The Ultimate Guide To Performance Anxiety

The Ultimate Guide To Performance Anxiety
Photo by Joice Kelly on Unsplash

ExecutiveChronicles | The Ultimate Guide To Performance Anxiety | That sinking feeling you experience when performing in front of an audience is a normal phenomenon for you and many people. However, these feelings of anxiety –also known as stage fright– can lead to something considered a disorder in clinical psychology. Many public performers, celebrities, athletes, and musicians usually have this problem. 

It’s normal to be nervous about performing. However, if this anxiousness overpowers you regularly and causes disruptive changes, it is an indication that there is something more going on. Performance anxiety can not only affect your current performance, but it can also negatively impact your career and self-image. It is good that performance anxiety is recognized as an actual disorder nowadays that can be managed and treated with the appropriate guidance from experts.

Definition of Performance Anxiety 

According to the Diagnostic and Statistical Manual of Mental Disorders, performance anxiety is categorized under social anxiety. It is defined as ‘a persistent fear of one or more social or performance situations in which the individual is exposed to unfamiliar people or possible scrutiny from others.’ The individual fears that they will behave in an unpleasant and humiliating manner (or exhibit anxiety symptoms).

Performance anxiety is a professionally acknowledged anxiety disorder recognized by doctors and experts. It is distinctive because it is characterized mostly by intense and excessive fear and worry over getting the work done. It can also relate to the fear of failing to complete and perform a task successfully and facing the consequences. This is referred to as stage fright when people suffer stress and tension while performing in front of an audience and being assessed. 

Almost anything can trigger performance anxiety. When left unchecked and untreated, it can result in an unhealthy pattern or throw someone in a loop of constant fear of performing. Luckily, numerous help for this type of disorder are available, such as Inpatient and Outpatient Anxiety Treatment and Counseling San Diego. Remember that proper diagnosis and treatments can help manage and resolve this problem and can even be overcome in time. 

Causes Of Performance Anxiety

As with other types of anxiety, the precise causes of this condition are unknown. Websites and blogs can provide information about the occurrence of performance anxiety in various scenarios. On the other hand, researchers may point out the reasons and risk factors that may be associated with:

  • Genetic factors

Many researchers believe that anxiety is genetic or passed down from your ancestors and is most certainly inherited. According to scientific evidence, genetic factors account for one-third of the risk of anxiety.

  • Biological factors

Anxiety occurs when the amygdala, the brain’s principal emotional processor, interprets incoming sensory cues as a threat, in this case, a performance. Other areas of the brain, particularly the hypothalamus, receive a distress signal and convey a warning to the rest of the body by activating the sympathetic nervous system. Furthermore, adrenaline, also known as epinephrine, is a hormone generated by the body’s adrenal glands to alert the brain, heightening one’s senses and inducing the fight-or-flight response. Simultaneously, serotonin and dopamine are two of the few necessary neurotransmitters in the body that, when interrupted, can lead to imbalances like anxiety.

  • Temperament and personality factors

Researchers suggest that temperament of behavioral inhibition may be a risk factor for anxiety. People with temperaments and personalities that are usually shy and nervous may be more prone to experiencing anxiety than others.

  • Environmental factors

A person’s circumstances or upbringing may cause or trigger risks of experiencing anxiety as well. Additionally, people can adapt to pressure from those around them or from those who exhibit obvious signs of stress in response to stimuli like the occurrence of a performance. 

Performance Anxiety vs. General Anxiety Disorder

The word anxiety is widely used these days in different contexts. Depending on the details and context, it may indicate several things. In Clinical Psychology, there are five types of anxiety disorders that a doctor may diagnose. Performance anxiety and General anxiety disorders are two of these five disorders that people may interchange without a proper diagnosis from a doctor. 

Generalized Anxiety Disorder (GAD) is defined by those who are so preoccupied with their fears and worries that it negatively impacts their daily life. Everyone experiences worry, but those with GAD feel it with greater intensity and frequency, as well as physical, biological, and behavioral symptoms. Typically, doctors diagnose GAD when a patient meets specific criteria, such as being unable to control their anxiety on more days than not for six months or half a year, as well as other symptoms of general anxiety disorder. Additionally, GAD may be caused or triggered by genetics, brain chemistry, and life circumstances. 

On the other hand, performance anxiety relies on experiencing symptoms anytime they are exposed to a setting that can give them anxiety, in this example, when they are being observed and evaluated by others. Rapid heart rate, hyperventilation, profuse sweating, bodily shaking or trembling, nausea, and other common symptoms. A little nervousness before a performance is normal, but when these fears become too much for a person to control and severely impact them physically, physiologically, and socially, it can be categorized as performance anxiety.

What makes performance anxiety different from a general anxiety disorder is the presence of a situation that can trigger the condition. Suppose a person only experiences these symptoms when subjected to a performance of any sort. In that case, it can signify that it is performance anxiety. Again, a proper diagnosis from a professional is needed to confirm these disorders, as self-diagnosis is highly discouraged in psychology.

Symptoms Of Performance Anxiety 

Various symptoms of performance anxiety can emerge in multiple ways and affect various aspects of your life. These symptoms may not appear in the same way for everyone, but they are usually comparable and can frequently occur in persons suffering from anxiety. 

Some manifestations of performance anxiety may include:

1. Physical

The most obvious indicators of someone suffering from performance anxiety can be found physically. Stress can activate an individual’s innate defensive system, commonly known as the fight-or-flight response. These indicators include, but are not limited to:

  • Blushing is a natural physical response caused by the sympathetic nervous system, which causes the blood vessels in the face to widen and increase blood flow to the skin, causing the skin to become red.
  • Tachycardia or heart palpitations. A surge of adrenaline causes your heart to beat faster as a response to the fight-or-flight mechanism, which ususally lasts for a few minutes.
  • Hyperhidrosis. Anxiety increases nervous system activity, driving adrenaline and triggering your sweat glands, causing excessive sweating.
  • Anxiety-related stomach and bowel issues trigger the release of the stress hormone cortisol, which stimulates the production of additional stomach acid.
  • Dyspnea or shortness of breath. Increased heart rate leads muscles to contract and prepare for action, necessitating increased oxygen intake and shortness of breath.
  • In some cases, a person may black out or faint. A blackout, also known as vasovagal syncope, occurs when the component of your nervous system that governs your heart rate and blood pressure overreacts to an emotional trigger. However, this scenario is not regarded as severe.

2. Cognitive

Performance anxiety can have long-term consequences for a person’s mental health. Other subtle signals that someone is suffering from performance anxiety are mental or cognitive problems such as:

  • Feelings of negative self-image. When someone cannot perform a task in front of an audience, they may feel negative and inferior to themselves. 
  • Negative self-evaluation of oneself. To rationalize their performance anxiety, a person may be unduly critical of themselves.
  • Internal locus of control or blaming oneself for flaws produced by forces beyond one’s control.
  • May find it difficult to accept compliments from other people due to negative self-image and negative self-evaluation
  • They have either too low or too high expectations about their talents. This rationale may encourage individuals to put pressure on themselves to improve, exacerbating their performance anxiety. 

3. Behavioral 

A person’s actions might also reveal whether or not they are suffering from performance anxiety. However, it may be the most elusive and difficult indicator to assess. These behaviors may, however, include:

  • Procrastination or deferring a task to a later time is the result of avoidance. It can both cause and be caused by anxiety.
  • Perfectionism and extreme fear of making mistakes are also warning signs. Performance mistakes are unavoidable, and perfectionism puts too much strain on one’s mental state.
  • Daydreaming is another escapism tactic and coping mechanism that can cause attention problems and, if used excessively, cause someone to lose their sense of reality.  

CBT Method For Performance Anxiety

Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for performance anxiety and other anxiety disorders. It seeks to comprehend your reaction to pressures and how your ideas function in this situation. A therapist may employ various tactics, such as pinpointing and identifying specific problems or challenges, understanding one’s unproductive thought patterns, and how they can affect one’s life. They can also assist in identifying and reshaping negative thinking to modify how you feel, and learn and implement new habits such as healthy coping methods. CBT therapists can also assist you in identifying which of your concerns are irrational and understanding how this affects your performance. 

Beta Blockers And Treatment of Performance Anxiety 

For people seeking management or treatment, physicians prescribe beta blockers to manage and treat the physical symptoms of anxiety. These beta blockers can help alleviate and control rapid heartbeat, trembling, and other physical manifestations of stress and can last several hours. Most of these medications are safe for patients and have little to no side effects. Beta-blockers are also non-habit forming for users. 

However, anxiety symptoms can sometimes be too intense. Beta-blockers can be ineffective in relieving symptoms because they cannot reduce or regulate them effectively. It’s also worth noting that beta blockers can lower blood pressure and slow heart rate. As a result, it is not suggested for persons with low blood pressure or a current diagnosis of cardiovascular disease. Furthermore, beta-blockers are also not recommended for people with diabetes or respiratory disorders like asthma.

Propranolol and Atenolol are two of the most often prescribed beta blockers today. These beta-blockers’ essential characteristics are as follows:

  • Propranolol 

Propranolol, often known as Inderal, is a short-term anxiety medication. It can control other performance anxiety symptoms and regulate peripheral symptoms, including rapid heartbeat, heavy sweating, and general tension. Propranolol is also noted for having few side effects among its users. 

Before taking Propranolol, you must first check with a doctor. Pregnant women and those who are breastfeeding await a doctor’s all-clear signal. Moreover, it is not recommended for people with chronic lung problems, asthma, diabetes, heart disease, or depression. Also, if Propranolol is taken daily, discontinuing the medicine abruptly is not advised.

Propranolol often has no adverse effects. However, there are a few cases of light-headedness, fatigue, short-term memory loss, languid pulse, lethargy, insomnia, diarrhea, cold hands and feet, numbness and tingling sensation in fingers and toes when taking this medication. For dosage and uses, consult a physician to ensure that the dosage is adequate for your situation and age. 

  • Atenolol

Atenolol, also known as Tenormin, lasts longer in comparison to Propranolol. It generally has lower side effects but tends to produce wheezing, among other beta blockers. 

However, if you’re taking it daily, discontinuing use abruptly can result in dangerously high blood pressure. For dosage and recommendations, a consultation from a physician is also highly recommended. 

Famous Cases of Performance Anxiety

Performance anxiety is a more common disorder than most people think ‐ it affects many Americans. Some of the famous people who have experienced this disorder are:

  • Former US President Thomas Jefferson was diagnosed posthumously by psychologists at Duke University.
  • Mahatma Gandhi ran out of the courtroom during his first trial.
  • The great Roman statesman Cicero once froze during a crucial public trial due to freezing and trembling. 

Other examples are celebrities like Barbra Streisand, Hugh Grant, and Donny Osmond. All have experienced messing up their public performances and speeches due to fear of performing in public.


Fear and anxiousness are expected before a performance. Still, when these anxieties generate more severe difficulties that affect you physically and mentally and interrupt your daily life, you should take them seriously. Understanding the causes of this disease, and the available aid and therapy for performance anxiety can help you manage and even conquer it later in life.

Photo by Joice Kelly on Unsplash