Performance anxiety

Why the body speeds up

Being evaluated touches something important: how others see us and what the result will mean. Faced with that, the body gets ready as if there were danger: a faster heart, sweaty hands, trembling, a dry mouth, racing thoughts. Feeling this before an exam or a presentation is common and, to some extent, expected.

The US National Institute of Mental Health notes that feeling stressed about a presentation at school or work is normal. In some people, however, anxiety shows up only in these situations and is strong enough to get in the way of life, such as speaking in public, competing in sport or playing on stage.

When anxiety weighs on the result

A review of thirty years of research on test anxiety found that more anxiety went with lower scores on standardised tests, entrance exams and grade averages. Anxiety was higher when the test seemed harder and when more was at stake.

This does not mean anxiety seals the outcome, only that it is worth looking after. The good news is that it responds well to help.

What tends to help

A meta-analysis of trials with university students showed that interventions for test anxiety reduced anxiety and improved academic performance, with the effect still present at follow-up. Behavioural approaches had the most consistent support; cognitive behavioural therapy and study-skills training looked promising but rested on fewer studies.

For fear of public speaking, a 2019 meta-analysis found good results with cognitive and behavioural interventions, and people kept improving after treatment ended. Technology-assisted versions, such as internet programmes, worked as well as face-to-face ones.

When social anxiety is intense and persistent, NICE guidance is to offer individual cognitive behavioural therapy designed for this condition as the first option.

To try before next time

Rehearse in conditions close to the real ones: standing up, out loud, against the clock, in front of someone you trust. Gradually facing the situation, rather than escaping it, is what usually reduces fear over time.

Write down what you are afraid will happen and what is most likely to happen. Afterwards, compare both with what actually happened. The prediction is often much worse than reality.

Use slow breathing to get through the minutes before you begin. One laboratory study suggested that treating a racing heart as excitement, instead of trying to calm down at all costs, improved performance in tasks such as singing and public speaking. It is an interesting finding, but still a single one.

Look after the basics the day before: sleep, food and less caffeine.

When to seek help

If you have been avoiding exams, meetings, interviews or opportunities because of fear, or if anxiety has lasted for months and gets in the way of study, work or relationships, talk to a professional. Effective treatments exist, and some medicines can help with the physical symptoms, always on prescription.

In the meantime, your check-ins can show how you arrive at these days. Tag work or studies as a context and notice your mood before and after the situations that weigh on you most.