It renders even the strongest weak, affecting schoolchildren and seasoned performers alike. Marked by sweating, shaking, racing hearts, and mad dashes to the bathroom, performance anxiety often lurks in the background—striking just before an important speech, presentation, toast or critical game. Star athletes, seasoned actors, admired musicians, and men experiencing intimacy have all suffered from the unsettling fear of failure.

For a famed athlete, the anxiety may suddenly peak upon signing a multi-million dollar contract. For the best man at his longtime friend's wedding, the fear of giving a toast in front of hundreds of guests may be a trigger. And for a teenager, the thought of reciting a Shakespeare sonnet in front of the entire class may result in overwhelming and debilitating fears.

Performance Effects

The tension and anxiety wrought by intense pressure to succeed may become self-fulfilling; as those gripped by the fear become unable to perform, causing concurrent sadness, depression and fatigue.

Fortunately, such anticipatory anxiety is not an indicator of actual ability, though it may require intervention and treatment for the individual to overcome fear and achieve their true potential.

How Does it Happen?

While it is normal to experience butterflies prior to a performance, the nervous feelings become unmanageable when an individual's way of thinking changes; rather than tuning in to the task of the moment, one suffering from performance anxiety begins to experience irrational fears of being judged and scrutinized.

Such irrational thoughts include: worrying about the approval of others, gaining affection and being hyper-critical of every single mistake. Past failures contribute to these negative thoughts, and the anxiety eventually leads the sufferer to isolate themselves and avoid the stress altogether.

What's Happening Physically?

Anxiety is associated with biological and psychological changes.

Neurotransmitters are chemicals in the brain that communicate vital messages to other organs. Serotonin is one such neurotransmitter, responsible for firing nerve impulses between nerve cells. It is also a mood regulator, associated with maintaining emotional stability and a happy state.

Other transmitters including dopamine, adrenaline, and norepinephrine control emotions similarly, working in the brain to enable us to feel pain and pleasure, happiness and sadness.

Stress is thought to reduce the production of neurotransmitter levels in the brain, thereby triggering anxiety and other psychological conditions. At the same time, stress hormones such as epinephrine and norepinephrine may be released in excess, contributing further to chemical imbalances.

Treatment Options

Anxiety disorders, which include: social anxiety, Obsessive-Compulsive Disorder, generalized anxiety, Post-Traumatic Stress Disorder, panic disorder and specific phobias, can be treated via psychotherapy.

Psychotherapy for anxiety focuses on thoughts, feelings and behaviors associated with the initial anxiety, as trained experts help people crippled by their fears to understand the root of their emotions, and work through them to regain confidence and abilities.

Additionally, medications which address the biological manifestations and roots of the disorder are sometimes prescribed to balance brain chemical levels.

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Jeremy Schwartz, LCSW
Carrie Potter, M.A.
Keith Whipple, MA, RDT
Lindsay Scharfstein, Ph.D.
Jess Baker, Ph.D.


Date of original publication:

Updated: May 25, 2017