for people with social anxiety. The fear of being judged, evaluated, and rejected by others can make speaking in front of an audience a terrifying experience. Even the thought of public speaking can make some people break out in a sweat and experience nausea, palpitations, and panic attacks. Fortunately, there are medications that can help with public speaking anxiety.

Public speaking anxiety medication options include beta-blockers (e.g., propranolol), benzodiazepines (e.g., lorazepam), and antidepressants (e.g., sertraline).

These medications can be effective in reducing physical symptoms of anxiety, such as sweating and tremors, and can help individuals feel more relaxed and confident during a presentation or speech. In this blog post, I’ll explore some of the medications used for public speaking anxiety and their benefits and risks.

What Is the Best Medication for Public Speaking Anxiety?

The best medication for public speaking anxiety varies from person to person, as different individuals may respond differently to various types of medication. It’s essential to consult with a doctor or mental health professional before starting any medication, as they can assess your individual needs and determine the best course of treatment.

Propranolol for Public Speaking

Beta-blockers are prescription drugs that block the effects of adrenaline, which is responsible for physical symptoms like increased heart rate, trembling, and sweating. They are typically used to treat high blood pressure, heart conditions, and migraines, but they can also be prescribed for public speaking anxiety.

One of the most commonly prescribed beta-blockers for this purpose is propranolol . It works by slowing down the heart rate and reducing tremors and sweating, making it easier for individuals to control their physical symptoms during a presentation or speech.

How Quickly Does Propranolol Work for Anxiety?

Propranolol is fast-acting, with effects peaking within 1-4 hours. This makes it an ideal medication for public speaking anxiety, as it can be taken before a presentation or speech and provide relief during that time. However, the duration of effects may vary from person to person, so it’s important to consult with a healthcare provider about the right dosage and timing for your specific needs.

How Much Propranolol Should You Take for Public Speaking?

The recommended dosage for propranolol in the treatment of public speaking anxiety is typically between 10-40 mg, depending on the severity of symptoms and individual response. This medication should be taken at least 30-60 minutes before a presentation or speech to allow enough time for it to take effect. Consult with your doctor or pharmacist for the best dosage and timing for your specific situation.

Can Ativan Help with Public Speaking?

Benzodiazepines are another type of medication that can be used to manage public speaking anxiety. They work by enhancing the effects of a neurotransmitter called GABA, which helps calm the brain and reduce feelings of anxiety. Benzodiazepines are typically prescribed for short-term use, as they can be addictive and may cause drowsiness and impaired cognition and coordination.

One commonly prescribed benzodiazepine for public speaking anxiety is lorazepam (brand name Ativan). It can help individuals feel more relaxed and less anxious during a presentation or speech. However, it should only be used under medical supervision due to the potential for dependency and side effects. For these reasons, it is not usually the first choice for public speaking anxiety medication.

Does Zoloft Help with Public Speaking?

Antidepressants are another option for treating public speaking anxiety. These medications work by balancing out brain chemicals that affect mood and emotions, such as serotonin. They are typically prescribed for long-term use and may take several weeks to start working. One commonly prescribed antidepressant for social anxiety is sertraline (brand name Zoloft). It can help reduce symptoms of anxiety and improve overall mood, making it easier for individuals to cope with public speaking situations.

While these medications can be effective in managing public speaking anxiety, they may also come with certain risks and side effects. Beta-blockers may cause low blood pressure, fatigue, and dizziness, while benzodiazepines can lead to dependency and impaired cognitive function. Antidepressants may cause nausea, headaches, and sexual dysfunction.

It’s important to discuss the potential benefits and risks of public speaking anxiety medication with a healthcare professional before starting treatment. They can help determine the best course of action based on an individual’s unique situation and medical history. In addition to medication, therapy and self-help techniques can also be effective in managing public speaking anxiety.

Performance Anxiety Medication Over the Counter

In addition to prescription medication, there are also some over-the-counter options for managing performance anxiety. These include natural supplements like L-theanine and valerian root, as well as herbal remedies such as passionflower and chamomile. While these may provide some relief for mild cases of public speaking anxiety, they may not be sufficient for more severe symptoms.

Supplements for Public Speaking Anxiety

Supplements like magnesium, L-theanine, and ashwagandha have been shown to help reduce stress and anxiety levels. Magnesium is essential for healthy brain function and can improve focus and concentration. L-theanine is an amino acid found in green tea that promotes relaxation without causing drowsiness. Ashwagandha , an herb from Ayurvedic medicine, has been used for centuries as a natural stress-reliever. You can find these supplements at most health food stores or online.

Natural Beta Blockers for Public Speaking

Beta blockers are typically prescribed by doctors to treat high blood pressure and anxiety. However, there are natural sources of beta blockers that can help manage performance anxiety. Chamomile tea , for example, contains apigenin, a natural beta blocker that can help calm nerves. Bananas also contain beta blockers, in the form of magnesium and potassium, which can help regulate heart rate and reduce physical symptoms of anxiety. Incorporating these natural options into your daily routine may help ease public speaking anxiety.

Does CBD Help with Public Speaking?

CBD , or cannabidiol, is a compound found in the cannabis plant that has been gaining popularity for its potential health benefits. It is not psychoactive like THC and does not cause a “high” feeling. Some studies have shown that CBD may help reduce symptoms of anxiety and improve overall mood, making it a potential option for managing public speaking anxiety. However, more research is needed to fully understand its effectiveness and safety. It’s important to consult with a healthcare professional before incorporating CBD into your anxiety management plan.

Other Strategies for Managing Public Speaking Anxiety

In addition to medication and supplements, there are also other strategies that can help individuals cope with public speaking anxiety. Cognitive-behavioral therapy (CBT) is a type of therapy that focuses on changing patterns of negative thinking and behavior related to anxiety. It can help individuals develop coping mechanisms for managing anxiety in public speaking situations.

Practicing relaxation techniques such as deep breathing, progressive muscle relaxation, and visualization can also be helpful in reducing anxiety. Engaging in regular physical exercise and maintaining a healthy diet can also have positive effects on overall mental health and reduce symptoms of anxiety.

Additionally, joining a support group or seeking guidance from a mentor or coach who has experience with public speaking may also provide valuable support and advice. Remember, everyone experiences some level of nervousness when speaking in public, and with the right tools and strategies, it is possible to manage and overcome public speaking anxiety.

Related Posts About Public Speaking Anxiety

• Social Anxiety Medication
• Nootropics for Social Anxiety
• What Causes Fear of Public Speaking?

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• Patient Care & Health Information
• Diseases & Conditions
• Anxiety disorders

You may start by seeing your primary care provider to find out if your anxiety could be related to your physical health. He or she can check for signs of an underlying medical condition that may need treatment.

However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy).

To help diagnose an anxiety disorder, your mental health provider may:

• Give you a psychological evaluation. This involves discussing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems — such as depression or substance misuse — which can make diagnosis more challenging.
• Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder.
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The two main treatments for anxiety disorders are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

• Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.

Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.

CBT includes exposure therapy, in which you gradually encounter the object or situation that triggers your anxiety so you build confidence that you can manage the situation and anxiety symptoms.

Medications

Several types of medications are used to help relieve symptoms, depending on the type of anxiety disorder you have and whether you also have other mental or physical health issues. For example:

• Certain antidepressants are also used to treat anxiety disorders.
• An anti-anxiety medication called buspirone may be prescribed.
• In limited circumstances, your doctor may prescribe other types of medications, such as sedatives, also called benzodiazepines, or beta blockers. These medications are for short-term relief of anxiety symptoms and are not intended to be used long term.

Talk with your doctor about benefits, risks and possible side effects of medications.

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Lifestyle and home remedies

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

• Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.
• Avoid alcohol and recreational drugs. These substances can cause or worsen anxiety. If you can't quit on your own, see your doctor or find a support group to help you.
• Quit smoking and cut back or quit drinking caffeinated beverages. Both nicotine and caffeine can worsen anxiety.
• Use stress management and relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.
• Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.
• Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed.

Alternative medicine

Several herbal remedies have been studied as a treatment for anxiety, but more research is needed to understand the risks and benefits. Herbal and dietary supplements aren't monitored by the Food and Drug Administration (FDA) the same way medications are. You can't always be certain of what you're getting and whether it's safe. Some of these supplements can interfere with prescription medications or cause dangerous interactions.

Before taking herbal remedies or dietary supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Coping and support

To cope with an anxiety disorder, here's what you can do:

• Learn about your disorder. Talk to your doctor or mental health provider. Find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends and ask for their support.
• Stick to your treatment plan. Take medications as directed. Keep therapy appointments and complete any assignments your therapist may give you. Consistency can make a big difference, especially when it comes to taking your medication.
• Take action. Learn what triggers your anxiety or causes you stress. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.
• Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
• Join an anxiety support group. Remember that you aren't alone. Support groups offer compassion, understanding and shared experiences. The National Alliance on Mental Illness and the Anxiety and Depression Association of America provide information on finding support.
• Learn time management techniques. You can reduce anxiety by learning how to carefully manage your time and energy.
• Socialize. Don't let worries isolate you from loved ones or activities.
• Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus your mind away from your worries.

Preparing for your appointment

You may start by seeing your primary care provider. He or she may refer you to a mental health professional.

What you can do

Before your appointment, make a list of:

• Your anxiety symptoms. Note when they occur, whether anything seems to make them better or worse, and how much they affect your day-to-day activities and interactions.
• What causes you stress. Include any major life changes or stressful events you've dealt with recently. Also note any traumatic experiences you've had in the past or as a child.
• Any family history of mental health problems. Note if your parents, grandparents, siblings or children have struggled with any mental health problems.
• Any other health problems you have. Include both physical conditions and mental health issues.
• All medications you're taking. Include any medications, vitamins, herbs or other supplements, and the doses.
• Questions to ask your doctor to make the most of your appointment.

Some basic questions to ask your doctor include:

• What's the most likely cause of my anxiety?
• Are there other possible situations, psychological issues or physical health problems that could be causing or worsening my anxiety?
• Do I need any tests?
• Should I see a psychiatrist, psychologist or other mental health provider?
• What type of therapy might help me?
• Would medication help? If so, is there a generic alternative to the medicine you're prescribing?
• In addition to treatment, are there any steps I can take at home that might help?
• Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, such as:

• What are your symptoms, and how severe are they? How do they impact your ability to function?
• Have you ever had a panic attack?
• Do you avoid certain things or situations because they make you anxious?
• Have your feelings of anxiety been occasional or continuous?
• When did you first begin noticing your feelings of anxiety?
• Does anything in particular seem to trigger your anxiety or make it worse?
• What, if anything, seems to improve your feelings of anxiety?
• What traumatic experiences have you had recently or in the past?
• What, if any, physical or mental health conditions do you have?
• Do you take any prescription drugs?
• Do you regularly drink alcohol or use recreational drugs?
• Do you have any blood relatives who have anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time.

• Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Feb. 26, 2018.
• Anxiety disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed Feb. 26, 2018.
• Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. March 5, 2018.
• Anxiety disorders. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders/Overview. Accessed Feb. 25, 2018.
• Help with anxiety disorders. American Psychiatric Association. https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders. Accessed Feb. 28, 2018.
• Reinhold JA, et al. Pharmacological treatment for generalized anxiety disorder in adults: An update. Expert Opinion in Pharmacotherapy. 2015;16:1669.
• Bandelow B, et al. Efficacy of treatments for anxiety disorders: A meta-analysis. International Clinical Psychopharmacology. 2015;30:183.
• Find support. National Alliance on Mental Illness. https://www.nami.org/Find-Support. Accessed Feb. 26, 2018.
• Bazzan AJ, et al. Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Review of Neurotherapeutics. 2014;14:411.
• Natural medicines in the clinical management of anxiety. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 26, 2018.
• Sarris J, et al. Plant-based medicines for anxiety disorders, Part 2: A review of clinical studies with supporting preclinical evidence. CNS Drugs. 2013;27:301.
• Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Herbs and medications. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2018.
• Bystritsky A. Pharmacotherapy for generalized anxiety disorder in adults. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2018.
• Sawchuk CN (expert opinion). Mayo Clinic, Rochester, Minn. March 21, 2018.

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Drugs for public speaking fear: Should I take Beta Blockers?

Beta blockers are a class of drugs for anxiety that block the action of adrenaline in the body. Therefore the physical symptoms of the stress response   are reduced. I’m often asked if they should they used for public speaking fear?

Firstly, beta blockers are not officially drugs for anxiety, but cardiac medications . However, by reducing some of the symptoms associated with public speaking anxiety, like the ‘shakes’, the idea is that they can help you concentrate on the task at hand.

For example, since they can lower heart rate, beta blockers have been used by Olympic marksmen to provide more aiming time between heartbeats. Some musicians use beta blockers to reduce the adrenaline-driven shaking  during auditions and performances. And it’s rumored that many politicians use them for important speeches.

The 3 questions are:

• Do they really work?
• Are they safe?
• What’s the best way to manage public speaking anxiety?

1. Do they really work?

What can they do.

Nobel prize-winning scientist, James Black , invented beta-blocker drugs to block the effect of adrenaline on the heart. So beta-blockers can reduce the adrenaline-related physical symptoms associated with the stress response. Some scientific studies show that beta blockers significantly reduce symptoms like shaking hands that can hinder some musicians playing. Those in the studies said they felt better about their performance after taking beta blockers, and music critics consistently judged their performances to be better.

One of my clients – a senior manager in the entertainment industry – has used beta blockers for important presentations with no side effects. He said the physical symptoms he usually felt (heart racing and shaking of hands) made him spend too much time thinking about the nerves and how to control them. So he was more formal and stuck closer to ‘script’.

With the beta blockers reducing those symptoms, he felt free to be more conversational and expansive. So, he found the experience positive, however…

What can’t they do?

… he pointed out that they are useless if you’re not prepared . Public speaking fear is built on uncertainty – and if you feel uncertain about your preparation, your anxiety will increase. Some of the work we did together focused on message and structure which provides a foundation of clarity – as well as providing a ‘roadmap’ for the delivery of a speech or presentation. If you’re standing there thinking ‘I’m not sure what my point is here’, they won’t improve things.

Beta blockers can’t help anxiety of a purely psychological nature. If your public speaking anxiety shows itself mainly in psychological ways (e.g. general uncertainty or negative inner voices), beta blockers will not help you.

Reduced energy levels

Another thing to consider is that many people feel adrenalin helps them focus, giving them an edge that adds intensity to the performance. Australian actress Cate Blanchett has said, ‘a little bit of fear keeps one on one’s toes’.

When I was 19 and playing football semi-professionally, I saw a specialist about the migraine headaches I would get after each match.‘Post exertional headaches are a documented condition’, he said. I remember feeling a wave of relief that modern medicine understood my pain and would have a cure. He placed a vial of pills on the table.

‘These are drugs to reduce heart rate and blood pressure, which should therefore reduce your headaches.’ ‘But won’t that reduce my energy and physical performance on the field – the same effect as me not exerting myself as much?’

‘Well, yes.’

I didn’t use them.

2. Are they safe?

Beta blockers are prescription medications for good reason. There’s a fairly long list of side effects , including:

Rash, anaphylactic shock (sudden unconsciousness or death), cold extremities, fainting, dizziness, fatigue, headache, depression, sleep disturbances, nightmares, hallucinations, short term memory loss, high or low blood sugar, stomach ache, flatulence, constipation, nausea, diarrhea, dry mouth, vomiting, heartburn, bloating, impotence or decreased libido, difficulty urinating, bronchospasm, cough, wheezes, naal stuffiness, joint pain, and muscle cramps.

Although this is an exhaustive list, many performers who take beta blockers in small doses and or special occasions have found no side effects at all from their use.

The positive view…

According to a 2004 New York Times article, the editor of the Harvard Medical Letter, Michael Craig Miller, thinks there is little risk in taking them because they only affect physical, not cognitive anxiety. “Stage fright is a very specific and time-limited type of problem. There’s very little downside except whatever number you do on yourself about taking the drugs” he said.

The cautionary view…

An opposing view can be found in the comments left by musicians at www.hornplayer.net :

• “A common side effect is loss of concentration, and my playing rapidly went downhill because of this… I ended up sounding as if I were sight reading. As soon as I figured out the connection, I quit the pills for good; I never really needed them, anyway.”
• “…in performance, I had 3 quite severe panic attacks, something I never had experienced prior to that year or since. If you ever read any of the books on prescription drugs, a caution often added is that certain drugs may produce the opposite effect from that intended, so – be careful and check it out, as it’s a very individual thing.”

3. What’s the best way to manage public speaking anxiety?

The real objective when speaking in public is to think clearly – and speak clearly. So a better question than ‘are drugs good’ is ‘what’s the best way to mange stage fright?’

Many people believe they can’t think clearly because the physical symptoms are overloading your system. The irony is that the intensity of your physical symptoms is a result  of not thinking clearly.

Half of the physical symptoms are due to the initial stress response, while the other half are the result of the way you think about the situation .

The physical symptoms are real, but their  intensity  is directly related to the way you process them. For example, if you believe that your shaking hand (a minor symptom of the adrenaline released to give you energy for your speaking event) means that you are ‘losing control of your body!’, all your physical symptoms will increase with the drama of that thought . In other words, the stress response increases when we perceive a threat to our safety.

So symptoms can be reduced if we come to the conclusion that there is no real threat . So, when you know WHAT to do and HOW to do it (tip: natural style), your mind is efficiently directed and speaking anxiety is manageable.

Now, it’s possible that one drug-induced positive experience will help you come to that conclusion. But there are some risks associated with that path.

You could also learn the Vivid Method which demystifies public speaking anxiety and shows you how to redirect your attention to stay in control.

You see, nerves are okay. They’re manageable. They’re a useful signal. If you rely on medication you are saying your nerves are out of your control, treating your body as the enemy and the signals as a demon to be exorcized.

This fight or flight response (and your public speaking fear) can be minimised when we understand what’s going on and realise it’s something we can influence – something we can manage. —– If you’d like to develop your presentation skills, consider:

• Presentation Skills Training
• Presentation Skills public course
• Message Development Sessions

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Presentation Anxiety Drugs & Medication

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Drugs & Medication

Presentation anxiety pills & medicines.

Many different types of medications are used in the treatment of phobias like presentation anxiety, including traditional anti-anxiety drugs such as benzodiazepines, and newer options like antidepressants and beta-blockers.

Drugs can seem very effective in the short term, but they are not a cure . Anxiety medication can provide temporary relief, but it doesn’t treat the underlying cause of the disorder. Once you stop taking the drug, usually all the symptoms of presentation anxiety return in full force.

You need to be aware of the risks of anxiety medication, too: Anxiety drugs often cause a wide range of unpleasant and sometimes even dangerous side effects.

Many anxiety meds are habit forming and physically addictive too, making it difficult to get off the medication once you’ve started. The bottom line is that anxiety medications can be helpful in the short term but can only ever mask the symptoms of presentation anxiety, never cure and tackle the root cause.

The Best Drug or Medication for Presentation Anxiety

We strongly believe that no medication is the best prescription for presentation anxiety . If you are currently taking meds, of course, you should consult with your doctor before changing anything, but we believe the goal should always be to deal with the source of the problem , so you will not need pharmaceuticals.

That said, three types of medication are commonly used in the treatment of presentation anxiety (glossophobia):

Beta blockers

Beta blockers are used for relieving performance anxiety. They work by blocking the flow of adrenaline that occurs when you’re anxious. While beta blockers don’t affect the emotional symptoms of anxiety, they can control physical symptoms such as shaking hands or voice, sweating, and rapid heartbeat.

Antidepressants

Antidepressants can be helpful when the feelings of fear are severe and debilitating. Three specific antidepressants — Paxil, Effexor, and Zoloft — have been approved by the U.S. Food and Drug Administration for phobias.

Benzodiazepines

Benzodiazepines are fast-acting anti-anxiety medications. However, they are sedating and addictive, so they are typically prescribed only when other medications have not worked.

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Beta-Blockers For Speeches – Can Beta Blockers Help With Public Speaking?

Over 40% of American adults claim to have a fear of public speaking, according to surveys, and the only fear more common is snakes! Since a 1965 article published in the Lancet, performers have been using beta-blockers (heart medication) “off-script” to help deal with their stage fright and performance anxiety, and that includes public speakers. Considering that the link between beta blockers and public speaking goes so far back, we wanted to investigate why performers are using beta blockers to help with their performance anxiety issues, if they actually work and what the side-effects may be, as well as covering several alternatives to beta-blockers.

Beta-Blockers for public speaking Key Takeaways

Without completely spoiling the rest of this article, here are the most interesting & useful takeways about Beta-Blockers for public speaking :

• Beta-blockers are prescription drugs typically prescribed for cardiovascular conditions like high blood pressure, angina (chest pains) and irregular heart rhythm (arrhythmia). The main function of beta-blockers is to block the release of adrenaline and other stress hormones in the body, and that's why many speakers and performers use beta-blockers to help with their performance anxiety and stage fright symptoms.
• The most popular beta-blocker used for public speaking is Propranolol (brand name Inderal), followed closely by alternatives like Metoprolol, Atenolol, Carvedilol & others. When used occasionally, beta-blockers appear to have minimal risk of side effects. However, dependency on beta-blockers to perform and speak is common, and why those who use beta-blockers regularly should consider alternatives.

Getting up to speak in front of an audience is a nerve-wracking experience for most (if not all). For some, public speaking is a full-blown phobia . It’s such a wide-spread fear, that the fear of public speaking (scientific name Glossophobia ) is often ranked in the top 5 list of peoples largest fears in life.

One particular survey found that the fear of public speaking affects 40% of Americans, making glossophobia/fear of public speaking the second most common fear in the US, behind snakes [1] . Another study found that nearly 75% of people suffer from some form of glossophobia at some point in their life [2] .

These studies just go to show that the physical and mental effort of speaking in front of a crowd is overwhelming for many. Fear of public speaking can cause problems in an affected person’s life, such as slowing professional progression, and causing anxiety over common social situations.

The good news is that there are several solutions and strategies to help overcome glossophobia/fear of public speaking, and one of the more popular solutions being used by professional performers today are beta blockers .

In this article we are going to look into using beta blockers for public speaking, going into whether beta-blockers actually help with performance anxiety and stage fright, if they’re safe, what the side-effects and alternatives are and much more.

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Beta Blockers & Public Speaking: a Long History

You may have heard about many performers (musicians, professional public speakers, actors, etc.) who used to experience pre-performance jitters and anxiety symptoms, benefiting from using beta-blockers .

Beta-blockers are a type of pharmaceutical drug that doctors typically prescribe for cardiovascular conditions like high blood pressure, angina (chest pains) and irregular heart rhythm (arrhythmia). The full name is beta-adrenergic blocking agents and their main function is to block the release of adrenaline and other stress hormones [3] .

Because of the way beta-blockers work within the body, many performers and public speakers use them to block the symptoms of performance anxiety . Actually one of the first popular mentions of beta blockers being used for anxiety purposes was a Lancet article from 1965 [4] . That article and tons of further research into stage fright & anxiety tells us that performers are experiencing the physical symptoms of performance anxiety in the first place because of the adrenaline pumping through their bloodstream and their heart working with greater force.

By blocking the release of stress hormones; beta-blockers are preventing the heart from going into overdrive, keeping blood pressure low, and keeping performance anxiety symptoms at bay [5] .

Do Beta Blockers Really work?

People use beta-blockers “off-script” for public speaking because it is too much adrenaline that is responsible for their performance anxiety symptoms in the first place.

When you’re feeling anxious about something, like giving a public speech, it is to be expected that you’ll feel some level of stress. Naturally, you will feel somewhat of an adrenaline rush as a part of that stress response. For most people, that stress response is not a big deal, and they might even use it to their advantage to up the intensity of their performance [6] .

But if you experience performance anxiety, that stress response has gone too far. You are experiencing a much greater effect of the adrenaline hormone, which causes your heart rate to skyrocket, along with other symptoms of stage fright and anxiety.

Since beta-blockers block the effects of adrenaline, they also prevent you from experiencing the physical symptoms of that same anxiety. Remaining physically calm has an overall calming effect, which then allows you to get through your speech and keep your stress response at bay.

So yes, beta blockers do work for blocking the effects of adrenaline.

Beta Blocker OTC Brand Names

There are various beta-blockers available today, but here are some of the most common ones available (and their ingredients).

• Inderal (Propranolol)
• Lopressor (Metoprolol)
• Sectral (Acebutolol)
• Coreg (Carvedilol)
• Tenormin (Atenolol)
• Zebeta (Bisoprolol)

All of these beta-blockers are prescription drugs. Inderal/Propranolol is the most common of them . There are also other medications that people commonly use off-script for anxiety, like Clonodine and Depakote , but these are not technically beta-blockers so we won’t cover them here.

It is critical to remember that everyone responds to medications and treatments differently. If you’re considering using beta-blockers for anxiety , or any another condition, be sure to consult a medical professional before you begin.

Are Beta Blockers Safe?

As long as you are only using beta-blockers occasionally, they seem to be quite safe with minimal risk of side effects.

Problems can arise if you need beta-blockers to be able to perform at all , as that’s when you might start using them frequently.

If you’re using beta-blockers too much, then it could get to a point where you become dependent on beta-blockers , and withdrawal could cause other problems such as high blood pressure.

So beta-blockers are safe to use when you need a quick stage fright solution, but it might be a good idea to start incorporating some natural alternatives to beta-blockers, as we will discuss later.

Beta-blocker side-effects

Beta-blockers are generally considered to be safe for public speakers (or any performer). Especially if you only take them occasionally. But beta blockers can come with potential side effects, although not too common among public speakers who only use beta-blockers every now and then.

Here is a list of the potential side effects of beta-blockers [7] :

• Mood disorders
• Digestive issues like gas, bloating, and constipation
• Nausea, and in some cases, vomiting

In some rare, but severe cases, one might also experience the following side effects from beta-blockers:

• Wheezing and/or shortness of breath
• Swelling of extremities like hands, feet, or ankles
• Pounding heartbeat

If you experience any of the side effects mentioned above, immediately notify your doctor.

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What’s the best way to handle public speaking anxiety?

Glossophobia/Fear of public speaking does not have to be a chronic, lifelong affliction. There are various strategies and tools that a person can use to overcome their fear of public speaking, including medications (like beta blockers of course), mental strategies and dietary supplements.

The strategy that works for one person may not work for the next. If you suffer from public speaking anxiety, it’s important that you try to understand the root causes of your phobia, and experiment with different tools to see what works for you.

Let’s take a look at a few ways people combat fears of public speaking.

Beta Blockers

As we’ve covered, beta-blockers don’t treat the actual causes of public speaking anxiety but they can lessen the symptoms of the fight or flight response, such as increased heart rate and blood pressure.

Beta-blockers do appear to have some level of efficacy at treating the symptoms of elevated stress hormones.

Many public speakers use beta-blockers as a short-term fix, and accept that beta-blockers may come with additional risks, such as addiction or dependence risks.

Mild cases of public speaking anxiety may be treatable simply with practice.

Many people struggle with public speaking simply because it’s new to them. The fear of the unknown and lack of confidence may manifest itself in extreme fear or anxiety .

However, once you get used to speaking in front of people, and develop confidence within these kinds of situations, the fear may go away.

This probably wont solve the fear of public speaking for everyone . For more serious cases of glossophobia, other tools and strategies will be needed. In particular, if someone doesn’t experience anxiety in any other social situations, yet speaking in front of a crowd immediately sparks a stress response, one of the more concentrated strategies may work best.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) helps you take challenges that you find overwhelming, such as speaking or performing in front of a crowd , and shifts your mindset around them.

CBT seeks to replace your harmful thought patterns by breaking them down into smaller parts, and then replacing them with positive ones [8] .

With CBT you work with a therapist and he or she will help you identify specific aspects of performing that you find stressful.

Then you would do mental exercises and assignments that create new positive associations with those performance aspects to make it less stressful, and eventually, something you look forward to.

Breathing Exercises

Certain breathing techniques can be effective in stopping the onset of physical anxiety symptoms caused by the body’s stress response.

While public speaking practice and CBT may help the problem long-term, breathing exercises can offer a short-term fix that you can put into practice before you need to address an audience.

One particular breathing exercise is known as “diaphragmatic breathing” or “belly breathing” , in which you take deep breaths, engaging the stomach and the diaphragm. In contrast to regular, unconscious breathing, an effort is made to bring the breath down into the stomach, which should rise and fall with each breath.

Diaphragmatic breathing has long been used in meditation, and meditative practices like yoga and tai-chi. Studies have shown deep breathing to have positive effects on cognition and stress, adequately reducing levels of cortisol, a hormone that gets released when we’re stressed or anxious [9] . It also helps reduce blood pressure and improve heart rate variability, which works to lessen the severity of symptoms one may experience with public speaking anxiety.

Natural Beta Blocker Alternatives

While many performers use beta-blockers like Propranolol and Metoprolol to help with their anxiety & stage fright, perhaps you’re not too excited about becoming dependent on a prescription beta-blocker every time you want to talk in front of an audience or know that you’ll be in a high-anxiety situation. Instead of having to get a prescription whenever you run out, you may want to consider a natural alternative to beta-blockers.

A natural alternative to beta-blockers would achieve the same end-result as a beta-blocker (providing relief from symptoms of performance anxiety) but it would do so by supporting your brain in a way that promotes overall relaxation, calmness, and improved cognitive function. The best natural alternative to beta blockers available today is PerformZen Calm Performance Formula .

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Performance Anxiety is common before a big event or performance. For some of us, the stakes are extremely high and we have to perform at our absolute best! PerformZen was created for you; the high level performer who wants to stay focused & creative while delivering the best performance of your life, without the crippling anxiety & nerves. 100% natural and with none of the side-effects of beta blockers. Get a 10% discount on PerformZen today :

PerformZen is a natural supplement designed to help public speakers overcome glossophobia symptoms, and maintain their composure and mental focus when they have to deliver a speech under pressure!

PerformZen works by boosting GABA, which is a neurotransmitter that promotes calmness [10] . It also contains magnesium and vitamin B6, which combine together to improve cognitive performance [11] .

Additionally, PerformZen contains L-theanine, theacrine, and Ginkgo Biloba, which are natural ingredients that promote calmness and provide a boost in clean energy.

If Beta Blockers aren’t the answer, what is?

Performance anxiety is no joke. If it’s more than a minor case of the jitters, it can have a significant impact on your life and ruin big moments for you (like giving successful public speeches).

But the good news is that you don’t have to let public speaking anxiety, or anxiety in general, control your life.

If you’ve been considering beta-blockers to help with your public speaking fears, you should know that although they can provide temporary relief, they are not a long term solution . Not to mention, there may be side effects, and you will need a prescription.

Natural supplements like PerformZen promote calmness and better mental function with ingredients that support your brain so it becomes more resilient to handle stressful situations like giving speeches/talks.

Check out PerformZen Calm Performance Formula today

Reference List:

• ^ https://news.gallup.com/poll/1891/snakes-top-list-americans-fears.aspx
• ^ https://sites.bu.edu/ombs/2017/11/27/what-is-glossophobia/
• ^ https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522
• ^ https://www.sciencedirect.com/science/article/abs/pii/S0140673665908639
• ^ https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/beta-blockers
• ^ https://uvitals.com/celebs-beta-blockers-anxiety/
• ^ https://www.nhs.uk/medicines/metoprolol/
• ^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/
• ^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/
• ^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594160/
• ^ http://www.researchautism.net/interventions/97/vitamin-b6,-magnesium-and-autism

Eric Reedle

Eric is a performance expert and a member of the PerformZen team since it was founded. Eric has battled anxiety his entire life and he is passionate about helping people gain control over the things that they fear most, with anxiety being at the top of that list for many!

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A Guide to Understnding Presentation Anxiety

We’ve all been there before. The room is dark, and the only light comes from the projector screen in front of you. You can feel everyone’s eyes on you, and your heart is racing. You take a deep breath and begin to speak, but your mind goes blank. You stumble over your words, and by the end of your presentation, you feel like a complete mess. If this sounds familiar, then you may be suffering from presentation anxiety. In this blog post, we will discuss what presentation anxiety is, how to recognize it, and how to overcome it!

• 1 Defining Presentation Anxiety
• 2 Signs And Symptoms
• 4 Link With Other Disorders
• 5 Consequences
• 6.1 Be rehearsed
• 6.2 Practice positive self-talk
• 6.3 Build cues
• 6.4 Ensure comfort
• 6.5 Release tension
• 6.6 Know your triggers
• 6.7 Set realistic goals
• 6.8 Breathe deeply
• 6.9 Normalize failure
• 6.10 Visualize success
• 6.11 Seek professional help
• 7 Conclusion

Defining Presentation Anxiety

The important thing to note is the difference between shyness/nervousness and anxiety. While everyone may get a bit nervous before presenting, those with presentation anxiety often experience more intense symptoms such as a racing heart, sweating, trembling, and even nausea. For some people, the fear is so intense that they may avoid presenting altogether.

It is also essential to keep in mind that presentation anxiety is not the same as stage fright. Stage fright is the fear of being on stage in front of an audience. This can be due to a bad experience in the past or a general feeling of uneasiness. While presentation anxiety is focused on the content of the presentation and how well you will do, stage fright is more about the physical act of being on stage.

Signs And Symptoms

Recognizing the signs and red flags of presentation anxiety is the first step in overcoming your fear. For some people, the symptoms may be very mild and only occur in specific situations. Others may find that their anxiety is more constant and interferes with their daily lives. The most common signs and symptoms of presentation anxiety include the following.

• Avoiding social situations or events where you know you will have to present
• Experiencing physical symptoms such as a racing heart, sweating, trembling, or nausea
• Feeling dizzy or lightheaded
• Having trouble sleeping or concentrating
• Feeling irritable or on edge
• Imagining the worst-case scenario
• Fearing that you will embarrass yourself or be judged negatively
• Having intrusive and negative thoughts
• Dry mouth or difficulty speaking
• Mind going blank during presentations
• Feeling like you are going to faint or pass out
• Experiencing anxiety or panic attacks in the days leading up to your presentation

It is important to remember that this is only an outline of some of the most common symptoms. Everyone experiences anxiety differently, so you may experience other symptoms not listed here. If you are unsure whether or not you are suffering from presentation anxiety, it is best to consult with a mental health professional.

• Fear of public speaking : For many people, the thought of speaking in front of a group is enough to trigger anxiety. This can be due to a bad experience in the past or a general feeling of uneasiness.
• Perfectionism: If you are someone who strives for perfection, then the thought of making a mistake in front of an audience can be very anxiety-inducing.
• Lack of experience : If you have little to no experience presenting, then it is only natural to feel anxious about it. The more you do it, the easier it will become.
• Imposter syndrome : This is the feeling of being a fraud or not good enough for the task at hand. It is common among high-achievers and can be very debilitating.
• Fear of being judged or evaluated negatively: This is a common cause of anxiety for many people. The fear of being judged by others can be very overwhelming and often leads to avoidance behaviors.
• Lack of preparation: If you do not feel prepared for your presentation, it is only natural to feel anxious.
• Previous bad experiences: If you have had a bad experience presenting in the past, it is likely that you will feel anxious about doing it again. This is because you may be worried that you will make the same mistakes or that the outcome will be just as bad.
• Low self-esteem or lack of confidence: Lastly, if you do not feel confident in your abilities, it is likely that you will feel anxious about presenting. This is because you may be worried that you will not be able to do a good job or that you will be found out as a fraud.

It is essential to remember that everyone experiences anxiety differently. What may cause one person to feel anxious may not have the same effect on another.

Link With Other Disorders

Our psychology and emotions are not separate entities. Therefore, it should come as no surprise that presentation anxiety is often linked with other disorders. The most common ones are as follows.

• Generalized anxiety disorder : This is a disorder characterized by excessive and long-lasting anxiety that interferes with daily life. It often leads to avoidance behaviors, as well as physical symptoms such as trembling, sweating, and difficulty sleeping.
• Social anxiety disorder : Also known as social phobia , this is a disorder characterized by intense fear and anxiety in social situations. It often leads to avoidance behaviors and can be very debilitating.
• Panic disorder: This is a disorder characterized by recurrent and unexpected panic attacks. These panic attacks are often accompanied by physical symptoms such as chest pain, heart palpitations, shortness of breath, and sweating.
• Agoraphobia : This is a disorder characterized by fear and anxiety of situations where escape may be difficult or impossible. It often leads to avoidance behaviors and can be very debilitating.
• Post-traumatic stress disorder: This is a disorder characterized by intrusive and distressing memories, flashbacks, and nightmares of a traumatic event. It often leads to avoidance behaviors and can be very debilitating.
• Obsessive-compulsive disorder : This is a disorder characterized by intrusive and distressing thoughts (obsessions) and/or repetitive behaviors (compulsions). It often leads to avoidance behaviors and can be very debilitating.

As you can see, presentation anxiety is often linked with other disorders. If you are experiencing anxiety, it is important to seek professional help.

Consequences

• Poor performance: When we are anxious, our performance often suffers. This is because we are not able to think clearly or focus on the task at hand. As a result, our presentations may be poorer quality and we may not be able to achieve our goals.
• Avoidance: As mentioned earlier, anxiety often leads to avoidance behaviors. This means that we may start to avoid situations where we have to present. This can lead to missed opportunities and a decline in our career or studies.
• Isolation : When we start to avoid social situations, we may start to feel isolated. This can lead to feelings of loneliness and depression .
• Health problems: Anxiety can also take a toll on our physical health. When we are anxious, our body goes into “fight or flight” mode. This means that our heart rate and blood pressure increase, and we may start to experience chest pain, headaches, and stomach problems.
• Mental health problems: Anxiety can also lead to mental health problems such as depression, eating disorders , and substance abuse .

If you are experiencing any of the above consequences, it is important to seek professional help. These consequences may be dire but are manageable. This is why it is important to seek professional help if you are experiencing anxiety.

Tips To Overcome

The good news is that there are a variety of treatment options available for those suffering from presentation anxiety. Some people may only need to make a few lifestyle changes, while others may require more intensive treatment. The key is to try different methods and see what works for you.

Be rehearsed

The foremost step to lessen your anxiety is to be rehearsed. This will help you be more confident and in control when presenting. You may do so by practicing your presentation in front of a mirror or videotaping yourself. This will help you catch any mistakes and give you a better idea of how you come across to others.

Practice positive self-talk

· “I am prepared.”

· “I can do this.”

· “I am confident.”

· “I am not perfect and that is okay.”

If you think you can make it to the end of your presentation without any cues, you are wrong. Cues help to ground us and remind us of what we need to say next. They can be anything from keywords written on index cards to physical prompts like rubbing your hands together. Incorporating these cues will help you feel more prepared and in control.

Ensure comfort

Anxiety is bound to make you feel odd or uncomfortable. To counter this, it is important to make sure that you are as comfortable as possible. This means wearing clothes that you feel good in, being aware of your posture, and making sure that the room temperature is not too hot or cold.

Release tension

Anxiety makes its way into our body and makes us hold onto tension. This can lead to physical discomfort and make it difficult to focus. To release this tension, you may want to try some relaxation techniques such as deep breathing, progressive muscle relaxation, or yoga. You may even want to try aromatherapy or meditation.

Know your triggers

Set realistic goals

When we set unrealistic goals, we are setting ourselves up for disappointment. This can trigger our anxiety and make it harder to cope. To avoid this, it is important to set realistic goals for ourselves. This means being realistic about what we can achieve and not putting too much pressure on ourselves.

Breathe deeply

Don’t forget to monitor your breathing. When we are anxious, our breathing becomes shallow and rapid. This can lead to dizziness and lightheadedness. To avoid this, make sure to take deep belly breaths throughout your presentation. This will help to calm you down and ease your anxiety.

Normalize failure

If you still fail or are unable to meet your goal, it is important to remember that this is normal. We all make mistakes and we all have days where things don’t go as planned. What is important is that you learn from your mistakes and keep trying. Don’t let one failure define you or your presentation skills.

Visualize success

Another method that can help ease your anxiety is to visualize yourself being successful. See yourself giving a great presentation and imagine the audience applauding you. This will help increase your confidence and reduce your anxiety.

Seek professional help

At last, if your condition is too severe and is impacting your daily life, it is important to seek professional help. This doesn’t mean that you are weak or crazy. It just means that you need a little extra help to get through this tough time. There is no shame in seeking help from a therapist or counselor. They may make use of the following techniques.

• Cognitive behavioral therapy : This type of therapy helps to identify and change the negative thoughts and behaviors that are causing your anxiety.
• Exposure therapy : This therapy involves gradually exposing yourself to the things that trigger your anxiety. This can help you to learn how to cope with your triggers and eventually overcome them.
• Narrative therapy : This therapy involves telling your story and working with a therapist to find a new perspective. This can help you to see your anxiety in a new light and eventually overcome it.
• Free association: This therapy involves saying whatever comes to mind without censoring yourself. This can help to identify the root of your anxiety and eventually work through it.
• Medication: In some cases, medication may be necessary to help control your anxiety. Your doctor can prescribe you with medication that will help to ease your symptoms.

If you suffer from presentation anxiety, know that you are not alone. Millions of people around the world suffer from this condition. However, there are ways to ease your anxiety and make it more manageable. By following the tips above, you will be on your way to giving a great presentation. So don’t let your anxiety hold you back—you can do this!

To conclude our blog post, we can say that presentation anxiety is a common problem that many people face. However, there are ways to overcome it. By being aware of your triggers, setting realistic goals, breathing deeply, and visualizing success, you will be on your way to giving a great presentation. If your anxiety is severe, don’t hesitate to seek professional help. With the right help, you can overcome your anxiety and live a normal life.

If you or someone you know is looking for psychological help, Therapy Mantra is here for you. We are the leading providers of online therapy and counseling. Our team of highly trained and experienced therapists can provide assistance at the most affordable rates. Contact us today to learn more about our services. You may also visit our website to book an  online therapy  session or download our free  Android  or  iOS app  for more information.

The mission of TherapyMantra is to provide inexpensive, accessible, and professional online mental health care to the individuals all around the world.

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Common Medications That Can Cause Anxiety

W hen we suffer from an ailment, whether something transient, such as a headache, or more chronic, like asthma, we trust that medication will help treat or cure whatever the ailment is. However, medications can come with side effects that can, at times, be just as troubling as the condition you're trying to treat. According to a 2013  study published by the AMIA Annual Symposium Proceedings Archive, nearly 70% of drugs have anywhere from 10 to 100 side effects. 

One of the potential side effects of your medication could be anxiety. While the Anxiety & Depression Association of America notes that nearly seven million adults suffer from Generalized Anxiety Disorder, one does not have to have anxiety to experience it as a side effect of medication. This is what is known as a substance-induced anxiety disorder, and it can be caused by the way the chemicals in your brain react to the medication you're taking (via Tufts Medical Center ). 

If you're experiencing symptoms of anxiety seemingly from out of nowhere, your medicine cabinet may be the first place you should check. These are a few medications that could be triggering anxious symptoms without you even realizing it. 

Read more: Scary Symptoms That Aren't As Serious As You Think

Corticosteroids

An anti-inflammatory medication, corticosteroids can be used to treat a number of conditions, including asthma, chronic obstructive pulmonary disease, and Chron's disease. They are very powerful medications, particularly when delivered in tablet form. Steroid tablets can impact the entire body, and caution should be exercised when prescribing or taking them, particularly when a person is suffering from any kind of mental health or behavioral issue. 

Because corticosteroids can reduce gamma-aminobutyric acid, which is a neurotransmitter that regulates central nervous system activity, it can lead to a change in mood and anxiety. A 2023  study published in Cureus showed that some patients who had taken corticosteroids exhibited signs of depression, anxiety, panic disorder, and other mental health issues. For patients taking corticosteroids for more than 60 days, the study reported that 90% showed adverse effects. Similarly, a 2020  study published in Neuroendocrinology revealed that corticosteroid use was linked to a reduction in executive cognitive functioning and a greater likelihood of developing anxiety disorders.  

Decongestants

No one enjoys having a stuffy nose, either as the result of allergies, the flu, or even a common cold. When the nose is blocked up, nasal decongestants usually offer the first line of defense, offering a brief respite from the blockage and allowing you to breathe more freely. These decongestants reduce the swelling of the blood vessels and tissues in your nose, which opens the airways and relieves that stuffed-up feeling.

According to the Mayo Clinic , some of the ingredients in nasal decongestants, such as pseudoephedrine , can cause such symptoms as insomnia, tremors, and anxiety. A 2018 study  published in the Journal of Undergraduate Neuroscience Education showed that the neurotransmitter responses to taking such stimulants as pseudoephedrine mimic the same responses generally associated with anxiety. In particular, pseudoephedrine increases the release of serotonin and dopamine in the brain. Having elevated levels of both of these neurotransmitters is also linked to anxiety. 

ADHD Medications

Stimulants such as Adderall change the chemicals in the brain to boost alertness and relieve the symptoms of ADHD. However, this chemical change can also produce anxiety, especially if the doses are not correct. While Adderall, for example, may not actually be the cause of your anxiety, it can cause such symptoms as higher blood pressure, raised heart rate, and insomnia . All of these conditions can increase anxiety or even induce a panic attack (via Everlast Recovery Center ). 

According to HealthMatch , Adderall can stimulate the amygdala, which is the part of the brain that reacts to danger. As a result, even if you are not in danger, this stimulation of the amygdala can trigger the fight-or-flight response in your brain, leading you to feel nervous, anxious, and tense. You could also feel physical symptoms such as hyperventilation, sweating, and trouble with concentration. If you're experiencing these kinds of symptoms while taking ADHD medication, it's a good idea to talk to your doctor. He or she can look into possibly prescribing an anti-anxiety medication to help balance out your symptoms.

Beta Blockers

Usually used to treat high blood pressure, beta blockers work by suppressing the body's production of adrenaline, which causes the heart to beat slower (via the Mayo Clinic ). In addition to hypertension, beta blockers can also treat other conditions such as arrhythmia, migraines, angina, and heart failure. Additionally, Calm Clinic notes that beta blockers could also increase the symptoms of anxiety. This is because the potential side effects of beta blockers, including shortness of breath, nightmares, and hallucinations, can cause panic in patients who already suffer from anxiety. 

According to a 2021  study published in Hypertension, beta blockers have been linked to a variety of mental health disorders, including depression and anxiety. These symptoms, among others, have been frequently listed as adverse reactions to these medications. Interestingly, however, beta blockers have also recently emerged as a possible treatment for anxiety in some cases, as reported by Texas Health . Because they block the production of adrenaline and slow the body's heart rate, beta blockers could be seen as a way to reduce the physical symptoms of anxiety and help to get the emotional effects under control as a result. However, this treatment may not be for everyone, and it's wise to discuss any anxiety treatment with your doctor to find the one that works best for you. 

Medications With Caffeine

Certain medications, such as those used to treat migraines, contain caffeine. Medications such as Excedrin, Anacin, and Darvon Compound all list caffeine as an active ingredient. This is partially because caffeine can affect the levels of a compound in the brain called adenosine. During migraine attacks, adenosine levels are known to rise, and caffeine can help reduce those levels and keep migraines at bay. 

However, particularly for patients who are already prone to anxiety, caffeine can make things worse. A 2013 study published in General Hospital Psychiatry showed that, in patients with a preexisting panic disorder, doses of caffeine equivalent to five cups of coffee were enough to induce a panic attack. However, these attacks were not always exclusive to patients who already had a panic condition. The study also reported that healthy adults also saw an increase in anxiety after consuming caffeine. Additionally, caffeine can impact your sleep, which can make managing anxiety even more difficult. A 2014  study published in the Journal of the American Academy of Child & Adolescent Psychiatry pointed to sleep problems as a red flag for anxiety disorders among young people.

Rescue Inhalers

For people who suffer from bronchial conditions such as asthma or chronic obstructive pulmonary disease (COPD), inhaled medications such as albuterol can be a great source of relief. Albuterol causes constricted airways to relax and allow air to flow more freely to the lungs. However, for all of its benefits, albuterol can come with some side effects, including chest pain, increased heart rate, dizziness, and feeling nervous. 

According to a 2022 article published in StatPearls, tremors and nervousness occurred in approximately one in every five patients who took albuterol. These tremors tend to be caused by albuterol's activation of the body's beta-2 receptor. This activation can trigger nerves in the body that control movement, resulting in shaking and tremors.  K Health  also notes that feelings of nervousness, agitation, increased excitability, and hyperactivity are all potential side effects of albuterol use, although they tend to be more common among children.

Antidepressants

Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) help to amplify the neurotransmitter serotonin in the brain, regulating your mood and making you feel happier (via Medical News Today ). However, in some cases, that boost of serotonin can cause anxiety levels to rise. A 2018  study published in Canadian Family Physician showed that, after starting an SSRI, the increase in serotonin levels could cause restlessness, irritability, and anxiety for anywhere from one to two weeks. 

In some cases, those side effects can persist even beyond those initial two weeks, as evidenced by a 2014  study  published by Neuropsychiatric Disease and Treatment. According to that study, seven percent of patients continued to experience antidepressant-induced jitteriness and anxiety a month after beginning antidepressant treatment. Additionally, these patients also experienced a host of other side effects, including hostility, aggression, panic attacks, and trouble staying still. This condition is known as either jitteriness syndrome or activation syndrome.

Thyroid Medications

If your thyroid gland is not producing enough thyroid hormone, it can lead to a condition known as hypothyroidism. When that happens, it can result in depression and anxiety. This is because the thyroid hormone plays a role in the regulation of such neurotransmitters as serotonin. When the thyroid isn't functioning properly, not only can serotonin production become low, it can also become irregular, leading to anxiety and panic attacks. 

However, treating hypothyroidism can also come with its own set of troubling side effects (via Medline Plus ). These can include anxiety, irritability, excessive sweating, and trouble falling asleep or staying asleep. According to a 2019 study  published in the International Journal of Environmental Research and Public Health, women who were treated with levothyroxine for hypothyroidism were more likely to experience anxiety and depression than women who did not have the condition. You should talk to your doctor before taking any medication for hypothyroidism to make sure that the medication and the dosage are right for you. They can check your blood regularly to keep an eye on your thyroid levels.

Anti-Seizure Medication

For patients who suffer from seizure disorders, medications such as phenytoin can be highly effective (via the Epilepsy Foundation ). Phenytoin, which is also marketed as Dilantin, keeps the brain cells from firing too fast during a seizure, sometimes stopping them before they have even had a chance to begin. It can also be used in some cases to treat psychiatric disorders, such as bipolar disorder. Because of its effectiveness and diverse uses, phenytoin is one of the most common anti-seizure medications currently on the market. 

Despite its effectiveness, phenytoin has been reported to cause alterations in mood and cognitive problems. A 2012 study published in the Indian Journal of Psychiatry reported a case of a 28-year-old male who displayed anxiety, aggression, and violent behavior. It was revealed that his phenytoin levels were very high and, over time, his symptoms improved greatly. It's also been reported that phenytoin can, in more serious cases, cause suicidal thoughts, increased depression, and potentially lead one to act on dangerous impulses (via Healthline ). If you are taking phenytoin and experience any of these effects, you should call your doctor or 911 right away. 

Read the original article on Health Digest .